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Meta-Analysis
. 2021 Dec;25(6):1471-1480.
doi: 10.1007/s10029-021-02487-5. Epub 2021 Sep 7.

Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis

U Bracale  1 , F Corcione  1   2 , D Neola  1 , S Castiglioni  1   3 , G Cavallaro  4 , C Stabilini  5 , E Botteri  6 , M Sodo  2 , N Imperatore  7 , R Peltrini  8   9   10
Affiliations
Meta-Analysis

Transversus abdominis release (TAR) for ventral hernia repair: open or robotic? Short-term outcomes from a systematic review with meta-analysis

U Bracale et al. Hernia. 2021 Dec.

Abstract

Purpose: To compare early postoperative outcomes after transversus abdominis release (TAR) for ventral hernia repair with open (oTAR) and robotic (rTAR) approach.

Methods: A systematic search of PubMed/MEDLINE, EMBASE, SCOPUS and Web of Science databases was conducted to identify comparative studies until October 2020. A meta-analysis of postoperative short-term outcomes was performed including complications rate, operative time, length of stay, surgical site infection (SSI), surgical site occurrence (SSO), SSO requiring intervention (SSOPI), systemic complications, readmission, and reoperation rates as measure outcomes.

Results: Six retrospective studies were included in the analysis with a total of 831 patients who underwent rTAR (n = 237) and oTAR (n = 594). Robotic TAR was associated with lower risk of complications rate (9.3 vs 20.7%, OR 0.358, 95% CI 0.218-0.589, p < 0.001), lower risk of developing SSO (5.3 vs 11.5%, OR 0.669, 95% CI 0.307-1.458, p = 0.02), lower risk of developing systemic complications (6.3 vs 26.5%, OR 0.208, 95% CI 0.100-0.433, p < 0.001), shorter hospital stay (SMD - 4.409, 95% CI - 6.000 to - 2.818, p < 0.001) but longer operative time (SMD 53.115, 95% CI 30.236-75.993, p < 0.01) compared with oTAR. There was no statistically significant difference in terms of SSI, SSOPI, readmission, and reoperation rates.

Conclusion: Robotic TAR improves recovery by adding the benefits of minimally invasive procedures when compared to open surgery. Although postoperative complications appear to decrease with a robotic approach, further studies are needed to support the real long-term and cost-effective advantages.

Keywords: Robotic TAR; Transversus abdominis release; Ventral hernia repair.

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Conflict of interest statement

Umberto Bracale, Francesco Corcione, Daniele Neola, Simone Castiglioni, Giuseppe Cavallaro, Cesare Stabilini, Emanuele Botteri, Francesco Corcione, Maurizio Sodo, Nicola Imperatore, Roberto Peltrini declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of the search strategy and selection of studies included in the meta-analysis
Fig. 2
Fig. 2
QUADAS-2 studies evaluation
Fig. 3
Fig. 3
Forest plots of outcomes included in the analysis: patients with complications (A); SSI (B); SSO (C); SSO requiring intervention (D); systemic complications (E); operative time (F); length of stay (G); readmission (H); reoperation (I)
See this image and copyright information in PMC

Comment in

References

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