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Subcostal Specimen Removal in Completely Portal Robotic Lobectomy
Published on: April 19, 2024
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Patient-reported outcomes in robotic vs. open transversus abdominis release.
Bradley S Kushner1,2,3, Mikhail Attaar4, Arnab Majumder4
1Department of Surgery, Washington University School of Medicine, St. Louis, MO, 63110, USA. bkushner33@gmail.com.
Surgical Endoscopy
|September 4, 2025
Summary
Patients undergoing open or robotic transversus abdominis release (TAR) for large abdominal wall defects experience significant quality of life (QoL) improvements. Both surgical approaches yield comparable long-term QoL outcomes, offering reassurance for patient recovery.
Area of Science:
- Abdominal Wall Reconstruction
- Minimally Invasive Surgery
- Patient-Reported Outcomes
Background:
- Large abdominal wall defects often require complex surgical repair, with component separation and myofascial release techniques being common.
- Existing research primarily focuses on complication rates and operative variables, neglecting the crucial aspect of patient quality of life (QoL).
- Transversus abdominis release (TAR) is a key component in these repairs, but its impact on patient-reported outcomes requires further investigation.
Purpose of the Study:
- To compare patient-reported quality of life (QoL) improvements following open transversus abdominis release (O-TAR) versus robotic transversus abdominis release (R-TAR).
- To assess the impact of surgical approach on QoL using validated hernia-specific tools: Hernia-Related Quality-of-life Survey (HerQLes) and Carolinas Comfort Scale (CCS).
Main Methods:
- Prospective enrollment of patients undergoing elective bilateral O-TAR or R-TAR between 2019 and 2023.
- Collection of HerQLes scores preoperatively and at 7, 30, and 180 days postoperatively.
- Collection of CCS scores at 7, 30, and 180 days postoperatively to evaluate QoL changes.
Main Results:
- A total of 75 patients (49 O-TAR, 26 R-TAR) completed at least one survey.
- While initial HerQLes scores were higher in the O-TAR group, both cohorts reported similar average scores at 6 months (31.4 vs. 24.6, p=0.29).
- No significant differences were observed in the mean percent change of HerQLes or CCS scores between the O-TAR and R-TAR groups at various postoperative time points.
Conclusions:
- Both open and robotic TAR procedures lead to substantial improvements in patient-reported quality of life for large abdominal wall defects.
- The choice between O-TAR and R-TAR should be guided by patient-specific factors and hernia characteristics.
- Patients can expect significant QoL enhancement approximately 6 months after either open or robotic TAR surgery.
