Novel “T‐Incision” Method With Robotic‐Assisted Transabdominal Preperitoneal Repair for Lateral Inguinal Hernia: An Operative Technique (With Video)

ABSTRACT Introduction Robotic‐assisted transabdominal preperitoneal repair (R‐TAPP) was first described in 2007. Since then, the procedure has gained increasing popularity, particularly in the United States, where its use surpassed laparoscopic repair in 2022. In Japan, R‐TAPP is performed only under self‐pay healthcare, but nationwide multicenter data have confirmed its safety and feasibility. Materials and Surgical Technique We developed a novel peritoneal incision method—the “T‐incision”—to optimize exposure and facilitate mesh placement during R‐TAPP for lateral inguinal hernia. This approach combines the advantages of linear and circular incisions. We describe the procedural details and provide step‐by‐step intraoperative images and video. Discussion Robotic platforms enable precise dissection in confined spaces. The T‐incision balances surgical exposure and safety, improving mesh placement without excessive dissection. We believe this technique will help to standardize R‐TAPP in Japan as the procedure becomes more widely implemented.