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Laparoscopic vs Robotic Intraperitoneal Mesh Repair for Incisional Hernia: An Americas Hernia Society Quality

Ajita S Prabhu1, Eugene O Dickens2, Chad M Copper3

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Journal of the American College of Surgeons
|April 29, 2017
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Summary

Robotic intraperitoneal mesh placement (rIPOM) offers shorter hospital stays for incisional hernia repair compared to laparoscopic methods (LapIPOM), with similar complication rates. Further research is needed to identify optimal candidates for rIPOM.

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Area of Science:

  • Minimally Invasive Surgery
  • Hernia Repair
  • Surgical Technology

Background:

  • Robotic intraperitoneal mesh placement (rIPOM) is a novel approach for minimally invasive incisional hernia repair.
  • It is compared against the established laparoscopic intraperitoneal mesh placement (LapIPOM) technique.
  • The study utilizes data from the Americas Hernia Society Quality Collaborative.

Purpose of the Study:

  • To compare robotic intraperitoneal mesh placement (rIPOM) versus laparoscopic intraperitoneal mesh placement (LapIPOM).
  • To evaluate differences in hospital length of stay (LOS) and 30-day postoperative complications.
  • To assess the safety and efficacy of rIPOM in incisional hernia repair.

Main Methods:

  • A propensity score analysis was employed to match patients undergoing LapIPOM and rIPOM.
  • The primary outcome was hospital length of stay (LOS).
  • Secondary outcomes included 30-day wound events and surgical site occurrences.

Main Results:

  • Robotic intraperitoneal mesh placement (rIPOM) was associated with a significantly shorter hospital length of stay (0 days) compared to laparoscopic intraperitoneal mesh placement (LapIPOM) (1 day).
  • The overall risk of surgical site occurrence was lower in the rIPOM group (5%) versus the LapIPOM group (14%).
  • Operative times exceeding two hours were more frequent in the rIPOM group (47%) than the LapIPOM group (31%).

Conclusions:

  • Robotic intraperitoneal mesh placement (rIPOM) leads to shorter hospital stays for incisional hernia repair compared to LapIPOM.
  • rIPOM does not increase the risk of wound complications requiring intervention, despite longer operative times.
  • Further investigation is warranted to determine the ideal patient selection for the rIPOM approach.