Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis...

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Health Economics

Background:

• Ventral hernia repair is a common surgical procedure.
• Robotic ventral hernia repair (RVHR) and laparoscopic ventral hernia repair (LVHR) are minimally invasive techniques.
• Comparing their outcomes and cost-effectiveness is crucial for clinical decision-making.

Purpose of the Study:

• To compare perioperative surgical outcomes and cost-effectiveness of RVHR versus LVHR with intraperitoneal mesh.
• To synthesize evidence from randomized controlled trials (RCTs) on RVHR and LVHR.

Main Methods:

• A meta-analysis of four RCTs involving 337 patients was conducted.
• Data on perioperative outcomes and costs were extracted and analyzed.
• Statistical analysis followed Cochrane Collaboration guidelines using RevMan 5 software.

Main Results:

• LVHR demonstrated shorter operation duration and lower costs compared to RVHR, though with significant statistical heterogeneity.
• No significant differences were observed between RVHR and LVHR regarding hernia recurrence and surgical site complications.
• Both hernia recurrence and surgical site complications showed no statistical heterogeneity between the two groups.

Conclusions:

• RVHR does not offer superiority over LVHR in terms of the evaluated perioperative variables.
• RVHR is not more cost-effective than LVHR based on current evidence.
• A large multi-center RCT is recommended to validate these findings due to limited RCTs and significant heterogeneity.