Comparative perioperative and 5-year outcomes of robotic and laparoscopic or open inguinal hernia repair: a study of 153,727 patients in the state of New York

Tatarian, Talar; Nie, Lizhou; McPartland, Connor; Brown, Andrew; Yang, Jie; Altieri, Maria S.; Spaniolas, Konstantinos; Docimo, Salvatore; Pryor, Aurora D.

doi:10.1007/s00464-020-08211-1

Cited by 21 publications

(15 citation statements)

References 18 publications

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“…1). Of these, nine studies published between 2010 and 2021 were found to be eligible for data extraction and were therefore included in the meta-analyses [4,5,8,[10][11][12][13][14][15]. A total of 62,426 patients who underwent RHR (n = 7589) or LHR (n = 54,837) from 2010 to 2021 were identified.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Only one multicenter randomized controlled trial was included [ 14 ]. One study analyzed the data which were extracted from an administrative database of the state of New York [ 15 ]; two studies exploited quality improvement databases [ 5 , 8 ] while Pokala et al queried a multi-institutional clinical database [ 13 ]. The remaining four studies were single-center comparative analyses.…”

Section: Resultsmentioning

confidence: 99%

“…Only three studies reported a follow-up of at least 1 year to evaluate late complications or recurrence [ 4 , 11 , 15 ]. The remaining six studies [ 5 , 8 , 10 , 12 – 14 ] reported short-term outcomes within the 30th postoperative day.…”

Section: Resultsmentioning

confidence: 99%

“…However, only a few studies comparing the laparoscopic and the robotic approach have been published [4][5][6][7][8][9][10][11][12][13][14][15][16]. The majority of them were characterized by small sample size, especially in the robotic arm, [6,7,9,16,17], limiting the power and, thus, the generalizability, of the studies.…”

Section: Introductionmentioning

confidence: 99%

“…Since then, several studies on the comparison between the robotic and the laparoscopic approach to repair inguinal hernia have been published adding further evidence on the topic. They included the first randomized controlled trial [ 14 ] and the two largest comparative studies [ 8 , 15 ] for a total of 6670 additional robotic inguinal hernia repairs which could be analyzed for more representative pooled outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Robotic versus laparoscopic inguinal hernia repair: an updated systematic review and meta-analysis

et al. 2021

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The aim of this study was to review the latest evidence on the robotic approach (RHR) for inguinal hernia repair comparing the pooled outcome of this technique with those of the standard laparoscopic procedure (LHR). A systematic literature search was performed in PubMed, Web of Science and Scopus for studies published between 2010 and 2021 concerning the comparison between RHR versus LHR. After screening 582 articles, 9 articles with a total of 64,426 patients (7589 RHRs) were eligible for inclusion. Among preoperative variables, a pooled higher ratio of ASA > 2 patients was found in the robotic group (12.4 vs 8.6%, p < 0.001). Unilateral hernia repair was more common in the laparoscopic group (79.9 vs 68.1, p < 0.001). Overall, operative time was longer in the robotic group (160 vs 90 min, p < 0.001); this was confirmed also in the sub-analysis on unilateral procedures (88 vs 68 min, p = 0.040). The operative time for robotic bilateral repair was similar to the laparoscopic one (111 vs 100, p = 0.797). Conversion to open surgery was 0% in the robotic group. The pooled rate of chronic pain and postoperative complications was similar between the groups. The standardized mean difference MD of the costs between LHR versus RHR was − 3270$ (95% CI – 4757 to − 1782, p < 0.001). In conclusion, laparoscopic and robotic inguinal hernia repair have similar safety parameters and postoperative outcomes. Robotic approach may require longer operative time if the unilateral repair is performed. Costs are higher in the robotic group.

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Section: Literature Search Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robotic versus laparoscopic inguinal hernia repair: an updated systematic review and meta-analysis

et al. 2021

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Comparison of Postoperative Outcomes of Laparoscopic vs Open Inguinal Hernia Repair

et al. 2023

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ImportanceAdvocates of laparoscopic surgery argue that all inguinal hernias, including initial and unilateral ones, should be repaired laparoscopically. Prior work suggests outcomes of open repair are improved by using local rather than general anesthesia, but no prior studies have compared laparoscopic surgery with open repair under local anesthesia.ObjectiveTo evaluate postoperative outcomes of open inguinal hernia repair under general or local anesthesia compared with laparoscopic repair.Design, Setting, and ParticipantsThis retrospective cohort study identified 107 073 patients in the Veterans Affairs Surgical Quality Improvement Program database who underwent unilateral initial inguinal hernia repair from 1998 to 2019. Data were analyzed from October 2021 to March 2022.ExposuresPatients were divided into 3 groups for comparison: (1) open repair with local anesthesia (n = 22 333), (2) open repair with general anesthesia (n = 75 104), and (3) laparoscopic repair with general anesthesia (n = 9636).Main Outcomes and MeasuresOperative time and postoperative morbidity were compared using quantile regression and inverse probability propensity weighting. A 2-stage least-squares regression and probabilistic sensitivity analysis was used to quantify and address bias from unmeasured confounding in this observational study.ResultsOf 107 073 included patients, 106 529 (99.5%) were men, and the median (IQR) age was 63 (55-71) years. Compared with open repair with general anesthesia, laparoscopic repair was associated with a nonsignificant 0.15% (95% CI, −0.39 to 0.09; P = .22) reduction in postoperative complications. There was no significant difference in complications between laparoscopic surgery and open repair with local anesthesia (−0.05%; 95% CI, −0.34 to 0.28; P = .70). Operative time was similar for the laparoscopic and open general anesthesia groups (4.31 minutes; 95% CI, 0.45-8.57; P = .048), but operative times were significantly longer for laparoscopic compared with open repair under local anesthesia (10.42 minutes; 95% CI, 5.80-15.05; P &lt; .001). Sensitivity analysis and 2-stage least-squares regression demonstrated that these findings were robust to bias from unmeasured confounding.Conclusions and RelevanceIn this study, laparoscopic and open repair with local anesthesia were reasonable options for patients with initial unilateral inguinal hernias, and the decision should be made considering both patient and surgeon factors.

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Spin is present in the majority of articles evaluating robot-assisted groin hernia repair: a systematic review

2022

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Comparative perioperative and 5-year outcomes of robotic and laparoscopic or open inguinal hernia repair: a study of 153,727 patients in the state of New York

Cited by 21 publications

References 18 publications

Robotic versus laparoscopic inguinal hernia repair: an updated systematic review and meta-analysis

Robotic versus laparoscopic inguinal hernia repair: an updated systematic review and meta-analysis

Comparison of Postoperative Outcomes of Laparoscopic vs Open Inguinal Hernia Repair

Spin is present in the majority of articles evaluating robot-assisted groin hernia repair: a systematic review

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