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Article: Intestinal ischemia due to internal hernia beneath the right external iliac artery after laparoscopic hysterectomy and lymphadenectomy: A case report.

Zanca, Kostas Mario / Marcantonio, Maria / Pini, Ramon / Mongelli, Francesco / La Regina, Davide / Cianfarani, Agnese

International journal of surgery case reports

2023 Volume 106, Page(s) 108187

Abstract: Introduction and importance: The occurrence of an internal hernia beneath the external iliac artery is rare but may occur after pelvic lymphadenectomy. The challenging treatment of this rare condition should be tailored to the patient's clinical and ... ...

Abstract	Introduction and importance: The occurrence of an internal hernia beneath the external iliac artery is rare but may occur after pelvic lymphadenectomy. The challenging treatment of this rare condition should be tailored to the patient's clinical and anatomical characteristics. Case presentation: We present the case of a 77-year-old woman with previous history of laparoscopic hysterectomy and adnexectomy with extended pelvic lymphadenectomy for endometrial cancer. The patient was admitted in the emergency department because of severe abdominal pain and a computed tomography scan showed signs of internal hernia. The laparoscopy confirmed such a finding below the right external iliac artery. A small bowel resection was deemed necessary and the defect was closed with an absorbable mesh. The post-operative course was uneventful. Clinical discussion: Internal hernia beneath the iliac artery is a rare condition after pelvic lymphadenectomy. The first challenge is the hernia reduction, which can be safely carried out laparoscopically. Secondly, a patch or a mesh should be used to close the defect if a primary peritoneal suture is not feasible, but it requires to be fixed in the small pelvis. The use of absorbable material is a valuable option and should leave a fibrotic area that covers the hernia defect. Conclusion: A strangulated internal hernia beneath the external iliac artery is a possible complication after extensive pelvic lymph node dissection. The laparoscopic approach to treat bowel ischemia and to close the peritoneal defect with a mesh, should reduce as much as possible the risk of internal hernia recurrence.
Language	English
Publishing date	2023-04-12
Publishing country	Netherlands
Document type	Case Reports
ISSN	2210-2612
ISSN	2210-2612
DOI	10.1016/j.ijscr.2023.108187
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Article ; Online: Switching from robotic-assisted extended transabdominal preperitoneal (eTAPP) to totally extraperitoneal (eTEP) hernia repair for umbilical and epigastric hernias.

Pini, Ramon / Mongelli, Francesco / Iaquinandi, Fabiano / Gaffuri, Paolo / Previsdomini, Marco / Cianfarani, Agnese / La Regina, Davide

Scientific reports

2024 Volume 14, Issue 1, Page(s) 1800

Abstract: Our study aimed to assess the safety and effectiveness of the robotic-assisted extended totally extraperitoneal (eTEP) repair compared to transabdominal preperitoneal (eTAPP) repair with a suprapubic trocar insertion to treat umbilical and epigastric ... ...

Abstract	Our study aimed to assess the safety and effectiveness of the robotic-assisted extended totally extraperitoneal (eTEP) repair compared to transabdominal preperitoneal (eTAPP) repair with a suprapubic trocar insertion to treat umbilical and epigastric hernias. On a prospectively maintained database, we identified patients who underwent either eTEP or eTAPP for treating umbilical and epigastric hernias. During the study period, 53 patients were included, 32 in the eTEP group and 21 in the eTAPP group. The mean age was 59.0 ± 13.9 years, 45 patients (84.9%) were male, and the mean BMI was 28.0 ± 5.9 kg/m
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Female ; Herniorrhaphy/adverse effects ; Robotic Surgical Procedures/adverse effects ; Laparoscopy ; Hernia, Abdominal/surgery ; Hernia, Umbilical/surgery ; Retrospective Studies
Language	English
Publishing date	2024-01-20
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-024-52165-6
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Article ; Online: Erector Spinae Plane Block versus Transversus Abdominis Plane Block for Robotic Inguinal Hernia Repair: A Blinded, Active-Controlled, Randomized Trial.

Ghielmini, Enea M / Greco, Lorenzo / Spampatti, Sebastiano / Kubli, Rahel / Saporito, Andrea / La Regina, Davide

Pain physician

2023 Volume 27, Issue 1, Page(s) 27–34

Abstract: Background: Regional anesthetic nerve blocks are widely used in the treatment of pain after outpatient surgery to reduce opioid consumption. Erector spinae plane (ESP) block is a recently described technique with promising results in different scenarios. ...

Abstract	Background: Regional anesthetic nerve blocks are widely used in the treatment of pain after outpatient surgery to reduce opioid consumption. Erector spinae plane (ESP) block is a recently described technique with promising results in different scenarios. Objectives: To compare ESP block efficacy with the commonly used transversus abdominis plane (TAP) block in patients undergoing robot-assisted inguinal hernia repair. Study design: This was a randomized, blinded, active controlled, superiority trial with 2 parallel groups. The study was approved by the local ethics committee. Registration took place on; www. Clinicaltrials: gov with the identifier NCT04750512. Setting: Adults undergoing robotic inguinal hernia repair were recruited between January 2021 and April 2022 in a single referral center of southern Switzerland. Methods: To ensure blinding, the study employed a "double dummy" design, where all patients underwent both TAP and ESP blocks, but only one block was therapeutically active. The therapeutic block contained ropivacaine 0.2%, while the other infiltration contained placebo. The therapeutic intervention varied between groups, with one group receiving the TAP block as the active treatment and the other group receiving the ESP block as the active treatment. Computer generated 1:1 randomization determined allocation, which took place immediately prior to the intervention. As a result, blinding included patients, anesthesia, and surgery providers, outcome assessors and statistical analysts. The main outcome measure was the highest reported pain score on a Visual Analog Scale (VAS) during the 6 hours following the end of general anesthesia. Secondary outcomes included pain scores at set intervals, analgesic consumption, and complications. Results: A total of 50 patients (25 per arm) were enrolled and included in the analysis. The study found no significant difference in the mean maximal VAS scores between the 2 groups (TAP block 22.2, ESP block 20, difference 2.2, 95% CI is -12.1 to 16.5). Secondary endpoints, including VAS pain scores at different time points, use of rescue analgesics, time to first walk, duration of stay, and frequency of adverse events, did not show any significant differences between the 2 groups. However, post-hoc analysis suggested a more stable effect over time for the ESP block compared to the TAP block. Limitations: The main limitation is a higher variance in VAS scores than expected in the power calculations. Conclusions: ESP block was not superior to TAP block in the treatment of post-operative pain among patients undergoing robotic inguinal hernia repair.
MeSH term(s)	Adult ; Humans ; Robotics ; Hernia, Inguinal/surgery ; Robotic Surgical Procedures ; Nerve Block ; Pain ; Abdominal Muscles/surgery
Language	English
Publishing date	2023-10-20
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2146393-1
ISSN	2150-1149 ; 1533-3159
ISSN (online)	2150-1149
ISSN	1533-3159
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Zs.A 5930: Show issues

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Article ; Online: Laparoscopic vs. ultrasound-guided transversus abdominis plane (TAP) block in colorectal surgery: a systematic review and meta-analysis of randomized trials.

Iaquinandi, Fabiano / Mongelli, Francesco / Christoforidis, Dimitri / Cianfarani, Agnese / Pini, Ramon / Saporito, Andrea / Popeskou, Sotirios Georgios / La Regina, Davide

Surgical endoscopy

2024 Volume 38, Issue 3, Page(s) 1119–1130

Abstract: Background: The transversus abdominis plane block (TAPB) is effective for postoperative pain management in patients undergoing colorectal surgery. However, evidence regarding the optimal delivery method, either laparoscopic (L-TAPB) or ultrasound-guided ...

Abstract	Background: The transversus abdominis plane block (TAPB) is effective for postoperative pain management in patients undergoing colorectal surgery. However, evidence regarding the optimal delivery method, either laparoscopic (L-TAPB) or ultrasound-guided (U-TAPB) is lacking. Our study aimed to compare the effectiveness of these delivery methods. Methods: We carried out a literature search of PubMed, Cochrane Library, Web of Science, and Google Scholar databases to include randomized studies comparing patients receiving either L-TAPB or U-TAPB during minimally invasive colorectal surgery. The primary endpoint was opioid consumption in the first 24 h after surgery. Risk of bias was assessed with the RoB-2 tool. Effect size was estimated for each study with 95% confidence interval and overall effect measure was estimated with a random effect model. Results: The literature search revealed 294 articles, of which four randomized trials were eligible. A total of 359 patients were included, 176 received a L-TAPB and 183 received a U-TAPB. We established the non-inferiority of L-TAPB, as the absolute difference of - 2.6 morphine-mg (95%CI - 8.3 to 3.0) was below the pooled non-inferiority threshold of 8.1 morphine-mg (low certainty level). No difference in opioid consumption was noted at 2, 6, 12, and 48 h (low to very low certainty level). Postoperative pain, nausea and vomiting were similar between groups at different timepoints (low to very low certainty level). No TAPB-related complications were recorded. Finally, the length of hospital stay was similar between groups. Conclusion: For postoperative multimodal analgesia both L-TAPB and U-TAPB may result in little to no difference in outcome in patients undergoing colorectal surgery. Registration Prospero CRD42023421141.
MeSH term(s)	Humans ; Analgesics, Opioid/therapeutic use ; Anesthetics, Local ; Colorectal Surgery ; Abdominal Muscles/surgery ; Randomized Controlled Trials as Topic ; Laparoscopy/methods ; Pain, Postoperative/etiology ; Pain, Postoperative/prevention & control ; Pain, Postoperative/surgery ; Morphine ; Ultrasonography, Interventional/adverse effects ; Benzamidines
Chemical Substances	Analgesics, Opioid ; Anesthetics, Local ; 1,3-bis(4-amidinophenoxy)-2-(4-amidinophenoxymethyl)ethylpropane (115044-37-6) ; Morphine (76I7G6D29C) ; Benzamidines
Language	English
Publishing date	2024-01-22
Publishing country	Germany
Document type	Meta-Analysis ; Systematic Review ; Journal Article ; Review
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-023-10658-x
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Zs.A 2214: Show issues

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Article ; Online: Safety and feasibility of emergency robot-assisted transabdominal preperitoneal repair for the treatment of incarcerated inguinal hernia: A retrospective study.

Murgante Testa, Nicole / Mongelli, Francesco / Sabbatini, Flaminia / Iaquinandi, Fabiano / Prouse, Giorgio / Pini, Ramon / La Regina, Davide

World journal of surgery

2024 Volume 48, Issue 3, Page(s) 622–628

Abstract: Background: Few studies assessed robotic in emergency setting and no solid evidence was demonstrated. The aim of this study was to evaluate the feasibility and safety of robot-assisted transabdominal preperitoneal (R-TAPP) repair for the treatment of ... ...

Abstract	Background: Few studies assessed robotic in emergency setting and no solid evidence was demonstrated. The aim of this study was to evaluate the feasibility and safety of robot-assisted transabdominal preperitoneal (R-TAPP) repair for the treatment of incarcerated inguinal hernia. Methods: We retrospectively searched from a prospectively maintained database patients who underwent R-TAPP or open surgery for incarcerated inguinal hernias from January 2018 to March 2023. The primary endpoint was to assess safety and feasibility of the R-TAPP compared to the standard approach. For eligible patients, data was extracted and analyzed using a propensity score-matching (PSM). Results: Thirty-four patients were retrieved from our database, 15 underwent R-TAPP, while 19 underwent open surgery. Mean age was 73.1 ± 14.6 years, 30 patients (88.2%) were male and mean BMI was 23.5 ± 3.2 kg/m Conclusions: Despite its limitations, our study appears to endorse the safety and feasibility of the robotic-assisted treatment for incarcerated inguinal hernia. This approach yielded comparable results to open surgery, albeit in a limited number of patients, suggesting it might be a viable alternative.
MeSH term(s)	Humans ; Male ; Middle Aged ; Aged ; Aged, 80 and over ; Female ; Robotics ; Retrospective Studies ; Hernia, Inguinal/surgery ; Feasibility Studies ; Laparoscopy/methods ; Herniorrhaphy/methods ; Treatment Outcome ; Surgical Mesh
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1002/wjs.12063
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Zs.A 1336: Show issues

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Article ; Online: Six Sigma can significantly reduce costs of poor quality of the surgical instruments sterilization process and improve surgeon and operating room personnel satisfaction.

Saporito, Andrea / Tassone, Claudio / Di Iorio, Antonio / Barbieri Saraceno, Marcella / Bressan, Alessandro / Pini, Ramon / Mongelli, Francesco / La Regina, Davide

Scientific reports

2023 Volume 13, Issue 1, Page(s) 14116

Abstract: Operating room (OR) management is a complex multidimensional activity combining clinical and managerial aspects. This longitudinal observational study aimed to assess the impact of Six-Sigma methodology to optimize surgical instrument sterilization ... ...

Abstract	Operating room (OR) management is a complex multidimensional activity combining clinical and managerial aspects. This longitudinal observational study aimed to assess the impact of Six-Sigma methodology to optimize surgical instrument sterilization processes. The project was conducted at the operating theatre of our tertiary regional hospital during the period from July 2021 to December 2022. The project was based on the surgical instrument supply chain analysis. We applied the Six Sigma lean methodology by conducting workshops and practical exercises and by improving the surgical instrument process chain, as well as checking stakeholders' satisfaction. The primary outcome was the analysis of Sigma improvement. Through this supply chain passed 314,552 instruments in 2022 and 22 OR processes were regularly assessed. The initial Sigma value was 4.79 ± 1.02σ, and the final one was 5.04 ± 0.85σ (SMD 0.60, 95%CI 0.16-1.04, p = 0.010). The observed improvement was estimated in approximately $19,729 of cost savings. Regarding personnel satisfaction, 150 questionnaires were answered, and the overall score improved from 6.6 ± 2.2 pts to 7.0 ± 1.9 pts (p = 0.013). In our experience the application of the Lean Six Sigma methodology to the process of handling the surgical instruments from/to the OR was cost-effective, significantly decreased the costs of poor quality and increased internal stakeholder satisfaction.
MeSH term(s)	Humans ; Total Quality Management ; Operating Rooms ; Surgeons ; Sterilization ; Personal Satisfaction
Language	English
Publishing date	2023-08-29
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-023-41393-x
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Article ; Online: Laparoscopic versus ultrasound-guided transversus abdominis plane block in colorectal surgery: a non-inferiority, multicentric randomized double-blinded clinical trial.

La Regina, Davide / Popeskou, Sotirios Georgios / Saporito, Andrea / Gaffuri, Paolo / Tasciotti, Edoardo / Dossi, Roberto / Christoforidis, Dimitri / Mongelli, Francesco

Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

2023 Volume 25, Issue 9, Page(s) 1921–1928

Abstract: Aim: The aim of this study was to assess if laparoscopic-assisted transversus abdominis plane (TAP) block (L-TAPB) is as efficient as ultrasound-guided TAP block (U-TAPB) in postoperative pain control.: Method: In all, 112 patients scheduled for ... ...

Abstract	Aim: The aim of this study was to assess if laparoscopic-assisted transversus abdominis plane (TAP) block (L-TAPB) is as efficient as ultrasound-guided TAP block (U-TAPB) in postoperative pain control. Method: In all, 112 patients scheduled for elective laparoscopic colon resection from February 2018 to December 2021 at two Swiss hospitals were included and randomized in a 1:1 ratio before surgery with either L-TAPB or U-TAPB. The primary end-point was the non-inferiority of the L-TAPB compared to U-TAPB with regard to the total opioid consumption within the first 24 h after surgery. Data regarding patients' characteristics, opioid consumption, pain on the visual analogue scale, operative and anaesthesia induction time, complications and length of stay were collected and analysed. Results: Fifty-five patients were allocated to the L-TAPB and fifty-seven to the U-TAPB. No significant difference was found in the overall dose of opioids within 24 h, and the non-inferiority of the L-TAPB was confirmed. There were almost twice as many patients in the L-TAPB group requesting opioid reserves compared to the U-TAPB group (54.5% vs. 29.8%, P = 0.008). The anaesthesia induction time was significantly longer in the U-TAPB group (17 ± 11 min vs. 23 ± 12 min, P = 0.014). For all other variables (pain on the visual analogue scale, opioid consumption, need of epidural analgesia, operating time, postoperative complications and hospital stay) no statistically significant difference between the L-TAPB and the U-TAPB groups was noted. Conclusion: Our results showed the non-inferiority of the laparoscopic delivery compared to ultrasound-guided administration of the TAP block, with the advantage of not affecting anaesthesia times. Study registration number: 2017-02017 CE 3294, ClinicalTrials.gov identifier NCT04575233.
MeSH term(s)	Humans ; Abdominal Muscles/diagnostic imaging ; Analgesics, Opioid/therapeutic use ; Colectomy/methods ; Colorectal Surgery ; Laparoscopy/methods ; Pain, Postoperative/drug therapy ; Pain, Postoperative/etiology ; Ultrasonography, Interventional
Chemical Substances	1,3-bis(4-amidinophenoxy)-2-(4-amidinophenoxymethyl)ethylpropane (115044-37-6) ; Analgesics, Opioid
Language	English
Publishing date	2023-07-31
Publishing country	England
Document type	Equivalence Trial ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	1440017-0
ISSN	1463-1318 ; 1462-8910
ISSN (online)	1463-1318
ISSN	1462-8910
DOI	10.1111/codi.16689
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Zs.A 5799: Show issues

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Article ; Online: Two-step treatment of dysphagia lusoria: robotic-assisted resection of aberrant right subclavian artery following aortic debranching.

La Regina, Davide / Prouse, Giorgio / Mongelli, Francesco / Pini, Ramon

European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

2020 Volume 58, Issue 5, Page(s) 1093–1094

Abstract: A 69-year-old female suffering from severe dysphagia due to an aberrant right subclavian artery was treated with a two-step approach. A right carotid-subclavian bypass was followed 2 weeks later by a robotic-assisted thoracoscopic resection of the ... ...

Abstract	A 69-year-old female suffering from severe dysphagia due to an aberrant right subclavian artery was treated with a two-step approach. A right carotid-subclavian bypass was followed 2 weeks later by a robotic-assisted thoracoscopic resection of the aberrant right subclavian artery. The postoperative course was uneventful, and the patient immediately recovered from her dysphagia. In our case, the robotic-assisted technology offered major advantages and, based on our experience, may be useful in the treatment of this rare disease.
MeSH term(s)	Aged ; Cardiovascular Abnormalities/complications ; Cardiovascular Abnormalities/diagnostic imaging ; Cardiovascular Abnormalities/surgery ; Deglutition Disorders/etiology ; Deglutition Disorders/surgery ; Female ; Humans ; Robotic Surgical Procedures ; Subclavian Artery/abnormalities ; Subclavian Artery/diagnostic imaging ; Subclavian Artery/surgery
Language	English
Publishing date	2020-07-04
Publishing country	Germany
Document type	Case Reports ; Journal Article
ZDB-ID	639293-3
ISSN	1873-734X ; 1010-7940 ; 1567-4258
ISSN (online)	1873-734X
ISSN	1010-7940 ; 1567-4258
DOI	10.1093/ejcts/ezaa182
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Article ; Online: Reoperative bariatric surgery after primary laparoscopic gastric plication for morbid obesity: a systematic review and meta-analysis.

Mongelli, Francesco / Horvath, Zsofia / Marengo, Michele / Volontè, Francesco / La Regina, Davide / Peterli, Ralph / Garofalo, Fabio

Langenbeck's archives of surgery

2022 Volume 407, Issue 5, Page(s) 1839–1850

Abstract: Background: Laparoscopic gastric plication (LGP) often requires reoperative bariatric surgery (RBS) due to complications and insufficient weight loss. The aim of our study was to assess perioperative morbidity and weight loss during follow-up in ... ...

Abstract	Background: Laparoscopic gastric plication (LGP) often requires reoperative bariatric surgery (RBS) due to complications and insufficient weight loss. The aim of our study was to assess perioperative morbidity and weight loss during follow-up in patients undergoing RBS after primary LGP for morbid obesity. Methods: A search of PubMed, Web of Science, Cochrane Library, and Google Scholar was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using ("conversion"OR "revision""OR "reoperat")AND("gastric"OR "curvatur")AND "plication." Studies were deemed eligible if data on RBS after LGP were provided. For each study, data were extracted and analyzed. Results:* In the literature review, 291 articles were screened and 7 included. The studies covered a total of 367 patients, of whom 119 received a sleeve gastrectomy (SG), 85 a Roux-en-y gastric bypass (RYGB), 75 a one anastomosis-gastric bypass (OAGB), 45 a re-LGP, and 25 a jejuno-ileal bypass. After RBS, excess weight loss was 50.8 ± 6.5% at 6 months, 71.0 ± 7.7% at 12 months, and 89.0 ± 7.8% at 24 months. Operative time was 101.3 ± 14.6 min. Postoperatively, 18/255 patients (7.1%) had a complication, and leakage and reoperations were reported in 6/255 (2.4%) and 5/255 (2.0%) patients, respectively. Length of hospital stay was 3.1 ± 2.4 days. The quality of evidence was rated as "very low." Conclusions: Despite limitations, this systematic review and meta-analysis showed that RBS after LGP has an acceptable rate of complications and is effective in terms of excess weight loss during follow-up. No specific operation (e.g., SG, RYGB, OAGB) can be suggested over another due to the lack of evidence.
MeSH term(s)	Bariatric Surgery ; Gastrectomy/adverse effects ; Gastric Bypass/adverse effects ; Humans ; Laparoscopy/adverse effects ; Obesity, Morbid/surgery ; Reoperation/adverse effects ; Retrospective Studies ; Treatment Outcome ; Weight Loss
Language	English
Publishing date	2022-03-02
Publishing country	Germany
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02485-w
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Article ; Online: Three-point mesh fixation in robot-assisted transabdominal preperitoneal (R-TAPP) repair of 208 inguinal hernias: preliminary results of a single-center consecutive series.

Spampatti, Sebastiano / La Regina, Davide / Pini, Ramon / Mongelli, Francesco / Gaffuri, Paolo / Porcellini, Iride / Romanzi, Andrea / Marcantonio, Maria

Langenbeck's archives of surgery

2022 Volume 407, Issue 6, Page(s) 2555–2561

Abstract: Purpose: The aim of this study was to assess the efficacy of our mesh fixation technique in robot-assisted transabdominal preperitoneal inguinal hernia repair (R-TAPP). The primary outcome was the recurrence rate. Secondary outcomes were postoperative ... ...

Abstract	Purpose: The aim of this study was to assess the efficacy of our mesh fixation technique in robot-assisted transabdominal preperitoneal inguinal hernia repair (R-TAPP). The primary outcome was the recurrence rate. Secondary outcomes were postoperative pain, chronic pain, and return to normal activities. Methods: Between January 2018 and December 2019, we performed 208 consecutive R-TAPP in 161 patients and the mesh was fixed by three intracorporeal stiches using a Polyglactin 910 (Vicryl®) 3-0 suture. Patients were followed up at 10 and 30 days after surgery with a clinical evaluation for detection of early complications, postoperative pain, need for analgesics, return to normal activities, and satisfaction rate. Patients were further followed up at study conclusion in February 2021 for recurrence and chronic pain detection. Results: Painkillers were stopped by 57% of the patients after the first postoperative day and by 96% after 1 week. Chronic pain (> 3 months after surgery) was observed in three patients (1.8%) and only one of them was treated with percutaneous ilioinguinal-iliohypogastric nerve infiltration. After a mean follow-up of 24.0 ± 6.7 months, only 1 recurrence (0.48%) was clinically detected and confirmed by a CT-scan. Conclusions: The 3-point mesh fixation technique is feasible during robot-assisted TAPP repair for inguinal hernia and seems to be a viable alternative to other fixation methods. Further long-term controlled investigations are needed to understand if this technique is effective in influencing recurrence and chronic pain rates.
MeSH term(s)	Chronic Pain/etiology ; Hernia, Inguinal/complications ; Hernia, Inguinal/surgery ; Herniorrhaphy/adverse effects ; Humans ; Laparoscopy/methods ; Pain, Postoperative/etiology ; Recurrence ; Robotics ; Surgical Mesh/adverse effects ; Treatment Outcome
Language	English
Publishing date	2022-05-18
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1423681-3
ISSN	1435-2451 ; 1435-2443
ISSN (online)	1435-2451
ISSN	1435-2443
DOI	10.1007/s00423-022-02542-4
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