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Laparoscopic Intraperitoneal Onlay Mesh Versus Robotic Retromuscular for Small- and Medium-Sized Ventral Hernia
Augusto Graziani E Sousa1, Yasmin Biscola da Cruz2, Júlia Copetti Burmann3
1Centro Universitário de Anápolis, Anápolis, Brazil.
Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|September 5, 2025
Summary
This meta-analysis found that laparoscopic intraperitoneal onlay mesh (IPOM) and robotic retromuscular (RM) hernia repair techniques show similar postoperative outcomes for small and medium ventral hernias. Further research is needed to fully understand the role of these surgical methods.
Area of Science:
- Minimally Invasive Surgery
- Hernia Repair Techniques
- Surgical Outcomes Research
Background:
- Ventral hernia repair (VHR) is a common surgical procedure.
- Laparoscopic intraperitoneal onlay mesh (IPOM) and robotic retromuscular (RM) are established VHR techniques.
- Comparative outcome data for these techniques in small to medium ventral hernias is limited.
Purpose of the Study:
- To systematically review and meta-analyze outcomes comparing laparoscopic IPOM versus robotic RM for small/medium ventral hernia repair.
- To assess key postoperative metrics including length of stay, infection, readmission, and reoperation rates.
Main Methods:
- Systematic literature search of PubMed, Cochrane, and Embase databases.
- Inclusion of retrospective observational studies comparing laparoscopic IPOM and robotic RM techniques.
- Statistical analysis using a random-effects model in R Studio (version 4.4.1).
Main Results:
- Analysis of 3 studies with 1351 patients (882 laparoscopic IPOM, 469 robotic RM).
- No significant differences found in length of stay (P=.08), surgical site infection (P=.85), or surgical site occurrence (P=.94).
- Comparable rates for readmission (P=.21) and reoperation (P=.74) between the two techniques.
Conclusions:
- Laparoscopic IPOM and robotic RM techniques demonstrate similar postoperative outcomes for small and medium ventral hernia repair.
- Current evidence suggests no significant advantage of one technique over the other for the studied endpoints.
- Further prospective studies are warranted to definitively establish the role of each operative method in VHR.
