Robotic Repair of Ventral Hernias: Preliminary Findings of a Case Series of 106 Consecutive Cases

Kudsi, Omar Yusef; Paluvoi, Nivedh; Bhurtel, Partha; McCabe, Zachary; El-Jabri, Raneem

doi:10.1166/ajrs.2015.1020

Cited by 36 publications

(19 citation statements)

References 9 publications

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“…While a single patient in this series had a robotic ventral hernia repair, this patient was notably more complex, with a body mass index of 40, and a recurrent hernia with a large 13.4 × 13.6 cm defect (Table ). Given hernia repair is fraught with high recurrence rates when performed in obese patients, the robotic platform potentially offers some advantage over laparoscopy, with 7° of freedom, three‐dimensional image, superior ergonomics that promote precision at difficult angles . Kudsi et al .…”

Section: Discussionmentioning

confidence: 99%

“…Given hernia repair is fraught with high recurrence rates when performed in obese patients, 26,27 the robotic platform potentially offers some advantage over laparoscopy, with 7 of freedom, three-dimensional image, superior ergonomics that promote precision at difficult angles. 28,29 Kudsi et al 28 reviewed 106 robotic cases performed at a single institution, where neither BTA nor the Venetian blind technique was utilized in any of their patients. In their series, relatively low postoperative morbidity (6%) and only two recurrences were reported.…”

Section: Discussionmentioning

confidence: 99%

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Minimally invasive Venetian blinds ventral hernia repair with botulinum toxin chemical component separation

Chan

Ravindran

Fan

et al. 2019

ANZ Journal of Surgery

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Background Laparoscopic ventral repair is safe, with lower wound infection rates compared with open repair. ‘Venetian blinds’ technique of plication in combination with mesh reinforcement, is totally intra‐corporeal, with hernia defect and sac plication to reduce seroma formation. While laparoscopic suturing of the abdominal wall can represent a technical challenge, pre‐operative botulinum toxin A (BTA) injections as an adjunct can assist. This study aims to demonstrate feasibility and efficacy of this technique in abdominal wall hernia repair, with BTA adjunct in midline hernias. Methods A single‐centre case series was conducted using minimally invasive ‘Venetian blinds’ technique for repair of complex ventral abdominal hernias. Twelve patients (seven midline, five non‐midline) underwent repair (11 laparoscopic; one robotic). Midline hernias received BTA (200–300 units Botox) 4–6 weeks prior to surgery. Repairs were mesh‐reinforced following fascial closure. Results Twelve (10 female, two male) patients, with a median age 72 years (range 31–83) and body mass index of 27.3 kg/m2 (range 22.8–61.7) were included. The median length of operation was 133 min (range 45–290) and length of hospital stay 3 days (range 1–28). To date there has been no recurrence of hernia. A single symptomatic seroma was treated with antibiotics and did not require mesh removal. One patient developed hospital‐acquired pneumonia and pseudomembranous colitis. Conclusion Minimally invasive ‘Venetian blinds’ technique has promising early results with both midline and non‐midline ventral hernias. The addition of BTA is a novel and feasible combination for repair of midline ventral hernias.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimally invasive Venetian blinds ventral hernia repair with botulinum toxin chemical component separation

Chan

Ravindran

Fan

et al. 2019

ANZ Journal of Surgery

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“…As it can be seen, therefore, the field of hernia repair has come a long way by establishing the new concept of primary defect closure for the sake of a more mechanically and physiologically normal abdominal wall, and avoidance of transfascial sutures and tacks to prevent chronic pain. Furthermore, all of the series have determined that the robotic platform offers the opportunity to perform enterolysis more efficiently through the multiple benefits that have been described before [84][85][86] (see Figures 8-10). …”

Section: Hernia Repair: From Closing Defects To Suturing Meshmentioning

confidence: 99%

The Surgical Robot: Applications and Advantages in General Surgery

Barrera¹

2018

Surgical Robotics

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The field of General Surgery with its multiple sub-specialties has experienced the progression of minimally invasive procedures performed with the robotic technology since the last decade. The robotic applications are extensive and have contributed to the enrichment of the surgical sub-specialties based on advantages such as increased surgeon control and autonomy, superior instrument dexterity and tissue handling, improved three-dimensional visualization, wristed articulation, all of this despite the lack of haptic feedback. The sub-specialties of Colorectal, Hepatobiliary and Pancreatic, Gastric Oncologic, Bariatric, Foregut, Pediatric, Endocrine, and Hernia Surgery, in addition to General Surgery as the principal specialty, have produced several high-quality randomized controlled trials, meta-analyses, prospective and retrospective series which have established, in many instances, superior results to those of laparoscopy, and at least non-inferior outcomes over the years. From the first pioneer single-surgeon experiences around the world to the most recent large trials, including the first Robotic General Surgery case series in an American community hospital not classified as a tertiary referral center, patients continue to benefit from this technology as surgeons engage in overcoming their learning curve and training their teams, involving their hospital administrators and working with the industry to perfect their techniques for the sake of their patients.

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“…There were no conversions to open technique or mortalities. The overall postoperative morbidity was 6% during the median follow‐up period of 6 months . A study by Chen et al compared robot‐assisted and laparoscopic repair of small ventral hernias; they demonstrated that there was no significant difference in terms of safety and early efficacy between the two procedures .…”

Section: Applications In Hernia Surgerymentioning

confidence: 99%

“…Robot‐assisted surgery seems to have the ability to overcome laparoscopic repair's suturing limitations. In fact, robotic surgery offers the advantages of several degrees of freedom, 3‐D imaging, and superior ergonomics, which enable precise suturing and dissection at difficult angles . It also facilitates, especially in ventral hernia, dissection, defect closure, and mesh positioning.…”

Section: Introductionmentioning

confidence: 99%