Eficacia de la técnica transabdominal preperitoneal laparoscópica versus la reparación transabdominal preperitoneal asistida por robot en el manejo de hernias inguinales en adultos. Revisión sistemática

Abstract

Introduction: This systematic review compares the efficacy of two minimally invasive surgical techniques in adults with inguinal hernia: laparoscopic transabdominal preperitoneal technique (LTAPP) and robotic-assisted transabdominal preperitoneal repair (RTAPP). Outcomes including recurrence, postoperative pain, hospitalization, functional recovery, and complications, are analyzed. Objective: To evaluate the efficacy of LTAPP versus RTAPP in the treatment of inguinal hernia in adults, considering key clinical indicators. Methodology: Studies published between 2020 and 2025 were selected from PubMed, Web of Science, and Springer Link databases. Inclusion criteria were limited to human clinical trials involving individuals aged 18 years or older; reviews, case reports, and gray literature were excluded. Risk of bias was assessed using the RoB 2 and JBI tools. The synthesis was based on clinical outcomes. Results: Ten studies with more than 1300 patients were analyzed. Both techniques showed low recurrence rates (<3.6%). RTAPP was associated with shorter hospitalization times (0-1.5 days) and slightly faster recovery, but also with a higher frequency of seromas and mild hematomas. Pain control was comparable in both techniques. Discussion: Both techniques are safe and effective. RTAPP offers advantages in early recovery, although with higher cost and minor complications. Methodological limitations and heterogeneity suggest the need for more robust studies. Conclusions: LTAPP and RTAPP are valid approaches. The choice should be based on available resources, the patient’s profile, and the surgical team’s experience