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Robotic intraperitoneal onlay mesh (rIPOM) and enhanced-view totally extraperitoneal (eTEP) repairs for ventral hernias showed similar postoperative pain. rIPOM offered shorter operative times and less surgeon workload compared to eTEP.

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Area of Science:

  • Minimally Invasive Surgery
  • Surgical Technology
  • Hernia Repair

Background:

  • Robotic intraperitoneal onlay mesh (rIPOM) and enhanced-view totally extraperitoneal (eTEP) are robotic techniques for ventral hernia repair.
  • The study investigated if avoiding mesh fixation in eTEP reduces postoperative pain compared to rIPOM.

Purpose of the Study:

  • To compare early postoperative pain between robotic eTEP and rIPOM for ventral hernia repair.
  • To evaluate secondary outcomes including length of stay, opioid consumption, and quality of life.

Main Methods:

  • A multi-center, randomized clinical trial involving 100 patients with midline ventral hernias (≤7 cm).
  • Patients were randomized to either rIPOM or robotic eTEP.
  • Primary outcome was postoperative pain on the first day; secondary outcomes included same-day discharge, length of stay, opioid use, and quality of life.

Main Results:

  • Postoperative pain on the first day was similar between rIPOM and eTEP groups (p=0.66).
  • No significant differences were observed in pain at other time points, same-day discharge, length of stay, or quality of life.
  • rIPOM demonstrated significantly shorter operative times (p<0.001), reduced surgeon workload (p<0.001), and fewer surgical site occurrences (p=0.004) compared to eTEP.

Conclusions:

  • Avoiding mesh fixation in robotic eTEP did not provide a significant advantage in early postoperative pain compared to rIPOM.
  • rIPOM offers benefits of shorter operative time and reduced surgeon workload, making it a favorable option for ventral hernia repair.