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. 2025 Jan;39(1):504-512.
doi: 10.1007/s00464-024-11326-4. Epub 2024 Oct 16.

Long-term patient reported outcomes after robotic, laparoscopic, and open ventral hernia repair

Brian T Fry  1   2 , Abigail L Kappelman  3   4   5 , Joshua K Sinamo  3 , Desmond Huynh  6 , Leah J Schoel  6   3 , Alexander K Hallway  3 , Anne P Ehlers  6   3 , Sean M O'Neill  6   3 , Michael A Rubyan  3   5   7 , Jenny M Shao  6 , Dana A Telem  6   3
Affiliations

Long-term patient reported outcomes after robotic, laparoscopic, and open ventral hernia repair

Brian T Fry et al. Surg Endosc. 2025 Jan.

Abstract

Introduction: Current evidence demonstrates questionable incremental benefit of robotic abdominal wall (ventral) hernia repair when compared to other approaches. However, data are mainly limited to 30-day outcomes and do not capture long-term patient reported outcomes (PROs) where the robotic may provide distinct advantages.

Methods: We analyzed patients who underwent ventral hernia repair from January 2020-September 30, 2022 in the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry (MSQC-COHR). Validated PROs included the Ventral Hernia Recurrence Inventory (VHRI), PROMIS Pain Intensity 3a (Pain 3a), and HerQLes quality of life measures. Survey weighting was employed to reduce non-response bias and balance respondents with the overall COHR population. Logistic regression was used to assess the relationship of operative approach with answering "Yes" to the 3 VHRI questions, reporting a worse than average Pain 3a score, and reporting a below median HerQLes score. Models accounted for patient, hernia, and operative characteristics.

Results: Our sample included 1583 patients undergoing hernia repair, of which 507 (32.0%) were robotic, 202 (12.8%) were laparoscopic, and 874 (55.2%) were open. Median follow up time was 1.3 years (IQR 1.2-1.5). Patient characteristics were similar across approaches. Robotic repairs were more often performed electively, on larger hernias, and with mesh. After controlling for covariates, a robotic approach was associated with a lower predicted probability of reporting a bulge [19.5% (95% CI 15.7-23.2%)] than a laparoscopic approach [26.8% (95% CI 20.4-33.2%)], but was no different than an open approach [18.8% (95% CI 16.1-21.6%)]. No other differences in PROs were found by approach.

Conclusions: We found a lower likelihood of reporting a bulge after robotic ventral hernia repair when compared with a laparoscopic approach, but no difference when compared with an open approach. No other differences in long-term PROs were found when comparing robotic to laparoscopic or open approaches.

Keywords: Laparoscopic; Open; Patient reported outcomes; Robotic; Robotic-assisted; Ventral hernia repair.

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Conflict of interest statement

Disclosures. Brian T Fry, Abigail L Kappelman, Joshua K Sinamo, Desmond Huynh, Leah J Schoel, Alexander K Hallway, Anne P Ehlers, Sean M O’Neill, Michael A Rubyan, Jenny M Shao, and Dana A Telemhave no conflicts of interest or financial ties to disclose.

References

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