Short-term outcomes of robotic-assisted versus laparoscopic inguinal hernia repair: a single-center retrospective study in Taiwan.

INTRODUCTION: Robotic-assisted surgery has emerged as an alternative to conventional laparoscopy for inguinal hernia repair; however, comparative evidence from Asian populations remains limited. This study compared the short-term outcomes of robotic-assisted and laparoscopic inguinal hernia repair at a tertiary medical center in Taiwan. METHODS: This single-center retrospective observational study included adults who underwent elective robotic-assisted or laparoscopic inguinal hernia repair between June 2020 and January 2023. Demographic characteristics, comorbidities, hernia characteristics, operative details, and postoperative outcomes were extracted from electronic medical records. The primary outcome was postoperative complications. Secondary outcomes included hernia recurrence, reoperation, 30-day readmission, operative time, intraoperative blood loss, postoperative analgesic use, and length of hospital stay. Between-group comparisons were performed using Student's t-test, the Wilcoxon rank-sum test, the Chi-squared test, or Fisher's exact test, as appropriate. RESULTS: Of 105 patients screened, 58 met the inclusion criteria; 13 underwent robotic-assisted repair and 45 underwent laparoscopic repair. Robotic-assisted procedures were more frequently performed using the transabdominal preperitoneal approach, whereas laparoscopic procedures predominantly used the totally extraperitoneal approach (69.2% vs. 6.7% for transabdominal preperitoneal repair, respectively; p < 0.001). Suture fixation was more common in the robotic group, whereas absorbable tack fixation predominated in the laparoscopic group (p < 0.001). Mean operative time was similar between the robotic and laparoscopic groups (146.8 ± 42.9 vs. 145.0 ± 39.9 minutes; p = 0.890). No conversions, transfusions, or intraoperative complications occurred. No significant differences were observed in postoperative complications, recurrence, reoperation, 30-day readmission, length of hospital stay, or duration of intravenous analgesic use. DISCUSSION: Robotic-assisted inguinal hernia repair was associated with similar observed short-term outcomes to conventional laparoscopic repair. However, the small robotic cohort, retrospective design, group imbalance, and limited follow-up reduced the ability to detect differences in uncommon or long-term outcomes. Larger prospective studies with longer follow-up are required to clarify the potential benefits of robotic-assisted repair, particularly in complex or recurrent cases.