Standard laparoscopic versus robotic retromuscular ventral hernia repair

Warren, Jeremy A.; Cobb, William S.; Ewing, Joseph A.; Carbonell, Alfredo M.

doi:10.1007/s00464-016-4975-x

Cited by 123 publications

(73 citation statements)

References 36 publications

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“…The introduction of lVHR provided several advantages over the open technique; however, this approach usually involves intraperitoneal placement of a prosthetic mesh without excision of the hernia sac or closure of the fascial defect . Failure to close the fascial defect is associated with increased seroma formation and other adverse hernia‐site outcomes . In addition, fixation of the mesh with tacs alone may increase hernia recurrence rates .…”

Section: Discussionmentioning

confidence: 99%

“…However, lVHR most often involves intraperitoneal placement of a prosthetic mesh without excision of the hernia sac or closure of the fascial defect . Failure to close the fascial defect is associated with increased seroma formation and other adverse hernia‐site outcomes . Consequently, laparoscopic techniques have been described to facilitate fascial closure, though this is often technically difficult particularly for those hernias wider than 10 cm .…”

Section: Introductionmentioning

confidence: 99%

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Robotic‐assisted ventral hernia repair with surgical mesh: how I do it and case series of early experience

Kozman

Tonkin²,

Eteuati

et al. 2019

ANZ Journal of Surgery

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Background: Laparoscopic ventral hernia repair provides several benefits over the open approach. Intraperitoneal surgical mesh placement without fascial defect closure is associated with increased seroma formation and other adverse hernia-site outcomes. Transfascial sutures and tacs for fascial closure and surgical mesh fixation are associated with greater post-operative pain. Robotic-assisted ventral hernia repair (rVHR) may afford benefits of the laparoscopic approach while facilitating a more robust and less painful repair. Methods: Consecutive patients managed by rVHR from May 2015 to August 2018 were identified from a prospectively maintained robotic database. Retrospective review of this data was performed. Results: Fifty patients underwent rVHR during the study period. Median body mass index was 31 (interquartile range (IQR) 29-34). Forty-eight had previous abdominal surgery. Forty-seven hernias were midline and three were lateral. Regarding hernia width, 15 were <4 cm wide, 32 were 4-10 cm and three were >10 cm. Median total anaesthetic time, docking time and surgical console time were 214 min (IQR 182-252), 5 min (IQR 4-8) and 144 min (IQR 104-174), respectively. No major intra-operative complications occurred. No documented cases of adhesional complications or chronic post-operative pain have occurred. To date, two recurrences have occurred in our series. Median length of hospital stay was 3 days (IQR 2-4). Conclusion: We describe our rVHR technique and report on our series and early experience, showing that rVHR can be performed safely with good patient outcomes. We demonstrate a team approach to achieving a safe transition to new technology.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Robotic‐assisted ventral hernia repair with surgical mesh: how I do it and case series of early experience

Kozman

Tonkin²,

Eteuati

et al. 2019

ANZ Journal of Surgery

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“…In our elderly cohort, the rate of SSEs was lower than their reported rate of 15.4% for the laparoscopically treated arm. Warren et al reported that overall perioperative morbidity of RVHR is comparable to LVHR, irrespective of age. However, they also reported a statistically higher rate of SSOs after RVHR.…”

Section: Discussionmentioning

confidence: 99%

Are elderly patients at high risk for postoperative complications after robotic ventral hernia repair? A propensity score matching analysis

Kudsi

Gökçal

Grange

et al. 2020

Robotics Computer Surgery

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Background: The purpose of this study was to compare the elderly (≥65 years) and non-elderly groups regarding perioperative outcomes after robotic ventral hernia repair (RVHR). Methods:A one-to-one propensity score matching (PSM) analysis was conducted to obtain balanced groups. Postoperative complications including surgical site events (SSEs) (surgical site infections [SSIs], surgical site occurrences [SSOs], and surgical site occurrence procedural interventions [SSOPIs]) were compared.Results: The unmatched sample included 521 patients. Of these, 139 patients were elderly (range 65-94 years). After PSM, 98 patients were assigned to each group.Intraoperative variables were similar. The non-elderly and elderly groups experienced similar complication rates during the first 90 days. SSEs (SSIs, SSOs, and SSOPIs) did not differ between the two groups.Conclusion: RVHR is safe and efficacious for patients aged 65 and over. Age alone need not be a prohibitive factor in determining patient selection for RVHR; however, it would be more beneficial to take into consideration other patient-related factors as well. K E Y W O R D S elderly, older adults, risk factors, robotic ventral hernia repair

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“…Although not yet scientifically proven, it may be that hernia sack resection included as a part of the method to diminish the dead space could reduce the seroma formation and possible further adverse events. The sack removal technique has been more commonly used in robotic hernia operations [27,28], where the instrumentation enables…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic versus hybrid approach for treatment of incisional ventral hernia: a prospective randomized multicenter study of 1-month follow-up results

Ahonen-Siirtola

Nevala

Vironen

et al. 2018

Hernia

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Standard laparoscopic versus robotic retromuscular ventral hernia repair

Cited by 123 publications

References 36 publications

Robotic‐assisted ventral hernia repair with surgical mesh: how I do it and case series of early experience

Robotic‐assisted ventral hernia repair with surgical mesh: how I do it and case series of early experience

Are elderly patients at high risk for postoperative complications after robotic ventral hernia repair? A propensity score matching analysis

Laparoscopic versus hybrid approach for treatment of incisional ventral hernia: a prospective randomized multicenter study of 1-month follow-up results

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