Outcomes During the Learning Curve and Feasibility of Implementing the European Hernia Society Recommendation Guidelines for Robotic Abdominal Wall Surgery Within a UK Centre

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Title: Outcomes During the Learning Curve and Feasibility of Implementing the European Hernia Society Recommendation Guidelines for Robotic Abdominal Wall Surgery Within a UK Centre
Authors: Javed Latif, Matthew Brazkiewicz, Ihsan Inan, Filip Muysoms, Imran Bhatti, Altaf Awan
Source: Journal of Abdominal Wall Surgery, Vol 4 (2025)
Publisher Information: Frontiers Media S.A., 2025.
Publication Year: 2025
Collection: LCC:Specialties of internal medicine
Subject Terms: European Hernia Society, hernia repair, robotic-assisted surgery, robotic training program, robotic abdominal wall surgery, Specialties of internal medicine, RC581-951
Description: BackgroundRobotic-assisted surgery (RAS) for abdominal wall hernia repair is an established, minimally invasive technique that is in the early phase of adoption within the UK. We aimed to demonstrate the impact on patient outcomes and safety of hernia repair by adhering to the robotic abdominal wall surgery pathway developed by the European Hernia Society.Materials and MethodsTwo experienced laparoscopic surgeons in the UK underwent four phases that involved preclinical and clinical phases. The surgeons performed RAS hernia surgery with a stepwise increase in complexity, from robotic transabdominal preperitoneal (rTAPP) inguinal hernia repair, robotic transabdominal retrorectus umbilical prosthesis (rTARUP)/extended totally extraperitoneal (eTEP) to robotic transversus abdominis release (rTAR).ResultsIn total, 144 patients underwent RAS for hernia repair. Of these, 97 underwent rTAPP inguinal hernia repair (23 bilateral cases). The median operative time was 56 min for unilateral and 101 min for bilateral repair. Four (3.3%) rTAPP patients experienced complications, with two recurrences at the 6-month follow-up. Forty-two patients underwent rTARUP/eTEP repair, with a median operative time of 167 min. Two (4.8%) of these patients experienced postoperative complications. No recurrences were observed at 6 months. Thirteen patients with incisional hernias underwent rTAR, with a median operative time of 426 min. No recurrences were observed in rTAR patients, followed for up to 12 months.DiscussionImplementation of the EHS training pathway for robotic abdominal wall surgery resulted in a low complication rate and satisfactory clinical outcomes and represents a robust mechanism for surgeons to safely adopt complex robotic abdominal wall surgery.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 2813-2092
Relation: https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.15008/full; https://doaj.org/toc/2813-2092
DOI: 10.3389/jaws.2025.15008
Access URL: https://doaj.org/article/3fd3e3f15c7e4c0a80d1ce89b9e28ba2
Accession Number: edsdoj.3fd3e3f15c7e4c0a80d1ce89b9e28ba2
Database: Directory of Open Access Journals
Description
Abstract:BackgroundRobotic-assisted surgery (RAS) for abdominal wall hernia repair is an established, minimally invasive technique that is in the early phase of adoption within the UK. We aimed to demonstrate the impact on patient outcomes and safety of hernia repair by adhering to the robotic abdominal wall surgery pathway developed by the European Hernia Society.Materials and MethodsTwo experienced laparoscopic surgeons in the UK underwent four phases that involved preclinical and clinical phases. The surgeons performed RAS hernia surgery with a stepwise increase in complexity, from robotic transabdominal preperitoneal (rTAPP) inguinal hernia repair, robotic transabdominal retrorectus umbilical prosthesis (rTARUP)/extended totally extraperitoneal (eTEP) to robotic transversus abdominis release (rTAR).ResultsIn total, 144 patients underwent RAS for hernia repair. Of these, 97 underwent rTAPP inguinal hernia repair (23 bilateral cases). The median operative time was 56 min for unilateral and 101 min for bilateral repair. Four (3.3%) rTAPP patients experienced complications, with two recurrences at the 6-month follow-up. Forty-two patients underwent rTARUP/eTEP repair, with a median operative time of 167 min. Two (4.8%) of these patients experienced postoperative complications. No recurrences were observed at 6 months. Thirteen patients with incisional hernias underwent rTAR, with a median operative time of 426 min. No recurrences were observed in rTAR patients, followed for up to 12 months.DiscussionImplementation of the EHS training pathway for robotic abdominal wall surgery resulted in a low complication rate and satisfactory clinical outcomes and represents a robust mechanism for surgeons to safely adopt complex robotic abdominal wall surgery.
ISSN:28132092
DOI:10.3389/jaws.2025.15008