Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

Olavarria, Oscar A.; Bernardi, Karla; Shah, Shinil K.; Wilson, Todd; Wei, Shuyan; Pedroza, Claudia; Avritscher, Elenir B.C.; Loor, Michele M.; Ko, Tien C.; Kao, Lillian S.; Liang, Mike K.

doi:10.1136/bmj.m2457

Cited by 83 publications

(89 citation statements)

References 41 publications

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“…The remaining two RCTs compared robotic with laparoscopic intraperitoneal onlay mesh (IPOM) repair ( Table 2 ). One 20 was multi-institutional and included 123 patients, and the other 21 included 75 patients at a single institution.…”

Section: Resultsmentioning

confidence: 99%

“…Seven 12 , 24 , 25 , 32 , 34–36 of eight studies, including all three with propensity matching, demonstrated increased operating time with robotic compared with open surgery by 66–88 min, whereas there was no statistically significant difference in the remaining non-matched study 27 . For the robotic versus laparoscopic comparison, all nine studies 20 , 21 , 26 , 28 , 30 , 31 , 36 , 38 , 40 reporting duration of surgery, including two RCTs and two propensity-matched studies, reported a longer operating time with robotic VHR by a median of 54 min.…”

Section: Resultsmentioning

confidence: 99%

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Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Childers

Virgilio

et al. 2021

BJS Open

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Background Robotic ventral hernia repair (VHR) has seen rapid adoption, but with limited data assessing clinical outcome or cost. This systematic review compared robotic VHR with laparoscopic and open approaches. Methods This systematic review was undertaken in accordance with PRISMA guidelines. PubMed, MEDLINE, Embase, and Cochrane databases were searched for articles with terms relating to ‘robot-assisted’, ‘cost effectiveness’, and ‘ventral hernia’ or ‘incisional hernia’ from 1 January 2010 to 10 November 2020. Intraoperative and postoperative outcomes, pain, recurrence, and cost data were extracted for narrative analysis. Results Of 25 studies that met the inclusion criteria, three were RCTs and 22 observational studies. Robotic VHR was associated with a longer duration of operation than open and laparoscopic repairs, but with fewer transfusions, shorter hospital stay, and lower complication rates than open repair. Robotic VHR was more expensive than laparoscopic repair, but not significantly different from open surgery in terms of cost. There were no significant differences in rates of intraoperative complication, conversion to open surgery, surgical-site infection, readmission, mortality, pain, or recurrence between the three approaches. Conclusion Robotic VHR was associated with a longer duration of operation, fewer transfusions, a shorter hospital stay, and fewer complications compared with open surgery. Robotic VHR had higher costs and a longer operating time than laparoscopic repair. Randomized or matched data with standardized reporting, long-term outcomes, and cost-effectiveness analyses are still required to weigh the clinical benefits against the cost of robotic VHR.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Childers

Virgilio

et al. 2021

BJS Open

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show abstract

“…Incisional hernia comprised 71.4% (n= 10) of Group 1 while it comprised 74% (n= 20) of the patients in Group 2 (p= 0.71). The median follow-up period was 8.5 months (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) in Group 1, and 14 months in the other group (p= 0.01) (p= 0.01). There were no significant effects of age, sex, ASA, BMI, hernia defect area, and smoking (Table 2) on the postoperating complication rates (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Ventral hernia repair is recommended for the cases to be potentially symptomatic and complicated 1 . In recent years, laparoscopic and robotic surgeries are also an option, however, the open method continues to be a common method of treatment 2 . For an optimal result, a tension-free hernia repair and the placement of mesh that will cover the edges of the defect approximately 4 cm (onlay, inlay, or sublay) in hernia cases larger than 2 cm are adopted 3 .…”

Section: Introductionmentioning

confidence: 99%

Tek seansta ventral herni onarımı ile birlikte pannikülektomi de uygulanmalı mı?

Kırmızı¹,

Hüseyinoğlu²

2021

Cukurova Medical Journal

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The aim of this study is to investigate whether simultaneous panniculectomy applications in ventral hernia repair increases postoperative morbidity rates. Materials and Methods: The study was carried out retrospectively between January 2018 and December 2020. The patients were evaluated in terms of sex, age, body mass index, accompanying diseases, hernia type and size, abdominal surgery history, ASA value (American Society of Anesthesiology), postoperative complications, hospitalization, and follow-up durations. Post-operative complications were evaluated according to the Clavien-Dindo classification. Results: It was determined that 14 patients underwent simultaneous panniculectomy and ventral hernia repair (Group 1), while 27 patients underwent sole ventral hernia repair (Group 2). In Group 1, the hernia defect area was approximately 6.25-fold higher. In patients with a panniculectomy, hospitalization time was significantly longer. The median follow-up period was 8.5 months (2-14) in Group 1, and 14 months in Group 2 (3-36). In multiple linear regression analyses, only the effect hernia defect area was significant on the hospitalization time. There were no significant differences between the groups in terms of complications and hernia recurrence. Conclusion: Simultaneous panniculectomy applications in ventral hernia repairs do not increase the rate of complications and hernia recurence. A simultaneous panniculectomy application can be applied safely to patients who want to "eliminate" both of their problems in a single session. Amaç: Bu çalışmanın amacı, ventral hernide eş zamanlı pannikülektomi uygulamasının postoperatif morbidite oranlarını artırıp artırmadığını araştırmaktır. Gereç ve Yöntem: Çalışma Ocak 2018-Aralık 2020 tarihleri arasında Yozgat Şehir Hastanesi Genel Cerrahi Servisinde, retrospektif olarak gerçekleştirildi. Hastaların cinsiyet, yaş, vücut kitle indeksi, yandaş hastalıkları, herni tipi ve boyutu, geçirilmiş karın cerrahisi öyküsü, ASA değeri (American Society of Anesthesiology), post-operatif komplikasyonlar, hastane yatış ve takip süreleri değerlendirildi. Post-operatif komplikasyonlar Clavien-Dindo sınıflamasına göre değerlendirildi. Bulgular: On dört hastaya eş zamanlı pannikülektomi ve ventral herni onarımı (Grup 1), 27 hastaya sadece ventral herni onarımı (Grup 2) yapıldı. Grup 1'de herni defekti alanı yaklaşık 6,25 kat daha fazlaydı. Hastane yatış süresi pannikülektomi uygulanan hastalarda anlamlı olarak daha uzundu. Ortanca takip süresi Grup 1 hastalarda 8,5 ay (2-14), diğer grupta 14 aydı . Çoklu lineer regresyon analizlerinde hastane yatış süresi üzerinde sadece herni defekt alanın anlamlı etkisi olduğu görüldü. En ciddi komplikasyon Clavien-Dindo sınıflamasına göre 3b (genel anestezi altında cerrahi müdahale) grubunda oluşan cilt nekrozuydu. Yara yeri komplikasyon ve herni rekürrensi açısından gruplar arasında anlamlı fark saptanmadı. Sonuç: Ventral herni onarımların eş zamanlı pannikülektomi uygulaması komplikasyonları ve nüks oranını artırmamaktadır. Her iki probleminden de tek s...

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“…Also, there are studies conducted on a retrospective review of patients who have undergone laparoscopic hernioplasty (by TAPP or Tep methods) on the example of the study of the main problems that lead to recurrence. These studies show that the recurrence rate after hernioplasty performed by experienced surgeons was extremely low, undesirable effects of surgery can be foreseen and corrected due to the experience of the surgeon, and a certain proportion of such cases, require replacement of the technique and equipment used during surgery [16]. As Trap R. (Surgeon, Doctor of Surgery and Gastroenterology, Grostrul Hospital, Denmark) notes in the scientific surgical publication Repair of Ventral Hernias should be operated with a tension-free technique.…”

Section: Introductionmentioning

confidence: 98%

Peculiarities of Pre-Peritoneal Hernioplasty in Surgical Treatment of Ventral Hernias of Lower and Median Localization

Serhiyovych¹,

Pavlovych²

2021

Int j pharm res allied sci

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The purpose of this research work is to analyze and substantiate the advantages of the laparoscopic hernioplasty method, its improvement, to improve the results of surgical treatment of hernias of medial and lower localization. In the process of this research, we used a comparison method based on the surgical intervention by TAPP and SUBLAY performed on 405 patients. Patients were questioned according to the SF-36 form to assess their physical and psychoemotional state before surgical intervention and in the remote postoperative period. Significant advantages of using preperitoneal laparoscopic hernioplasty over open preaponeurotic hernioplasty include low complication rates (9.24% and 11.25%, respectively), easier nature of complications, shorter hospital stay, and quicker return to habitual activities. Treatment of patients by the TAPP method compares favorably with the SUBLAY method due to a smaller number of early and late complications, the nature and severity of complications, complications are easier to correct, the period of hospitalization is shorter, and the rehabilitation period is shorter. Laparoscopic technique for the treatment of hernias of medium and lower localization has a large number of supporters, both in Ukraine and in the world, who believe that the main advantage of this technique is the absence of contact with the free abdominal cavity and no reason for the formation of adhesions of the abdominal cavity organs, and therefore significantly reduced the risk of intra-and postoperative complications. Thus, the development and implementation of laparoscopic techniques show significant advantages in comparison with open laparotomy methods.

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Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial

Cited by 83 publications

References 41 publications

Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Clinical outcomes and cost of robotic ventral hernia repair: systematic review

Tek seansta ventral herni onarımı ile birlikte pannikülektomi de uygulanmalı mı?

Peculiarities of Pre-Peritoneal Hernioplasty in Surgical Treatment of Ventral Hernias of Lower and Median Localization

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