Robotic-assisted compared with laparoscopic incisional hernia repair following oncologic surgery: short- and long-term outcomes of a randomized controlled trial

Costa, Thiago Nogueira; Abdalla, René Jorge; Tustumi, Francisco; Ribeiro, Ulysses; Ivan, Cristina

doi:10.1007/s11701-022-01403-y

Cited by 7 publications

(9 citation statements)

References 35 publications

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“…This study investigated the differences in direct costs from the data generated from a randomized trial protocol (Brazilian Registry of Clinical Trials, ReBEC; ID: RBR-5s6mnrf). The clinical outcomes of this protocol were previously reported 5 .…”

Section: Methodsmentioning

confidence: 94%

“…Several comparative studies of robotic-assisted primary, inguinal, or incisional ventral hernia repair versus laparoscopy found no significant differences in postoperative outcomes 5 , 6 , 10 , 15 , 21 - 23 . Both robotic and laparoscopic hernia repair approaches are equally effective for postoperative recovery compared with open surgery 15 .…”

Section: Introductionmentioning

confidence: 99%

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Robotic-Assisted Versus Laparoscopic Incisional Hernia Repair: Differences in Direct Costs From a Brazilian Public Institute Perspective

Costa

Tustumi

Ferros

et al. 2022

ABCD, arq. bras. cir. dig.

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BACKGROUND: Robotic-assisted surgery research has grown dramatically in the past two decades and the advantages over traditional videolaparoscopy have been extensively debated. For hernias, the robotic system can increase intraoperative strategies, especially in complex hernias or incisional hernias. AIMS: This study aimed to compare the direct cost differences between robotic and laparoscopic hernia repair and determine each source of expenditure that may be related to the increased costs in a robotic program from the perspective of a Brazilian public institution. METHODS: This study investigated the differences in direct costs from the data generated from a trial protocol (ReBEC: RBR-5s6mnrf). Patients with incisional hernia were randomly assigned to receive laparoscopic ventral incisional hernia repair (LVIHR) or robotic ventral incisional hernia repair (RVIHR). The direct medical costs of hernia treatment were described in the Brazilian currency (R$). RESULTS: A total of 19 patients submitted to LVIHR were compared with 18 submitted to RVIHR. The amount spent on operation room time (RVIHR: 2,447.91±644.79; LVIHR: 1,989.67±763.00; p=0.030), inhaled medical gases in operating room (RVIHR: 270.57±211.51; LVIHR: 84.55±252.34; p=0.023), human resources in operating room (RVIHR: 3,164.43±894.97; LVIHR: 2,120.16±663.78; p<0.001), material resources (RVIHR: 3,204.32±351.55; LVIHR: 736.51±972.32; p<0.001), and medications (RVIHR: 823.40±175.47; LVIHR: 288.50±352.55; p<0.001) for RVIHR was higher than that for LVIHR, implying a higher total cost to RVIHR (RVIHR: 14,712.24±3,520.82; LVIHR: 10,295.95±3,453.59; p<0.001). No significant difference was noted in costs related to the hospital stay, human resources in intensive care unit and ward, diagnostic tests, and meshes. CONCLUSION: Robotic system adds a significant overall cost to traditional laparoscopic hernia repair. The cost of the medical and robotic devices and longer operative times are the main factors driving the difference in costs.

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Section: Methodsmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Robotic-Assisted Versus Laparoscopic Incisional Hernia Repair: Differences in Direct Costs From a Brazilian Public Institute Perspective

Costa

Tustumi

Ferros

et al. 2022

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

show abstract

“…The present study investigated the differences in direct costs from the data generated from a randomized trial protocol (Registro Brasileiro de Ensaios Clínicos, ReBEC; ID: RBR-5s6mnrf). The clinical outcomes of this protocol were previously reported [15].…”

Section: Study Design and Participantsmentioning

confidence: 94%

Robotic-assisted versus laparoscopic incisional hernia repair: differences in direct costs from a Brazilian public institute perspective

Costa

Tustumi

Ferros

et al. 2022

Preprint

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Background This study aimed to compare the direct cost differences between robotic (RVIHR) and laparoscopic (LVIHR) hernia repair and determine each source of expenditure that may be related to the increased costs in a robotic program from the perspective of a Brazilian public institution. Methods The present study investigated the differences in direct costs from the data generated from a trial protocol (ReBEC: RBR-5s6mnrf). Patients with incisional hernia were randomly assigned to receive LVIHR or RVIHR. The direct medical costs of hernia treatment were described in the Brazilian currency (R$). Results Nineteen patients submitted to LVIHR were compared with eighteen submitted to RVIHR. The amount spent on operation room time (RVIHR: 2447,91 ± 644,79; LVIHR: 1989,67 ± 763,00; p = 0,030), inhaled medical gases in operating room (RVIHR: 270,57 ± 211,51; LVIHR: 84,55 ± 252,34; p = 0,023), human resources in operating room (RVIHR: 3164,43 ± 894,97; LVIHR: 2120,16 ± 663,78; p < 0,001), material resources (RVIHR: 3204,32 ± 351,55; LVIHR: 736,51 ± 972,32; p < 0,001), and medications (RVIHR: 823,40 ± 175,47; LVIHR: 288,50 ± 352,55; p < 0,001) for RVIHR was higher than LVIHR, implying a higher total cost to RVIHR (RVIHR: 14712,24 ± 3520,82; LVIHR: 10295,95 ± 3453,59; p < 0,001). No significant difference was noted in costs related to the hospital stay, human resources in ICU and ward, diagnostic tests, and meshes. Conclusion Robotic system adds a significant overall cost to traditional laparoscopic hernia repair. The cost of the medical and robotic devices plus longer operative times are the main factors driving the difference in costs.

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“…Although evidence at low risk of bias is generally lacking to support the widespread use of robotic surgery, it has seen rapid growth, particularly in the field of general surgery 1,3 . Previous studies have demonstrated robotic ventral hernia repair is safe in the short term but few randomized controlled trials (RCTs) have published long-term data 3–6 . Our objective was to assess the outcomes of robotic versus laparoscopic ventral hernia repair at 2 years postoperative.…”

mentioning

confidence: 99%

“…1,3 Previous studies have demonstrated robotic ventral hernia repair is safe in the short term but few randomized controlled trials (RCTs) have published long-term data. [3][4][5][6] Our objective was to assess the outcomes of robotic versus laparoscopic ventral hernia repair at 2 years postoperative.…”

mentioning

confidence: 99%

Robotic Versus Laparoscopic Ventral Hernia Repair

et al. 2023

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Objective: Report the 2-year outcomes of a multicenter randomized controlled trial comparing robotic versus laparoscopic intraperitoneal onlay mesh ventral hernia repair. Background: Ventral hernia repair is one of the most common operations performed by general surgeons. To our knowledge, no studies have been published to date comparing long-term outcomes of laparoscopic versus robotic ventral hernia repair. Methods: The trial was registered at clinicaltrials.gov (NCT03490266). Clinical outcomes included surgical site infection, surgical site occurrence, hernia occurrence, readmission, reoperation, and mortality. Results: A total of 175 consecutive patients were approached that were deemed eligible for elective minimally invasive ventral hernia repair. In all, 124 were randomized and 101 completed follow-up at 2 years. Two-year follow-up was completed in 54 patients (83%) in the robotic arm and 47 patients (80%) in the laparoscopic arm. No differences were seen in surgical site infection or surgical site occurrence. Hernia recurrence occurred in 2 patients (4%) receiving robotic repair versus in 6 patients (13%) receiving laparoscopic repair (relative risk: 0.3, 95% CI: 0.06–1.39; P=0.12). No patients (0%) required reoperation in the robotic arm whereas 5 patients (11%) underwent reoperation in the laparoscopic arm (P=0.019, relative risk not calculatable due to null outcome). Conclusions: Robotic ventral hernia repair demonstrated at least similar if not improved outcomes at 2 years compared with laparoscopy. There is potential benefit with robotic repair; however, additional multi-center trials and longer follow-up are needed to validate the hypothesis-generating findings of this study.

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Robotic-assisted compared with laparoscopic incisional hernia repair following oncologic surgery: short- and long-term outcomes of a randomized controlled trial

Cited by 7 publications

References 35 publications

Robotic-Assisted Versus Laparoscopic Incisional Hernia Repair: Differences in Direct Costs From a Brazilian Public Institute Perspective

Robotic-Assisted Versus Laparoscopic Incisional Hernia Repair: Differences in Direct Costs From a Brazilian Public Institute Perspective

Robotic-assisted versus laparoscopic incisional hernia repair: differences in direct costs from a Brazilian public institute perspective

Robotic Versus Laparoscopic Ventral Hernia Repair

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