Repair of Groin Hernias After Abdominal Prostatectomy With Robotic TAPP

Study Overview
=================
Brief Summary
-----------------
This retrospective study investigates if robotic assisted groin hernia repair in patients who previously underwent abdominal prostatectomy has an equal or more favorable clinical outcome, compared to open repair in those patients.

Detailed Description
-----------------
In the personal practice of the investigators, there has been a decrease in open groin hernia repair from 17% to 6% since the introduction of robotic assisted surgery. This reflects a change in indication for complex hernias from an open to a minimal invasive approach. One of the typical indications for open approach before adopting the robotic platform were groin hernias after previous abdominal prostatectomy. Since prostatectomy results in scarring of the retropubic area where we need to dissect during MIS groin hernia repair, an open anterior approach is often suggested. With the enhanced view and instrument dexterity of the robotic platform, the investigators have now changed to a minimal invasive approach in these patients. Therefore, this study will evaluate the clinical outcome after robotic assisted repair of groin hernias in patients who previously underwent an abdominal prostatectomy in comparison to open groin hernia repair.

Official Title
-----------------
Lichtenstein or Robotic TAPP Repair of Groin Hernias After Abdominal Prostatectomy: a Single Centre Retrospective Comparative Study

Conditions
-----------------
Inguinal Hernia

Intervention / Treatment
-----------------
* Procedure: Robotic assisted inguinal hernia repair
* Procedure: Open inguinal hernia repair


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adult patients Underwent uni-or bilateral groin hernia repair in the period March 2015 - March 2020 Groin hernia repair via robotic assisted laparoscopy or open surgery History of abdominal prostatectomy before the groin hernia repair Exclusion Criteria: Age below 18 Groin hernia repair via conventional laparoscopy Groin hernia repair via open surgery other than Liechtenstein method Groin hernia repair without mesh placement

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
Male

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Open hernia repair<br>Patients who underwent inguinal hernia repair via an open Liechtenstein procedure | Procedure: Open inguinal hernia repair<br>* Classical approach (open repair)<br>|
| Robotic assisted hernia repair<br>Patients who underwent inguinal hernia repair via robotic assisted laparoscopy | Procedure: Robotic assisted inguinal hernia repair<br>* Robotic assisted inguinal hernia repair with DaVinci Xi system instead of open repair<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intra-hospital complications | Complications during hospital stay according to Clavien-Dindo | From admission until hospital discharge, on average 12-24 hours | 
| Operative time and per-operative complications | Skin-to-skin operating time and complications during the procedure | During the hernia repair procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Early complications at home | Complications at 1 month follow-up (readmission, seroma, infection) according to Clavien-Dindo | Immediately post hospital discharge until 1 month postoperative |