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Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial.
Oscar A Olavarria1,2, Karla Bernardi3,2, Shinil K Shah3,4
1Department of Surgery, Lyndon B. Johnson General Hospital, McGovern Medical School at UTHealth, Houston, TX 77026, USA oscarolavarria@hotmail.com.
BMJ (Clinical Research Ed.)
|July 16, 2020
Summary
Robotic ventral hernia repair showed no difference in hospital days compared to laparoscopic repair. However, robotic surgery led to longer operating times and higher healthcare costs, with a lower reported quality of life improvement.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Hernia Repair
Background:
- Ventral hernia repair is a common surgical procedure.
- Minimally invasive techniques, including robotic and laparoscopic approaches, are increasingly utilized.
- Comparative effectiveness data are crucial for guiding surgical choices.
Purpose of the Study:
- To compare the 90-day postoperative hospital stay between robotic and laparoscopic ventral hernia repair.
- To evaluate secondary outcomes such as operative time, complications, recurrence, quality of life, and costs.
Main Methods:
- A pragmatic, blinded randomized controlled trial was conducted.
- 124 patients undergoing elective minimally invasive ventral hernia repair were randomized to robotic (n=65) or laparoscopic (n=59) repair.
- Outcomes were analyzed on an intention-to-treat basis, with pre-specified outcomes.
Main Results:
- No significant difference was observed in 90-day hospital days between robotic and laparoscopic repair (median 0 vs 0 days).
- Robotic repair was associated with significantly longer operative duration (141 vs 77 min) and increased healthcare costs.
- Laparoscopic repair demonstrated a greater improvement in abdominal wall quality of life at one month post-surgery.
Conclusions:
- Robotic ventral hernia repair does not reduce postoperative hospital days compared to laparoscopic repair.
- Robotic repair is associated with increased operative time and healthcare expenditure.
- Laparoscopic ventral hernia repair may offer advantages in terms of quality of life improvement and cost-effectiveness.
