Robotic Versus Laparoscopic Transabdominal Preperitoneal (TAPP) Repair for Primary Unilateral Inguinal Hernia: A Comparative Study of Short-term Perioperative Outcomes and Quality of Life

Abstract

Background: Robotic transabdominal preperitoneal (TAPP) repair is increasingly used for inguinal hernia, although comparative evidence on perioperative outcomes and patient-reported quality of life remains limited. Aim: This study compared robotic and laparoscopic TAPP repair in adults with primary unilateral inguinal hernia. Methods: This single-centre prospective comparative observational study included 24 consecutive patients undergoing elective TAPP repair, with 12 in each group. The approach was selected according to surgeon preference, robotic-system availability, and patient preference. Operative duration and short-term clinical outcomes were recorded. Quality of life was assessed three months postoperatively using the WHOQOL-BREF questionnaire. Results: Mean operative duration was shorter in the robotic group than in the laparoscopic group (69.8 ± 6.9 vs 88.5 ± 8.9 minutes; p < 0.001). At three months, the robotic group had higher mean physical health (17.86 ± 0.98 vs 15.19 ± 0.93; p < 0.001), psychological health (18.72 ± 1.08 vs 14.50 ± 1.07; p < 0.001), and social relationships scores (18.89 ± 1.11 vs 14.44 ± 1.59; p < 0.001). Environmental domain scores did not differ significantly (16.08 ± 0.85 vs 16.63 ± 1.13; p = 0.199). No recurrence, reoperation, or recorded early postoperative complication occurred during the three-month follow-up. Conclusion: In this small non-randomised cohort, robotic TAPP was associated with shorter recorded operative duration and higher three-month scores in three WHOQOL-BREF domains. Larger prospective studies with baseline quality-of-life assessment, longer follow-up, comprehensive complication reporting, and cost evaluation are required.