Ramkumar Mohan1, Marcus Yeow1, Joel Yat Seng Wong1, Nicholas Syn1, Sujith Wijerathne2,3, Davide Lomanto4,5. 1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 2. Department of Surgery, Minimally Invasive Surgical Centre, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore. 3. Department of Surgery, Alexandra Hospital, Singapore, Singapore. 4. Department of Surgery, Minimally Invasive Surgical Centre, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore. davide_lomanto@nuhs.edu.sg. 5. Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. davide_lomanto@nuhs.edu.sg.
Abstract
PURPOSE: There has not been a consensus on the superiority of a surgical approach for minimally invasive ventral hernia repair. This systematic review and meta-analysis (SRMA) aims to compare clinical, and patient-reported outcomes of robotic-assisted ventral hernia repair (rVHR) to traditional endo-laparoscopic ventral hernia repair (lapVHR). METHODS: We searched PubMed, EMBASE, Cochrane and Scopus from inception to 16th March 2021. We selected randomised controlled trials and propensity score matched studies comparing rVHR to lapVHR. A meta-analysis was done for the outcomes of operative time, length of hospital stay, open conversion, recurrence, surgical site occurrence and cost. RESULTS: A total of 5 studies (3732 patients) were included in the qualitative and quantitative synthesis. Significantly shorter operative times were reported with the lapVHR as compared to rVHR (weighted mean difference (WMD): 62.52, 95% CI: 50.84-74.19). There was also significantly less rates of open conversion with rVHR as compared to lapVHR (WMD: 0.22, 95% CI: 0.09-0.54). No significant differences in patient-reported outcomes that was discernible from the two papers that reported them. CONCLUSION: Overall, rVHR is comparable to lapVHR with longer operative times but less open conversion. It is, therefore, important to have proper patient selection to maximise the utility of rVHR.
PURPOSE: There has not been a consensus on the superiority of a surgical approach for minimally invasive ventral hernia repair. This systematic review and meta-analysis (SRMA) aims to compare clinical, and patient-reported outcomes of robotic-assisted ventral hernia repair (rVHR) to traditional endo-laparoscopic ventral hernia repair (lapVHR). METHODS: We searched PubMed, EMBASE, Cochrane and Scopus from inception to 16th March 2021. We selected randomised controlled trials and propensity score matched studies comparing rVHR to lapVHR. A meta-analysis was done for the outcomes of operative time, length of hospital stay, open conversion, recurrence, surgical site occurrence and cost. RESULTS: A total of 5 studies (3732 patients) were included in the qualitative and quantitative synthesis. Significantly shorter operative times were reported with the lapVHR as compared to rVHR (weighted mean difference (WMD): 62.52, 95% CI: 50.84-74.19). There was also significantly less rates of open conversion with rVHR as compared to lapVHR (WMD: 0.22, 95% CI: 0.09-0.54). No significant differences in patient-reported outcomes that was discernible from the two papers that reported them. CONCLUSION: Overall, rVHR is comparable to lapVHR with longer operative times but less open conversion. It is, therefore, important to have proper patient selection to maximise the utility of rVHR.
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