Trends and outcomes of open, laparoscopic, and robotic inguinal hernia repair in the veterans affairs system

Holleran, Timothy J.; Napolitano, Michael A.; Sparks, Andrew; Duncan, James E.; Garrett, Melissa; Brody, Fred

doi:10.1007/s10029-021-02419-3

Cited by 15 publications

(10 citation statements)

References 41 publications

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“…1). Of these, nine studies published between 2010 and 2021 were found to be eligible for data extraction and were therefore included in the meta-analyses [4,5,8,[10][11][12][13][14][15]. A total of 62,426 patients who underwent RHR (n = 7589) or LHR (n = 54,837) from 2010 to 2021 were identified.…”

Section: Literature Search Resultsmentioning

confidence: 99%

“…Only one multicenter randomized controlled trial was included [ 14 ]. One study analyzed the data which were extracted from an administrative database of the state of New York [ 15 ]; two studies exploited quality improvement databases [ 5 , 8 ] while Pokala et al queried a multi-institutional clinical database [ 13 ]. The remaining four studies were single-center comparative analyses.…”

Section: Resultsmentioning

confidence: 99%

“…Only three studies reported a follow-up of at least 1 year to evaluate late complications or recurrence [ 4 , 11 , 15 ]. The remaining six studies [ 5 , 8 , 10 , 12 – 14 ] reported short-term outcomes within the 30th postoperative day.…”

Section: Resultsmentioning

confidence: 99%

“…However, only a few studies comparing the laparoscopic and the robotic approach have been published [4][5][6][7][8][9][10][11][12][13][14][15][16]. The majority of them were characterized by small sample size, especially in the robotic arm, [6,7,9,16,17], limiting the power and, thus, the generalizability, of the studies.…”

Section: Introductionmentioning

confidence: 99%

“…Since then, several studies on the comparison between the robotic and the laparoscopic approach to repair inguinal hernia have been published adding further evidence on the topic. They included the first randomized controlled trial [ 14 ] and the two largest comparative studies [ 8 , 15 ] for a total of 6670 additional robotic inguinal hernia repairs which could be analyzed for more representative pooled outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Robotic versus laparoscopic inguinal hernia repair: an updated systematic review and meta-analysis

et al. 2021

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The aim of this study was to review the latest evidence on the robotic approach (RHR) for inguinal hernia repair comparing the pooled outcome of this technique with those of the standard laparoscopic procedure (LHR). A systematic literature search was performed in PubMed, Web of Science and Scopus for studies published between 2010 and 2021 concerning the comparison between RHR versus LHR. After screening 582 articles, 9 articles with a total of 64,426 patients (7589 RHRs) were eligible for inclusion. Among preoperative variables, a pooled higher ratio of ASA > 2 patients was found in the robotic group (12.4 vs 8.6%, p < 0.001). Unilateral hernia repair was more common in the laparoscopic group (79.9 vs 68.1, p < 0.001). Overall, operative time was longer in the robotic group (160 vs 90 min, p < 0.001); this was confirmed also in the sub-analysis on unilateral procedures (88 vs 68 min, p = 0.040). The operative time for robotic bilateral repair was similar to the laparoscopic one (111 vs 100, p = 0.797). Conversion to open surgery was 0% in the robotic group. The pooled rate of chronic pain and postoperative complications was similar between the groups. The standardized mean difference MD of the costs between LHR versus RHR was − 3270$ (95% CI – 4757 to − 1782, p < 0.001). In conclusion, laparoscopic and robotic inguinal hernia repair have similar safety parameters and postoperative outcomes. Robotic approach may require longer operative time if the unilateral repair is performed. Costs are higher in the robotic group.

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