Short-term quality of life comparison of laparoscopic, open, and robotic incisional hernia repairs

Forester, Beau; Attaar, Mikhail; Donovan, Kara; Kuchta, Kristine; Ujiki, Michael; Denham, Woody; Carbray, JoAnn; Linn, John G.

doi:10.1007/s00464-020-07711-4

Cited by 24 publications

(9 citation statements)

References 12 publications

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“…However, the mesh sensation score was worse in patients with Rives-Stoppa hernia repair. The sensation score for component separation was at the same level as in a study conducted by Klima et al [ 26 ], while Forester et al Reported a slightly higher sensation score for open incisional hernia repair with mesh than it was revealed in our study [ 27 ]. The difference between these two groups in sensation may be due to the difference in the technique of these two types of operations.…”

Section: Discussionsupporting

confidence: 80%

Quality of life following two different techniques of an open ventral hernia repair for large hernias: a prospective randomized study

et al. 2022

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Background We compare the health-related quality of life (QoL) of patients with incision hernias before and after surgery with two different techniques. Methods In this prospective randomized study, the study population consisted of all patients who underwent the first surgical incisional hernias repair during the 1-year study period. Patients who met the criteria for inclusion in the study were randomized into two groups: the first group consisted of patients operated by an open Rives sublay technique, and the second group included patients operated by a segregation component technique. The change in the quality of life before and 6 months after surgery was assessed using two general (Short form of SF-36 questionnaires and European Quality of Life Questionnaire—EQ-5D-3L), and three specific hernia questionnaires (Hernia Related Quality of Life Survey-HerQles, Eura HS Quality of Life Scale—EuraHS QoL, and Carolinas Comfort Scale—CCS). Results A total of 93 patients were included in the study. Patients operated on by the Rives technique had a better role physical score before surgery, according to the SF-36 tool, although this was not found after surgery. The postoperative QoL measured with each scale of all questionnaires was significantly better after surgery. Comparing two groups of patients after surgery, only the pain domain of the EuraHS Qol questionnaire was worse in patients operated by a segregation component technique. Conclusion Both techniques improve the quality of life after surgery. Generic QoL questionnaires showed no difference in the quality of life compared to repair technique but specific hernia-related questionnaires showed differences.

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Section: Discussionsupporting

confidence: 80%

Quality of life following two different techniques of an open ventral hernia repair for large hernias: a prospective randomized study

et al. 2022

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“…Most studies report that RVHR incurs higher costs and longer operative times compared to other approaches, being significantly higher than LVHR. 6,[15][16][17][19][20][21][23][24][25][26][27]29,[32][33][34][36][37][38]41,42,44,46,[48][49][50] The costs of robotic systems, software, equipment and maintenance outweigh that of laparoscopic and open surgery. These costs may be offset with reduced hospital costs associated with LOS and complications.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies focussed on incisional hernias. 23,26,36,43,44 Han et al (2022) focussed on recurrent hernias. 31 Kudsi et al (2021) studied emergent hernia repair.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of robotic ventral hernia repair with meta‐analysis

Tran,

Sun,

Gundara

2023

ANZ Journal of Surgery

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BackgroundDespite being one of the most common operations performed by general surgeons, there is a lack of consensus regarding the recommended approach for ventral hernia repair (VHR). Recent times have seen the rapid development of new techniques, such as robotic ventral hernia repair (RVHR). This systematic review and meta‐analysis aims to evaluate the currently available evidence relating to RVHR, in comparison to open VHR (OVHR) and laparoscopic VHR (LVHR).MethodsA systematic search of the following databases was conducted: PubMed, Embase, Scopus and Web of Science. A meta‐analysis was performed for the outcomes of length of stay (LOS), recurrence, operative time, intraoperative complications, wound complications, 30‐day readmission, 30‐day reoperation, mortality and costs.ResultsA total of 39 studies met inclusion criteria. Overall, RVHR reduced LOS, intra‐operative complications, wound complications and readmission compared to OVHR. Compared to LVHR, RVHR was associated with increased operative time and costs, with comparable clinical outcomes.ConclusionThere is currently a lack of robust evidence to support the robotic approach in VHR. It does not demonstrate major benefits in comparison to LVHR, which is more affordable and accessible. Strong quality, long‐term data is required to help with establishing a gold standard approach in VHR.

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“…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%

“…In the first randomized controlled trial comparing robotic versus laparoscopic incisional ventral hernia repair in Brazil, we also found no evidence of differences in hospitalization, surgical complications, and recurrence rate. However, robotic surgery has nearly doubled operating room (OR) time 10 .…”

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.

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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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Short-term quality of life comparison of laparoscopic, open, and robotic incisional hernia repairs

Cited by 24 publications

References 12 publications

Quality of life following two different techniques of an open ventral hernia repair for large hernias: a prospective randomized study

Quality of life following two different techniques of an open ventral hernia repair for large hernias: a prospective randomized study

Systematic review of robotic ventral hernia repair with meta‐analysis

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

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