Robotic-assisted versus laparoscopic transabdominal preperitoneal inguinal hernia repair: A cross-sectional comparison of surgical outcomes

Introduction: Inguinal hernias are the most common type of abdominal wall hernias, comprising approximately 75% of cases. Surgical management has advanced from traditional open repair to minimally invasive techniques such as laparoscopic transabdominal preperitoneal (TAPP) repair. Robotic-assisted TAPP represents a newer evolution in hernia surgery. This study compares robotic-assisted and laparoscopic TAPP in terms of post-operative pain, intraoperative visualisation and procedural feasibility. Patients and Methods: A descriptive, observational study was conducted at SMS Hospital, Jaipur, involving 72 patients (36 in each group) undergoing unilateral or bilateral uncomplicated inguinal hernia repair. Post-operative pain was assessed using the Visual Analogue Scale (VAS) at 8, 16 and 24 h. Intraoperative ergonomics and feasibility were measured using standard fatigue and visualisation scores. Results: The robotic-assisted TAPP group demonstrated significantly lower pain scores at all post-operative time points ( P < 0.001). Mean VAS scores at 8, 16 and 24 h were 5.03, 3.22 and 1.94, respectively, in the robotic-assisted group, compared to 5.83, 4.28 and 2.83 in the laparoscopic group. The overall mean VAS score was 3.38 for robotic-assisted and 4.31 for laparoscopic TAPP ( P < 0.01). Visualisation was rated as ‘very good’ in 100% of robotic-assisted cases versus only ‘good’ or ‘average’ in laparoscopic cases ( P < 0.001). Conclusion: Robotic-assisted TAPP is associated with significantly reduced post-operative pain, superior surgical field visualisation and improved ergonomic feasibility compared to laparoscopic TAPP. These findings support the use of robotic-assisted TAPP as a preferred approach for inguinal hernia repair.