Minimally invasive inguinal hernia repair is superior to open: a national database review

Pokala, Bhavani; Armijo, Priscila Rodrigues; Flores, Laura; Hennings, Dietric; Oleynikov, Dmitry

doi:10.1007/s10029-019-01934-8

Cited by 50 publications

(51 citation statements)

References 27 publications

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“…The Vizient CDB is a validated administrative database used to answer diverse research questions. 9 10 We identified patients whose date of hospital discharge was from April f1 to July 31 2020 and included those with ICD-10 codes for EVT and ischemic stroke ( online supplemental table 1 ). 11 12 The concordance between the clinical diagnosis of ischemic stroke and the used ICD-10 codes has previously been shown to be >95% 11 and the codes for mechanical thrombectomy are specific to a procedure, making the use of the code without performing the procedure unlikely.…”

Section: Methodsmentioning

confidence: 99%

Endovascular thrombectomy in acute ischemic stroke patients with COVID-19: prevalence, demographics, and outcomes

Havenon

Yaghi

Mistry

et al. 2020

J NeuroIntervent Surg

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BackgroundWe aimed to compare the outcome of acute ischemic stroke (AIS) patients who received endovascular thrombectomy (EVT) with confirmed COVID-19 to those without.MethodsWe performed a retrospective analysis using the Vizient Clinical Data Base and included hospital discharges from April 1 to July 31 2020 with ICD-10 codes for AIS and EVT. The primary outcome was in-hospital death and the secondary outcome was favorable discharge, defined as discharge home or to acute rehabilitation. We compared patients with laboratory-confirmed COVID-19 to those without. As a sensitivity analysis, we compared COVID-19 AIS patients who did not undergo EVT to those who did, to balance potential adverse events inherent to COVID-19 infection.ResultsWe identified 3165 AIS patients who received EVT during April to July 2020, in which COVID-19 was confirmed in 104 (3.3%). Comorbid COVID-19 infection was associated with younger age, male sex, diabetes, black race, Hispanic ethnicity, intubation, acute coronary syndrome, acute renal failure, and longer hospital and intensive care unit length of stay. The rate of in-hospital death was 12.4% without COVID-19 vs 29.8% with COVID-19 (P<0.001). In mixed-effects logistic regression that accounted for patient clustering by hospital, comorbid COVID-19 increased the odds of in-hospital death over four-fold (OR 4.48, 95% CI 3.02 to 6.165). Comorbid COVID-19 was also associated with lower odds of a favorable discharge (OR 0.43, 95% CI 0.30 to 0.61). In the sensitivity analysis, comparing AIS patients with COVID-19 who did not undergo EVT (n=2139) to the AIS EVT patients with COVID-19, there was no difference in the rate of in-hospital death (30.6% vs 29.8%, P=0.868), and AIS EVT patients had a higher rate of favorable discharge (32.4% vs 47.1%, P=0.002).ConclusionIn AIS patients treated with EVT, comorbid COVID-19 infection was associated with in-hospital death and a lower odds of favorable discharge compared with patients without COVID-19, but not compared with AIS patients with COVID-19 who did not undergo EVT. AIS EVT patients with COVID-19 were younger, more likely to be male, have systemic complications, and almost twice as likely to be black and over three times as likely to be Hispanic.

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Section: Methodsmentioning

confidence: 99%

Endovascular thrombectomy in acute ischemic stroke patients with COVID-19: prevalence, demographics, and outcomes

Havenon

Yaghi

Mistry

et al. 2020

J NeuroIntervent Surg

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“…23,26,28,32,33,37 The robotic approach was compared with the open approach in 14 studies (Table 2), [19][20][21][22][23][24][25][26][28][29][30]32,35,36 while the robotic approach was compared with the laparoscopic approach in 18 studies (Table 1). [18][19][20][21][24][25][26][27][28][31][32][33][34][35][36][37][38][39] The majority of the studies were performed within the US, with 2 performed at non-US institutions. 26,34 Eight studies analyzed patients from prospectively maintained datasets.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…26,34 Eight studies analyzed patients from prospectively maintained datasets. 19,21,23,25,28,34,35,37 Five studies used propensity matching. 20,22,25,29,32 The studies varied in size from 55 to 75,981 patients.…”

Section: Study Characteristicsmentioning

confidence: 99%

Clinical and Cost Outcomes of Robot-Assisted Inguinal Hernia Repair: A Systematic Review

Tang

Shenoy

et al. 2021

Journal of the American College of Surgeons

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Inguinal hernia repair is one of the most common general surgical procedures, with more than 20 million hernias repaired worldwide annually. 1 While most surgeons use an open approach, there has been a growth in laparoscopic and robotic techniques among unilateral, bilateral, and recurrent hernia repairs. 2,3 Advantages have been lauded, with laparoscopic and robotic repair allowing for superior visualization of bilateral groin anatomy and exploration of both inguinal and femoral spaces. Also, some reports suggest that patients may have less postoperative pain. 4 A recent study found that robotic inguinal hernia repair use increased 41-fold in Michigan (2012 to 2018). 5 Proponents of the robotic platform argue that its magnified 3-dimensional visualization, stable platform, and superior range of motion may translate into better clinical outcomes. 6 The number of robotic inguinal hernia repair procedures continues to rise despite confirmation of the clinical benefits. 7,8 The economic value of robotic surgery is also unclear. Technology acquisition and implementation require substantial upfront investment along with ongoing costs for annual maintenance contracts, instrument purchases, staff and training, infrastructure upgrades, and marketing. 9 The cost benefit in relationship to clinical outcomes associated with the use of robotic technology must be apparent to provider and patient.Two systematic reviews of robotic inguinal hernia repair were published in 2019 but are already dated, as at least 10 additional studies have since been published, including the first randomized controlled trial (RCT). 10,11 We proceeded with this systematic review to provide the most up-to-date assessment of perioperative and long-term clinical outcomes and cost for robotassisted inguinal hernia repair compared with open and laparoscopic approaches. METHODSThis review is part of a larger report commissioned by the Department of Veterans Affairs on the clinical outcomes and cost-effectiveness of robotic procedures for cholecystectomy, inguinal hernia repair, and ventral hernia repair. This systematic review is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards, 12 and the a priori protocol was registered in PROSPERO: CRD42020156945.

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“…9 Minimally invasive surgery such as laparoscopic or robotic reduces risk of infection. 10 Antibiotics used prophylactically 11 do not cover all possible organisms. Increasing antimicrobial resistance patterns also results in decreased effectiveness.…”

Section: Introductionmentioning

confidence: 99%

“…Some advocate biologics in high‐risk situations; however, break down after implantation with the potential for hernia recurrence has plagued this mesh type 9 . Minimally invasive surgery such as laparoscopic or robotic reduces risk of infection 10 …”

Section: Introductionmentioning

confidence: 99%

The Promise of viral phage therapy in hernia mesh infection, is this the biological ‘silver bullet’ of the future?

Speck

Warner

Clark

et al. 2020

ANZ Journal of Surgery

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Minimally invasive inguinal hernia repair is superior to open: a national database review

Cited by 50 publications

References 27 publications

Endovascular thrombectomy in acute ischemic stroke patients with COVID-19: prevalence, demographics, and outcomes

Endovascular thrombectomy in acute ischemic stroke patients with COVID-19: prevalence, demographics, and outcomes

Clinical and Cost Outcomes of Robot-Assisted Inguinal Hernia Repair: A Systematic Review

The Promise of viral phage therapy in hernia mesh infection, is this the biological ‘silver bullet’ of the future?

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