Nationwide Readmissions Analysis of Minimally Invasive Versus Open Ventral Hernia Repair: A Retrospective Population-Based Study

Ayuso, Sullivan A.; M, Katzen; Aladegbami, Bola; Nayak, Raageswari B.; Augenstein, Vedra A.; Colavita, Paul D.

doi:10.1177/00031348211050835

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…Most studies report that RVHR incurs higher costs and longer operative times compared to other approaches, being significantly higher than LVHR. 6,[15][16][17][19][20][21][23][24][25][26][27]29,[32][33][34][36][37][38]41,42,44,46,[48][49][50] The costs of robotic systems, software, equipment and maintenance outweigh that of laparoscopic and open surgery. These costs may be offset with reduced hospital costs associated with LOS and complications.…”

Section: Discussionmentioning

confidence: 99%

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Systematic review of robotic ventral hernia repair with meta‐analysis

Tran,

Sun,

Gundara

2023

ANZ Journal of Surgery

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BackgroundDespite being one of the most common operations performed by general surgeons, there is a lack of consensus regarding the recommended approach for ventral hernia repair (VHR). Recent times have seen the rapid development of new techniques, such as robotic ventral hernia repair (RVHR). This systematic review and meta‐analysis aims to evaluate the currently available evidence relating to RVHR, in comparison to open VHR (OVHR) and laparoscopic VHR (LVHR).MethodsA systematic search of the following databases was conducted: PubMed, Embase, Scopus and Web of Science. A meta‐analysis was performed for the outcomes of length of stay (LOS), recurrence, operative time, intraoperative complications, wound complications, 30‐day readmission, 30‐day reoperation, mortality and costs.ResultsA total of 39 studies met inclusion criteria. Overall, RVHR reduced LOS, intra‐operative complications, wound complications and readmission compared to OVHR. Compared to LVHR, RVHR was associated with increased operative time and costs, with comparable clinical outcomes.ConclusionThere is currently a lack of robust evidence to support the robotic approach in VHR. It does not demonstrate major benefits in comparison to LVHR, which is more affordable and accessible. Strong quality, long‐term data is required to help with establishing a gold standard approach in VHR.

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Section: Discussionmentioning

confidence: 99%

“…Most studies report that RVHR incurs higher costs and longer operative times compared to other approaches, being significantly higher than LVHR 6,15–17,19–21,23–27,29,32–34,36–38,41,42,44,46,48–50 . The costs of robotic systems, software, equipment and maintenance outweigh that of laparoscopic and open surgery.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of robotic ventral hernia repair with meta‐analysis

Tran,

Sun,

Gundara

2023

ANZ Journal of Surgery

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“…Indeed, studies comparing open and laparoscopic ventral hernia repair generally demonstrate similar recurrence rates and improved short-term outcomes such as shorter length of stay (LOS) and lower 90-day readmission rates with a minimally invasive approach, even in patients with obesity [9,10]. There is also some evidence that laparoscopic and RVHR have similar safety pro les [11], though less is known about the impact of obesity on RVHR outcomes.…”

Section: Introductionmentioning

confidence: 99%

Comparison of short-term outcomes following robotic ventral hernia repair in patients with obesity: a review of 9,742 patients from the Abdominal Core Health Quality Collaborative database

Taylor,

Lopez-Canizares,

Valor

et al. 2024

Preprint

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Background Despite the paucity of evidence on robotic ventral hernia repair (RVHR) in patients with obesity, the robotic platform is being used more frequently in hernia surgery. The impact of obesity on RVHR outcomes has not been thoroughly studied. Obesity is considered a major risk factor for the development of recurrent ventral hernias and postoperative complications; however, we hypothesize that patients undergoing robotic repairs will have similar complication profiles despite their body mass index (BMI). Study design: We performed a retrospective analysis of patients ages 18–90 years who underwent RVHR between 2013–2023 using data from the Abdominal Core Health Quality Collaborative registry. Preoperative, intraoperative, and postoperative characteristics were compared in non-obese and obese groups, determined using a univariate and logistic regression analysis to compare short-term outcomes. Results The registry identified 9,742 patients; 3,666 were non-obese; 6,076 were classified as obese (BMI > 30 kg/m2). There was an increased odds of surgical site occurrence in patients with obesity, mostly seroma formation; however, obesity was not a significant factor for a complication requiring a procedural intervention after RVHR. In contrast, the hernia-specific quality of life scores significantly improved following surgery for all patients, with those with obesity having more substantial improvement from baseline. Conclusion Obesity does increase the risk of complications following RVHR in a BMI-dependent fashion on sub-analysis; however, the odds of requiring a procedural intervention are not significantly increased by BMI. Patients with obesity have a significant improvement in their quality of life, and RVHR should be carefully considered in this population.

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“…Since the introduction, surgeons worldwide are using the robotic approach for an increasing amount of abdominal wall procedures and the indication for robotic repair, thus, widens. One key advantage of robotic ventral hernia repair seems to be a reduced length of post-operative hospital stay, which can be compared to the enhanced recovery after various other surgical procedures when traditional open surgery was replaced by minimally invasive approaches [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Enhanced recovery after robotic ventral hernia repair: factors associated with overnight stay in hospital

Marckmann,

Krarup,

Henriksen

et al. 2023

Hernia

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Purpose Enhanced recovery after surgery (ERAS) protocols lead to reduced post-operative stay and improved outcomes after most types of abdominal surgery. Little is known about the optimal post-operative protocol after robotic ventral hernia repair (RVHR), including the potential limits of outpatient surgery. We report the results of an ERAS protocol after RVHR aiming to identify factors associated with overnight stay in hospital, as well as patient-reported pain levels in the immediate post-operative period. Methods This was a prospective cohort study of consecutive patients undergoing RVHR. Patients were included in a prospective database, registering patient characteristics, operative details, pain and fatigue during the first 3 post-operative days and pre- and 30-day post-operative hernia-related quality of life, using the EuraHS questionnaire. Results A total of 109 patients were included, of which 66 (61%) underwent incisional hernia repair. The most performed procedure was TARUP (robotic transabdominal retromuscular umbilical prosthetic hernia repair) (60.6%) followed by bilateral roboTAR (robotic transversus abdominis release) (19.3%). The mean horizontal fascial defect was 4.8 cm, and the mean duration of surgery was 141 min. In total, 78 (71.6%) patients were discharged on the day of surgery, and factors associated with overnight stay were increasing fascial defect area, longer duration of surgery, and transverse abdominis release. There was no association between post-operative pain and overnight hospital stay. The mean EuraHS score decreased significantly from 38.4 to 6.4 (P < 0.001). Conclusion An ERAS protocol after RVHR was associated with a high rate of outpatient procedures with low patient-reported pain levels.

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Nationwide Readmissions Analysis of Minimally Invasive Versus Open Ventral Hernia Repair: A Retrospective Population-Based Study

Cited by 11 publications

References 22 publications

Systematic review of robotic ventral hernia repair with meta‐analysis

Systematic review of robotic ventral hernia repair with meta‐analysis

Comparison of short-term outcomes following robotic ventral hernia repair in patients with obesity: a review of 9,742 patients from the Abdominal Core Health Quality Collaborative database

Enhanced recovery after robotic ventral hernia repair: factors associated with overnight stay in hospital

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