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Laparoscopic Versus Robotic Ventral Hernia Repair - An ACHQC Database 5-Year Analysis
Diego L Lima1, Raquel Nogueira1, Joao P G Kasakewich2
1Department of Surgery, Montefiore Medical Center, The Bronx, NY, United States.
Journal of Abdominal Wall Surgery : JAWS
|March 26, 2025
Summary
Robotic ventral hernia repair (VHR) involves more complex cases but shows similar postoperative complication rates compared to laparoscopic VHR. This study analyzed 11,096 VHR procedures from the Abdominal Core Health Quality Collaborative database. Both approaches demonstrated comparable outcomes.
Area of Science:
- Minimally Invasive Surgery
- Abdominal Wall Reconstruction
- Surgical Outcomes Research
Background:
- Ventral hernia repair (VHR) is a common surgical procedure.
- Laparoscopic and robotic approaches are increasingly utilized for VHR.
- Comparative data on outcomes between these approaches are essential for clinical decision-making.
Purpose of the Study:
- To compare outcomes of laparoscopic ventral hernia repair (LVHR) versus robotic ventral hernia repair (RVHR).
- To analyze perioperative and postoperative outcomes using the Abdominal Core Health Quality Collaborative (ACHQC) database.
Main Methods:
- Retrospective review of prospectively collected data from the ACHQC database (2018-2023).
- Inclusion of adult patients undergoing laparoscopic or robotic VHR with mesh.
- Univariate analysis to compare outcomes between LVHR and RVHR groups.
Main Results:
- 11,096 VHR cases analyzed: 2,063 laparoscopic (LAP) and 9,033 robotic (ROBO).
- Robotic repairs were associated with larger hernia width, higher rates of incisional and recurrent hernias, and increased use of retromuscular repair and Transversus Abdominis Release (TAR).
- Despite longer operative times in the robotic group, no significant differences were observed in 30-day readmission rates, recurrence, reoperation, or overall postoperative complications.
Conclusions:
- Robotic VHR is often employed for more technically challenging cases.
- Both laparoscopic and robotic VHR demonstrate comparable postoperative complication rates.
- The choice of approach may depend on case complexity and surgeon preference, with similar safety profiles observed.
