N A Henriksen1, K K Jensen2, F Muysoms3. 1. Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark. nadiahenriksen@gmail.com. 2. Digestive Disease Center, Bispebjerg University Hospital, Copenhagen, Denmark. 3. Department of Suregery, Maria Middelares, Ghent, Belgium.
Abstract
PURPOSE: The number of robot-assisted hernia repairs is increasing, but the potential benefits have not been well described. The aim of this study was to evaluate the available literature reporting on outcomes after robot-assisted hernia repairs. METHODS: This is a qualitative review and meta-analysis of papers evaluating short-term outcomes after inguinal or ventral robot-assisted hernia repair compared with either open or laparoscopic approach. The primary outcome was postoperative complications and secondary outcomes were duration of surgery, postoperative length of stay and financial costs. RESULTS: Fifteen studies were included. Postoperative complications were significantly decreased after robot-assisted inguinal hernia repair compared with open repair. There were no differences in complications between robot-assisted and laparoscopic inguinal hernia repair. For ventral hernia repair, sutured closure of the defect, retromuscular mesh placement and transversus abdominis release is feasible when using the robot. Length of stay was decreased by a mean of 3 days for robot-assisted repairs compared with open approach. There were no differences in postoperative complications and the operative time was significantly longer for robot-assisted ventral hernia repair compared with laparoscopic or open approach. CONCLUSIONS: For ventral hernias that would normally require an open procedure, a robot-assisted repair may be a good option, as the use of a minimally invasive approach for these procedures decreases length of stay significantly. For inguinal hernias, the benefit of the robot is questionable. Randomized controlled trials and prospective studies are needed.
PURPOSE: The number of robot-assisted hernia repairs is increasing, but the potential benefits have not been well described. The aim of this study was to evaluate the available literature reporting on outcomes after robot-assisted hernia repairs. METHODS: This is a qualitative review and meta-analysis of papers evaluating short-term outcomes after inguinal or ventral robot-assisted hernia repair compared with either open or laparoscopic approach. The primary outcome was postoperative complications and secondary outcomes were duration of surgery, postoperative length of stay and financial costs. RESULTS: Fifteen studies were included. Postoperative complications were significantly decreased after robot-assisted inguinal hernia repair compared with open repair. There were no differences in complications between robot-assisted and laparoscopic inguinal hernia repair. For ventral hernia repair, sutured closure of the defect, retromuscular mesh placement and transversus abdominis release is feasible when using the robot. Length of stay was decreased by a mean of 3 days for robot-assisted repairs compared with open approach. There were no differences in postoperative complications and the operative time was significantly longer for robot-assisted ventral hernia repair compared with laparoscopic or open approach. CONCLUSIONS: For ventral hernias that would normally require an open procedure, a robot-assisted repair may be a good option, as the use of a minimally invasive approach for these procedures decreases length of stay significantly. For inguinal hernias, the benefit of the robot is questionable. Randomized controlled trials and prospective studies are needed.
Authors: Alfredo M Carbonell; Jeremy A Warren; Ajita S Prabhu; Conrad D Ballecer; Randy J Janczyk; Javier Herrera; Li-Ching Huang; Sharon Phillips; Michael J Rosen; Benjamin K Poulose Journal: Ann Surg Date: 2018-02 Impact factor: 12.969
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: Kathleen M Coakley; Stephanie M Sims; Tanushree Prasad; Amy E Lincourt; Vedra A Augenstein; Ronald F Sing; B Todd Heniford; Paul D Colavita Journal: Am J Surg Date: 2017-09-20 Impact factor: 2.565
Authors: A Aiolfi; M Cavalli; G Micheletto; F Lombardo; G Bonitta; A Morlacchi; P G Bruni; G Campanelli; D Bona Journal: Hernia Date: 2019-05-14 Impact factor: 4.739
Authors: Oscar A Olavarria; Karla Bernardi; Shinil K Shah; Todd D Wilson; Shuyan Wei; Claudia Pedroza; Elenir B Avritscher; Michele M Loor; Tien C Ko; Lillian S Kao; Mike K Liang Journal: BMJ Date: 2020-07-14