Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 2;6(3):zrac057.
doi: 10.1093/bjsopen/zrac057.

Open versus robotic-assisted laparoscopic posterior component separation in complex abdominal wall repair

Maxime Dewulf  1 , Juha M Hiekkaranta  2 , Elisa Mäkäräinen  2 , Juha Saarnio  2 , Maaike Vierstraete  3 , Pasi Ohtonen  2 , Filip Muysoms  3 , Tero Rautio  2
Affiliations

Open versus robotic-assisted laparoscopic posterior component separation in complex abdominal wall repair

Maxime Dewulf et al. BJS Open. .

Abstract

Background: Transversus abdominis release (TAR) is a surgical technique used in the treatment of complex ventral hernias. The aim of this study was to compare outcomes of open (oTAR) versus robotic-assisted (rTAR) posterior component separation by TAR.

Methods: Consecutive patients at two European hernia centres who underwent bilateral TAR were included. The primary endpoint was the duration of postoperative hospital stay.

Results: Data from 90 rTAR and 79 oTAR operations were evaluated. Patient demographics were similar between groups in terms of age, sex, BMI, and co-morbidities. There were more smokers, and hernias were larger in the oTAR group (width 8.7 cm versus 10.0 cm; P = 0.031, length 11.6 cm versus 14.1 cm; P = 0.005). Duration of postoperative hospital stay was significantly shorter in the rTAR group (3.4 days versus 6.9 days; P < 0.001). Short-term serious complications (Clavien-Dindo grade III and above) were more frequent (20.3 per cent versus 7.8 per cent; P = 0.018), and there were more surgical site infections (12.7 per cent versus 3.3 per cent; P = 0.010) in the oTAR group. During a median follow-up of 19 months in the rTAR group and 43 months in the oTAR group, reoperation (4.4 per cent versus 8.9 per cent; P = 0.245), and recurrence rates (5.6 per cent versus 5.1 per cent; P > 0.009) were similar.

Conclusion: Patients with ventral incisional hernias who undergo bilateral rTAR had significantly shorter postoperative hospital stays and fewer short-term complications compared with patients undergoing bilateral oTAR.

PubMed Disclaimer

References

    1. Parker S, Halligan S, Liang M, Muysoms F, Adrales G, Boutall A et al. International classification of abdominal wall planes (ICAP) to describe mesh insertion for ventral hernia repair. Br J Surg 2020;107:209–217 - PubMed
    1. Rives J, Pire J, Flament J, Convers G. Le traitement des grandes éventrations a propos de 133 cas) [Treatment of large eventrations (apropos of 133 cases)]. Minerva Chir 1977;32:749–756 - PubMed
    1. Tandon A, Pathak S, Lyons NJR, Nunes QM, Daniels IR, Smart NJ. Meta-analysis of closure of the fascial defect during laparoscopic incisional and ventral hernia repair. Br J Surg 2016;103:1598–1607 - PubMed
    1. Sneiders D, Yurtkap Y, Kroese LF, Jeekel J, Muysoms FE, Kleinrensink G et al. Anatomical study comparing medialization after Rives–Stoppa, anterior component separation, and posterior component separation. Surgery 2019;165:996–1002 - PubMed
    1. Balla A, Alarcón I, Morales-Conde S. Minimally invasive component separation technique for large ventral hernia: which is the best choice? A systematic literature review. Surg Endosc 2020;34:14–30 - PubMed

MeSH terms