Ascending the Learning Curve of Robotic Abdominal Wall Reconstruction

Halpern, David; Howell, Robert J.; Boinpally, Harika; Magadan-Alvarez, Cristina; Petrone, Patrizio; Brathwaite, Collin E.

doi:10.4293/jsls.2018.00084

Cited by 21 publications

(13 citation statements)

References 26 publications

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“…Robotic‐assisted retrorectus repair was reported by Abdalla et al for extraperitoneal access in 2012, 18 Warren et al for transabdominal access in 2017, 19 and Belyansky et al for eTEP access in 2018 20 . Robotic transabdominal single‐docking approach has been performed for 3.4–7 cm defect wide 21–24 …”

Section: Discussionmentioning

confidence: 99%

The first case of robotic‐assisted transabdominal retrorectus repair for incisional hernia in Japan

Shimada

Matsubara

Sanbonmatsu

et al. 2022

Asian J Endoscop Surgery

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Extraperitoneal mesh repair for ventral hernia has garnered attention and its rate has been increasing due to concerns for the potential complications of intraperitoneal mesh repair. Recently, robotic-assisted ventral hernia repair is highlighted as a solution to the technically demanding nature of laparoscopic transabdominal or enhanced-view totally extraperitoneal retrorectus ventral hernia repair. A 78-year-old man, who had undergone robot-assisted radical prostatectomy 10 months earlier, presented with an incisional hernia of European Hernia Society Classification M3W2, length 4 cm, width 5 cm with rectus diastasis. A right single-docking robotic-assisted transabdominal retrorectus repair was performed using a 21 by 14 cm self-gripping mesh and anterior wall reconstruction was done by 0 barbed nonabsorbable running suture.There were no complications and recurrence observed during a 7 months postoperative period. Single-docking robotic-assisted transabdominal retrorectus repair was considered a good option for midline moderate-size incisional hernias from the point of view of the ease of suturing, adequateness of dissection and prevention of bowel injury.

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Section: Discussionmentioning

confidence: 99%

The first case of robotic‐assisted transabdominal retrorectus repair for incisional hernia in Japan

Shimada

Matsubara

Sanbonmatsu

et al. 2022

Asian J Endoscop Surgery

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“…This finding is not related to a proportional occurrence of SSOPI between both groups. Few papers reported a SSOPI rate ranged from 4 to 6%, for the most part reported as interventional radiology guided drainage [9,16,19,20]. Few authors reported specific details regarding the nature of post-operative complications and there appeared to be broad distribution over various organ systems.…”

Section: Discussionmentioning

confidence: 99%

Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis

Bracale

Corcione

Neola

et al. 2021

Hernia

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Purpose To compare early postoperative outcomes after transversus abdominis release (TAR) for ventral hernia repair with open (oTAR) and robotic (rTAR) approach. Methods A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Web of Science databases was conducted to identify comparative studies until October 2020. A meta-analysis of postoperative short-term outcomes was performed including complications rate, operative time, length of stay, surgical site infection (SSI), surgical site occurrence (SSO), SSO requiring intervention (SSOPI), systemic complications, readmission, and reoperation rates as measure outcomes. Results Six retrospective studies were included in the analysis with a total of 831 patients who underwent rTAR (n = 237) and oTAR (n = 594). Robotic TAR was associated with lower risk of complications rate (9.3 vs 20.7%, OR 0.358, 95% CI 0.218–0.589, p < 0.001), lower risk of developing SSO (5.3 vs 11.5%, OR 0.669, 95% CI 0.307–1.458, p = 0.02), lower risk of developing systemic complications (6.3 vs 26.5%, OR 0.208, 95% CI 0.100–0.433, p < 0.001), shorter hospital stay (SMD − 4.409, 95% CI − 6.000 to − 2.818, p < 0.001) but longer operative time (SMD 53.115, 95% CI 30.236–75.993, p < 0.01) compared with oTAR. There was no statistically significant difference in terms of SSI, SSOPI, readmission, and reoperation rates. Conclusion Robotic TAR improves recovery by adding the benefits of minimally invasive procedures when compared to open surgery. Although postoperative complications appear to decrease with a robotic approach, further studies are needed to support the real long-term and cost-effective advantages.

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“…Since the first report of robot-assisted modified Rives/ Stoppa for the treatment of midline hernias in 2012, 16 several further series have been published. [2][3][4][5][6][7][8][17][18][19][20][21][22][23] When the port placement sites are described, the trocars are inserted quite lateral through the abdominal wall, to enable the necessary working space and, in large hernias, perform a double-docking. Only Sharbaugh et al 7 describe an "inferior port placement" for the treatment of epigastric hernias.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted treatment of epigastric hernias with a suprapubic approach

Pini

Giuseppe

Toti

et al. 2020

Preprint

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BackgroundRobotic ventral hernia repair has shown itself to be feasible and safe in abdominal wall surgery. Presently, the ports are commonly placed laterally to meet the distance from the fascial defect. The aim of our study is to reort our experience of epigastric hernias treatment with the trocars’ insertion in the suprapubic region.MethodsA retrospective search on a prospectively collected dataset was performed to identify patients treated for primary or incisional hernias of the epigastric region with a robotic-assisted approach. In all cases, three 8-mm trocars were inserted in the suprapubic area and the preperitoneal or the posterior rectus sheath spaces dissected to ensure a proper mesh overlap. After hernia reduction, the fascia was closed with a running suture, the mesh placed and the peritoneum sutured.ResultsTwelve patients were selected. Median age was 58.5 years (interquartile range (IQR) 47.8–67.3) and four patients were male (33.3%). All patients were referred to surgery because of pain. The median measure of the hernia defect was 30 mm (IQR 13.75-31), median larger mesh diameter was 13.5 cm (IQR 9.5–15.0) and median operative time was 136.5 minutes (IQR 120-186.5). No intraoperative complication or conversion to open surgery occurred. Postoperatively, two patients presented a seroma and the median length of hospital stay was 2.0 days (IQR 1.75-3).ConclusionsIn the robot-assisted treatment of hernias of the epigastric region, a suprapubic port placement can be considered instead of a lateral one. Further studies are needed to assess the benefits and limitations of such technique.Trial registrationRetrospectively registered (Comitato Etico Cantonale Ticino n. 2019-01132 CE3495)

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Ascending the Learning Curve of Robotic Abdominal Wall Reconstruction

Cited by 21 publications

References 26 publications

The first case of robotic‐assisted transabdominal retrorectus repair for incisional hernia in Japan

The first case of robotic‐assisted transabdominal retrorectus repair for incisional hernia in Japan

Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis

Robot-assisted treatment of epigastric hernias with a suprapubic approach

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