Safety and feasibility of robotic component separation for ventral hernia repair: first Korean multi-center...

Robotic component separation techniques have revolutionized complex ventral hernia repair, offering advantages of minimally invasive surgery. However, outcome data from Asian populations remain scarce. This study reports the first multi-center evaluation of robotic component separation techniques in Korea.

This retrospective multi-center cohort study included 60 patients undergoing robotic ventral hernia repair at three Korean tertiary institutions between January and December 2024. Surgical techniques comprised enhanced total extraperitoneal (eTEP), transversus abdominis release (TAR), and transabdominal preperitoneal (TAPP) approaches. Surgical protocols were standardized across institutions to minimize variability. Primary outcomes were conversion and recurrence rates; secondary outcomes were operative time, hospital length of stay, and 30-day complications graded by the Clavien-Dindo system.

The mean age was 53.4 ± 13.6 (95% confidence interval [CI], 49.9-56.8) years, and the mean BMI was 28.5 ± 5.8 (95% CI, 26.9-29.9) kg/m². Mean hernia width and height were 6.7 ± 3.5 (95% CI, 5.8-7.5) cm and 8.7 ± 5.0 (95% CI, 7.4-9.9) cm, respectively. Most patients were female (78.3%) with prior surgical history (95.0%). Transversus abdominis release (TAR) was the most frequently utilized technique, accounting for 73.3% of all procedures. The mean operative time was 274.1 ± 99.5 (95% CI, 248.9-299.3) minutes, and the mean length of hospital stay was 3.7 ± 2.3 (95% CI, 3.12-4.30) days, with no conversions to open surgery. Only one patient (1.7%) experienced a postoperative complication classified as Clavien-Dindo grade IIIa. At the 3-month follow-up, no recurrences were observed.

Robotic ventral hernia repair using component separation techniques appeared safe and feasible in Korea. This approach can be successfully implemented across multiple institutions in Korea.