Ajita S Prabhu1, Eugene O Dickens2, Chad M Copper3, John W Mann4, Jonathan P Yunis5, Sharon Phillips6, Li-Ching Huang6, Benjamin K Poulose7, Michael J Rosen8. 1. Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH. Electronic address: prabhua@ccf.org. 2. Department of Surgery, University of Oklahoma, Tulsa, OK. 3. Department of Surgery, Northeast Georgia Medical Center, Gainesville, GA. 4. Department of Surgery, Novant Health Medical Park Hospital, Winston-Salem, NC. 5. Department of Surgery, Sarasota Memorial Hospital, Sarasota, FL. 6. Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN. 7. The Vanderbilt Hernia Center, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN. 8. Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH.
Abstract
BACKGROUND: Robotic intraperitoneal mesh placement (rIPOM) has emerged recently as an alternative to laparoscopic intraperitoneal mesh placement (LapIPOM) for minimally invasive incisional hernia repair. We aimed to compare LapIPOM with rIPOM in terms of hospital length of stay (LOS) and 30-day postoperative complications in patients undergoing incisional hernia repair within the Americas Hernia Society Quality Collaborative. STUDY DESIGN: Propensity score analysis was used to compare matched groups of patients within the Americas Hernia Society Quality Collaborative undergoing LapIPOM vs rIPOM. The primary outcomes measure was hospital LOS and secondary outcomes were 30-day wound events. RESULTS: Four hundred and fifty-four (71.9%) patients underwent LapIPOM and 177 (28.1%) underwent rIPOM. The laparoscopic group had an increased median LOS (1 vs 0 days; interquartile range 3.00; p < 0.001). The risk of surgical site occurrence was higher in the LapIPOM group vs the rIPOM group (14% vs 5%; p = 0.001); however, surgical site occurrence requiring procedural intervention was similar between the groups (1% vs 0%; p = 1). Operative time longer than 2 hours was more common in the rIPOM group (47% vs 31%; p < 0.05). CONCLUSIONS: Despite longer operative times using the rIPOM approach, patients undergoing rIPOM had a significantly shorter LOS than LapIPOM, without additional risk of wound morbidity requiring intervention. Additional studies are necessary to identify the best candidates for the rIPOM approach.
BACKGROUND: Robotic intraperitoneal mesh placement (rIPOM) has emerged recently as an alternative to laparoscopic intraperitoneal mesh placement (LapIPOM) for minimally invasive incisional hernia repair. We aimed to compare LapIPOM with rIPOM in terms of hospital length of stay (LOS) and 30-day postoperative complications in patients undergoing incisional hernia repair within the Americas Hernia Society Quality Collaborative. STUDY DESIGN: Propensity score analysis was used to compare matched groups of patients within the Americas Hernia Society Quality Collaborative undergoing LapIPOM vs rIPOM. The primary outcomes measure was hospital LOS and secondary outcomes were 30-day wound events. RESULTS: Four hundred and fifty-four (71.9%) patients underwent LapIPOM and 177 (28.1%) underwent rIPOM. The laparoscopic group had an increased median LOS (1 vs 0 days; interquartile range 3.00; p < 0.001). The risk of surgical site occurrence was higher in the LapIPOM group vs the rIPOM group (14% vs 5%; p = 0.001); however, surgical site occurrence requiring procedural intervention was similar between the groups (1% vs 0%; p = 1). Operative time longer than 2 hours was more common in the rIPOM group (47% vs 31%; p < 0.05). CONCLUSIONS: Despite longer operative times using the rIPOM approach, patients undergoing rIPOM had a significantly shorter LOS than LapIPOM, without additional risk of wound morbidity requiring intervention. Additional studies are necessary to identify the best candidates for the rIPOM approach.
Authors: J D Thomas; C K Gentle; D M Krpata; A S Prabhu; A Fafaj; S J Zolin; S E Phillips; S Rosenblatt; M J Rosen; C C Petro Journal: Hernia Date: 2022-01-30 Impact factor: 2.920
Authors: Peter A Walker; Audriene C May; Jiandi Mo; Deepa V Cherla; Monica Rosales Santillan; Steven Kim; Heidi Ryan; Shinil K Shah; Erik B Wilson; Shawn Tsuda Journal: Surg Endosc Date: 2018-02-06 Impact factor: 4.584
Authors: S A Ayuso; J M Shao; E B Deerenberg; S A Elhage; M B George; B T Heniford; V A Augenstein Journal: Hernia Date: 2020-11-13 Impact factor: 4.739