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Updated: Mar 3, 2026
Application of a New Mesh Fixation Method in Laparoscopic Incisional Hernia Repair
Published on: December 23, 2022
Laparoscopic vs Robotic Intraperitoneal Mesh Repair for Incisional Hernia: An Americas Hernia Society Quality
Ajita S Prabhu1, Eugene O Dickens2, Chad M Copper3
1Comprehensive Hernia Center, Digestive Disease and Surgical Institute, The Cleveland Clinic Foundation, Cleveland, OH.
Background:
Robotic intraperitoneal mesh placement (rIPOM) has emerged recently as an alternative to laparoscopic intraperitoneal mesh placement (LapIPOM) for minimally invasive incisional hernia repair. We aimed to compare LapIPOM with rIPOM in terms of hospital length of stay (LOS) and 30-day postoperative complications in patients undergoing incisional hernia repair within the Americas Hernia Society Quality Collaborative.
Study Design:
Propensity score analysis was used to compare matched groups of patients within the Americas Hernia Society Quality Collaborative undergoing LapIPOM vs rIPOM. The primary outcomes measure was hospital LOS and secondary outcomes were 30-day wound events.
Results:
Four hundred and fifty-four (71.9%) patients underwent LapIPOM and 177 (28.1%) underwent rIPOM. The laparoscopic group had an increased median LOS (1 vs 0 days; interquartile range 3.00; p < 0.001). The risk of surgical site occurrence was higher in the LapIPOM group vs the rIPOM group (14% vs 5%; p = 0.001); however, surgical site occurrence requiring procedural intervention was similar between the groups (1% vs 0%; p = 1). Operative time longer than 2 hours was more common in the rIPOM group (47% vs 31%; p < 0.05).
Conclusions:
Despite longer operative times using the rIPOM approach, patients undergoing rIPOM had a significantly shorter LOS than LapIPOM, without additional risk of wound morbidity requiring intervention. Additional studies are necessary to identify the best candidates for the rIPOM approach.
Insights
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.
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.
