Short-Term outcomes of robotic versus laparoscopic inguinal hernia repair performed by Endoscopic Surgical Skill Qualification System (ESSQS)-Qualified surgeons: A propensity Score-matched and weighted analysis.

PURPOSES: Robotic transabdominal preperitoneal repair (R-TAPP) is being adopted increasingly for inguinal hernia. However, there is limited evidence about how its short-term outcomes compare with those of laparoscopic TAPP (L-TAPP). We evaluated the safety and efficacy of R-TAPP at a single institution.

METHODS

We reviewed 980 inguinal hernia repairs (R-TAPP 82, L-TAPP 898) performed between January 2021 and July 2025 at our institution. The primary outcome was operative time and the secondary outcomes were intraoperative blood loss, postoperative hospital stay, complications, and chronic pain. This study was restricted to procedures performed by Endoscopic Surgical Skill Qualification System (ESSQS)-qualified surgeons, using propensity score matching (PSM) and inverse-probability of treatment weighting (IPTW) analysis.

RESULTS

The operative times for both unilateral and bilateral repairs were significantly shorter in the R-TAPP group than in the L-TAPP group (69.5 min vs. 96.0 min and 114.0 min vs. 150.0 min, respectively; both p < 0.001), even after PSM (69.0 min vs. 84.0 min, p < 0.001). Using IPTW, R-TAPP was associated with a 16.7 min reduction in operative time compared with L-TAPP (p < 0.001). Intraoperative blood loss was significantly lower with R-TAPP, but there were no significant differences in the other secondary outcomes.

CONCLUSIONS

R-TAPP reduces the operative time required without compromising perioperative safety, supporting its use as a safe and efficient option for inguinal hernia repair.