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Randomized Controlled Trial
. 2021 Jun 1;273(6):1076-1080.
doi: 10.1097/SLA.0000000000004795.

Robotic Versus Laparoscopic Ventral Hernia Repair: One-year Results From a Prospective, Multicenter, Blinded Randomized Controlled Trial

Affiliations
Randomized Controlled Trial

Robotic Versus Laparoscopic Ventral Hernia Repair: One-year Results From a Prospective, Multicenter, Blinded Randomized Controlled Trial

Naila H Dhanani et al. Ann Surg. .

Abstract

Objective: The aim of this study was to compare clinical and patient-reported outcomes of robotic versus laparoscopic ventral hernia repair (LVHR) at 1-year postoperative.

Summary of background data: Despite a relative lack of research at low risk for bias assessing robotic ventral hernia repair (RVHR), the growth of RVHR has been rapid. We previously reported short-term results of the first randomized control trial comparing RVHR versus LVHR; there was no clear difference in clinical outcomes but increased operative time and cost with robotic repair.

Methods: Patients from a multicenter, blinded randomized control trial comparing RVHR versus LVHR were followed at 1 year. Outcomes included wound complication (surgical site infection, surgical site occurrence, wound dehiscence), hernia occurrence including recurrence and port site hernia, readmission, reoperation, and patient-reported outcomes (functional status, pain, and satisfaction with repair and cosmesis).

Results: A total of 124 patients were randomized and 113 patients (91%; 60 robot, 53 laparoscopic) completed 1-year follow-up. Baseline demographics were similar in both groups. No differences were seen in wound complication (15% vs 15%; P = 0.899), hernia recurrence (7% vs 9%; P = 0.576), or readmission (2% vs 6%; P = 0.251). No patients underwent reoperation in the robotic arm, whereas 5 (9%) did in the laparoscopic arm (P = 0.020). No differences were seen in patient-reported outcomes. Both arms reported clinically significant improvements in functional status, low pain scores, and high satisfaction scores at 1-year post repair.

Conclusion: This study confirms that robotic ventral hernia repair is safe when compared to laparoscopy. Further studies are needed to confirm these findings.

Trial registration: ClinicalTrials.gov NCT03490266.

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Conflict of interest statement

SKS reports grants/payments from C-SATS and Activ Surgical. The remaining authors report no conflicts of interest.

References

    1. Poulose BK, Shelton J, Phillips S, et al. Epidemiology and cost of ventral hernia repair: making the case for hernia research. Hernia 2011; 16:179–183.
    1. Holihan JL, Alawadi Z, Martindale RG, et al. Adverse events after ventral hernia repair: the vicious cycle of complications. J Am Coll Surg 2015; 221:478–485.
    1. Available at: https://www.davincisurgery.com/procedures/general-surgery/ventral-hernia . Accessed August 1, 2020.
    1. Olavarria OA, Bernardi K, Shah SK, et al. Robotic versus laparoscopic ventral hernia repair: multicenter, blinded randomized controlled trial. BMJ 2020; 370:m2457.
    1. Available at: https://clinicaltrials.gov/ct2/show/NCT03490266 . Accessed August 1, 2020.

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