Robotic Inguinoscrotal Hernia Repair: Transabdominal Preperitoneal (TAPP)

Abstract

Large indirect or scrotal hernias present several challenges for surgeons with both the open and minimally invasive approaches. Some argue that open surgery provides more benefits than laparoscopic repair in terms of ease of hernia manipulation, but increased wound morbidity and risk of adverse postoperative outcomes explain the choice of minimally invasive techniques for these repairs. One technique that carries over from the open and laparoscopic approaches into robotic repair is the preperitoneal method. As opposed to laparoscopic repair, the robotic platform may be favorable in terms of a superior visual field and more precise dissection in a region with surrounding delicate structures such as gonadal and iliac vessels, as well as nearby femoral nerve branches. Suturing of the peritoneal flap is also arguably facilitated with the robotic platform, and this advantage may carry over into the postoperative period, with lower rates of complications and pain.