Robotic-assisted, laparoscopic, and open incisional hernia repair: early outcomes from the Prospective Hernia Study

LeBlanc, Karl A.; Gonzalez, Anthony; Dickens, Eugene; Olsofka, John M.; Ortiz-Ortiz, Carlos; Verdeja, Juan-Carlos; Pierce, Richard A.

doi:10.1007/s10029-021-02381-0

Cited by 24 publications

(16 citation statements)

References 23 publications

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“…A study by Sharbaugh et al25 showed a similar rate of recurrence of 12% on long-term follow-up at a mean of 626 days postoperative, as assessed by physical exam and diagnostic imaging. Our median HerQles score of 82 (IQR: 56 to 97) was comparable to 2 rVHR studies with median HerQles scores of 90 at 1-year follow-up26 and 71.7 at 3-month follow-up 27. Furthermore, in our study, median HerQLes score decreased with increasing number of patient factors present (ie, presence of a bulge, symptoms at hernia site, or both) with the difference being statistically significant ( P =0.0059) (Fig.…”

Section: Discussionsupporting

confidence: 75%

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Hernia Defect Closure With Barbed Suture: An Assessment of Patient-reported Outcomes in Extraperitoneal Robotic Ventral Hernia Repair

Tagerman

Pereira

Lima

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Primary closure of a fascial defect during ventral hernia repair is associated with lower rates of recurrence and better patient satisfaction compared with bridging repairs. Robotic surgery offers enhanced ability to close these defects and this has likely been aided by the use of barbed suture. The goal of this study was to evaluate the perioperative safety and the long-term outcomes for the use of barbed suture for the primary closure of hernia defects during robotic ventral hernia repair (rVHR) with mesh. Methods: This is a retrospective study of adult patients who underwent rVHR with the use of a barbed suture for fascial defect closure from August 2018 to August 2020 in an academic center. All the patients included were queried by phone to complete a quality of life assessment to assess patient-reported outcomes (PROs). Subjective sense of a bulge and pain at the previous hernia site has been shown to correlate with hernia recurrence. These questions were used in conjunction with a Hernia-related Quality of Life Survey (HerQles) score to assess a patient’s quality of life. Results: A total of 81 patients with 102 hernias were analyzed. Sixty patients (74%) were successfully reached and completed the PRO form at median postoperative day 356 (range: 43 to 818). Eight patients (13% of patients with PRO data) claimed to have both a bulge and pain at their previous hernia site, concerning for possible recurrence. Median overall HerQLes score was 82 [Interquartile Range (IQR): 54 to 99]. Patients with a single hernia defect, when compared with those with multiple defects, had a lower rate of both a bulge (15% vs. 30%) and symptoms (33% vs. 48%), as well as a higher median HerQLes score (85 vs. 62) at the time of PRO follow-up. Patients with previous hernia repair had a lower median HerQLes score of 65 (IQR: 43 to 90) versus 88 (IQR: 62–100). These patients also had a higher rate of sensing a bulge (29% vs. 18%), whereas a sense of symptoms at the site was less (33% vs. 44%). Conclusions: Barbed suture for fascial defect closure in rVHR was found to be safe with an acceptable rate of possible recurrence by the use of PRO data. Patients with multiple hernias and previous repairs had a higher likelihood of recurrence and a lower quality of life after rVHR.

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Section: Discussionsupporting

confidence: 75%

“…These patients also had a higher rate of sensing a bulge (29% vs. 18%), whereas a sense of symptoms at the site was less (33% vs. 44%). When stratifying by mesh type, the patients with permanent coated mesh had the lowest median HerQLes score of 42 (27,53). These patients also had the highest rate of bulge and symptoms both at 60%.…”

Section: Resultsmentioning

confidence: 99%

Hernia Defect Closure With Barbed Suture: An Assessment of Patient-reported Outcomes in Extraperitoneal Robotic Ventral Hernia Repair

Tagerman

Pereira

Lima

et al. 2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Previous large cohort studies reported conflicting results regarding outcomes after laparoscopic versus robot-assisted ventral hernia repair. [14][15][16] One possible reason for similar short-term outcomes in some of these studies may be similar techniques, in the form of an IPOM mesh placement, however, utilizing different approaches. Likewise, 2 recent randomized trials reported no differences in short-term complications after laparoscopic compared to robot-assisted IPOM repair, indicating that it is not per se the use of a robotic approach that impacts the patient's postoperative course but rather the type of procedure performed.…”

Section: Discussionmentioning

confidence: 95%

Short-term Outcomes After Laparoscopic IPOM vs. Robot-assisted Retromuscular Repair of Small to Medium Ventral Hernias

2023

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Objective: To examine the short-term outcomes after laparoscopic intraperitoneal onlay mesh (IPOM) compared with robot-assisted retromuscular repair of small to medium-sized ventral hernia. Background: With the introduction of a robot-assisted approach, retromuscular mesh placement is technically more feasible compared with laparoscopic IPOM, with potential gains for the patient, including avoidance of painful mesh fixation and intraperitoneal mesh placement. Methods: This was a nationwide cohort study of patients undergoing either laparoscopic IPOM or robot-assisted retromuscular repair of a ventral hernia with a horizontal fascial defect <7 cm in the period 2017 to 2022, matched in a 1:2 ratio using propensity scores. Outcomes included postoperative hospital length of stay, 90-day readmission, and 90-day operative reintervention, and multivariable logistic regression analysis was performed to adjust for the relevant confounder. Results: A total of 1136 patients were included for analysis. The rate of IPOM-repaired patients hospitalized > 2 days was more than 3 times higher than after robotic retromuscular repair (17.3% vs. 4.5%, P < 0.001). The incidence of readmission within 90 days postoperatively was significantly higher after laparoscopic IPOM repair (11.6% vs. 6.7%, P = 0.011). There was no difference in the incidence of patients undergoing operative intervention within the first 90 days postoperatively (laparoscopic IPOM 1.9% vs. robot-assisted retromuscular 1.3%, P = 0.624). Conclusions: For patients undergoing first-time repair of a ventral hernia, robot-assisted retromuscular repair was associated with a significantly reduced incidence of prolonged length of postoperative hospital stay and risk of 90-day readmission compared to laparoscopic IPOM.

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“…Choosing the best technique for repairing an inguinal hernia is challenging because the available data is controversial. To date, numerous observational studies [5][6][7][8] and one randomized trial have failed to demonstrate that short-term and functional outcomes after robotic surgery are superior to those of laparoscopic surgery for patients with inguinal hernia. The aim of the review is to provide an overview about the current practice for inguinal hernia repair with the focus on robotic approach.…”

Section: Robotic-assisted Inguinal Hernia Repair: a Historical Reviewmentioning

confidence: 99%

Robotic-assisted inguinal hernia repair: A historical review

Al‐Dhaheri¹,

Mubarak²,

Alwali³

et al. 2022

YJM

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Inguinal hernia repair is one of the most common procedures performed in general surgery. Approximately 20 million hernia surgeries are performed every year worldwide. Conventionally, hernial repair is carried out with the open Lichtenstein technique; however, laparoscopic and robotic inguinal hernia repairs have been developed as a minimally invasive alternative to the classic Lichtenstein repair. The prosthetic mesh can be placed by totally extraperitoneal and transabdominal pre-peritoneal approaches. Choosing the best technique for repairing an inguinal hernia is a challenge because the available data are contradictory. However, a growing number of studies have claimed that robotic-assisted hernia repair is not only feasible and safe, but it is associated with outcomes that are comparable to those obtained with laparoscopy and open surgery, including shorter hospital stay, and fewer complications. The aim of the review article is to provide an overview of the current practice of inguinal hernia repair, with a focus on the advances in robotic-assisted inguinal hernia repair, as well as the advantages and disadvantages of this surgical procedure compared to the laparoscopic technique in view of the current reports in the literature.

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Robotic-assisted, laparoscopic, and open incisional hernia repair: early outcomes from the Prospective Hernia Study

Cited by 24 publications

References 23 publications

Hernia Defect Closure With Barbed Suture: An Assessment of Patient-reported Outcomes in Extraperitoneal Robotic Ventral Hernia Repair

Hernia Defect Closure With Barbed Suture: An Assessment of Patient-reported Outcomes in Extraperitoneal Robotic Ventral Hernia Repair

Short-term Outcomes After Laparoscopic IPOM vs. Robot-assisted Retromuscular Repair of Small to Medium Ventral Hernias

Robotic-assisted inguinal hernia repair: A historical review

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