Short-term outcomes after open versus robot-assisted repair of ventral hernias: a nationwide database study

Abstract

Purpose The robotic platform is widely implemented; however, evidence evaluating outcomes of robotic ventral hernia repair is still lacking. The aim of the study was to evaluate the short-term outcomes after open and robot-assisted repair of primary ventral and incisional hernias. Methods Nationwide register-based cohort study with data from the Danish Ventral Hernia Database and the National Danish Patients Registry was from January 1, 2017 to August 22, 2022. Robot-assisted ventral hernia repairs were propensity score matched 1:3 with open repairs according to the confounding variables defect size, Charlson comorbidity index score, and age. Logistic regression analyses were performed for factors associated with length of stay > 2 days, readmission, and reoperation within 90 days. Results A total of 528 and 1521 patients underwent robot-assisted and open repair, respectively. The mean length of hospital stay in days was 0.5 versus 2.1 for robot-assisted and open approach, respectively (P < 0.001) and open approach was correlated with risk of length of stay > 2 days (OR 23.25, CI 13.80–39.17, P < 0.001). The incidence of readmission within 90 days of discharge was significantly lower after robot-assisted repair compared to open approach (6.2% vs. 12.1%, P < 0.001). Open approach was independently associated with increased risk of readmission (OR 21.43, CI 13.28–39.17, P = 0.005, P < 0.001). Conclusion Robot-assisted ventral hernia repair is safe and feasible and associated with shorter length of stay and decreased risk of readmission compared with open ventral hernia repair.

Robotic Assisted Hernia Repair in Four Nordic Countries - Status and Challenges

“…Although some studies show no significant differences, data from the Nordic countries indicate that robotic-assisted hernia surgery for ventral hernia reduces postoperative pain, shortens hospital stay, accelerates recovery time and ultimately improves patient satisfaction and quality of life compared to open and laparoscopic approaches; [ 3 , 5 , 7 – 11 ]. The outcomes of robotic-assisted inguinal hernia repair are excellent and comparable with the traditional laparoscopic methods [ 12 , 13 ].…”

“…However, recent registry and single-centre studies have shown that robotic-assistedhernia repair has emerged as a promising alternative, providing benefits such as improved precision, reduced invasiveness, and better outcomes in terms of less pain, fewer wound complications and a shorter length of stay [ 3 – 5 ]. Therefore, the integration of robotic hernia surgery represents a significant opportunity to improve surgical practice and patient experience.…”