Comparative outcomes of Toumai robotic and laparoscopic transabdominal preperitoneal inguinal hernia repair in a retrospective cohort

To compare the clinical efficacy of the “Toumai” surgical robot and conventional laparoscopic inguinal hernia repair in order to inform surgical practice. A retrospective analysis was conducted on clinical data from 50 patients who underwent inguinal hernia repair at the Department of General Surgery, Gansu Provincial Hospital, between January 2022 and October 2023. Among them, 16 patients received robot-assisted repair (robotic group), and 34 underwent conventional laparoscopic repair (laparoscopic group), all via the transabdominal preperitoneal approach. Evaluation indicators included: (1) preoperative baseline characteristics; (2) intraoperative and postoperative outcomes; and (3) postoperative incision healing and adverse events. Outpatient follow-up and clinical re-examination were conducted 1 to 3 months after surgery to assess wound recovery and recurrence. Continuous variables were expressed as mean ± standard deviation or median (M), and analyzed using the t-test; categorical data were compared using the chi-square test. There were no significant differences in baseline characteristics between the robot-assisted and laparoscopic groups, including sex ratio, age, weight, and hernia classification ( P > 0.05). Intraoperatively and postoperatively, the robot group had a significantly longer operative time (104.19 ± 18.93 min vs. 90.17 ± 22.31 min), but demonstrated significantly less blood loss (6.94 ± 3.80 mL vs. 12.24 ± 9.31 mL), shorter hospital stay (3.18 ± 0.54 vs. 3.68 ± 0.81 days), lower pain scores (2.06 ± 0.93 vs. 3.03 ± 1.29), and reduced Subjective Mental Load Scale scores (18.12 ± 12.23 vs. 30.17 ± 11.46) compared to the laparoscopic group (all P < 0.05). No intraoperative complications were observed in either group. Follow-up results showed that postoperative recurrence occurred in 1 case in the robot group and 2 cases in the laparoscopic group. Poor incision healing occurred in 0 and 3 cases, and incision pain in 1 and 4 cases, respectively. In this retrospective cohort, Toumai robot-assisted repair was associated with lower estimated blood loss, lower postoperative pain scores, and shorter length of stay, but longer operative time, compared with laparoscopic repair.