Robotic trans-abdominal retromuscular hernia repair: mid-term outcomes and Surgical Site Occurrence (SSO) analysis in 120 patients

Abstract

Background Robotic surgery has become a popular method for treating ventral hernias due to its promising perioperative outcomes. However, the long-term results of this approach are still unclear. In this study, 120 patients underwent robotic trans-abdominal retromuscular mesh placement (r-TARM) with a mean follow-up period of 18.1 months. This study aims to evaluate the feasibility of the robotic approach reporting peri-operative and mid-term outcomes. Additionally, we examined possible risk factors that may contribute to the development of surgical site occurrences (SSOs). Methods Between January 2021 and September 2023, 120 patients underwent r-TARM for midline hernias, including 39 primary, 71 incisional, and 10 recurrent cases. A retrospective analysis was performed. A logistic regression model was used to identify possible patient risk factors for SSO’s development. Results The average operative time was 153.5 ± 47.2 minutes, and there were no open or laparoscopic approach conversions. The mean length of hospital stay was 1.9 ± 0.9. We observed SSO in 16 patients (13.3%). One patient (0.8%) required angiographic embolization due to post-operative parietal bleeding. The mean follow-up time was 18.1 ± 7.8 months, and we observed hernia recurrence in only 1 (0.8%) patient. The logistic regression model did not identify any possible risk factors for SSO. Conclusions r-TARM is a safe and effective method for treating ventral hernias not requiring posterior component separation. Our results indicate that patient and hernia characteristics were not predictive of SSO. Mid-term outcomes are encouraging, though longer follow-up is needed.