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28-04-2021 | Inguinal Hernia | Original Article

Trends and outcomes of open, laparoscopic, and robotic inguinal hernia repair in the veterans affairs system

Authors: T. J. Holleran, M. A. Napolitano, A. D. Sparks, J. E. Duncan, M. Garrett, F. J. Brody

Published in: Hernia | Issue 3/2022

Abstract

Purpose

Robotic inguinal hernia repair (RHR) is an evolving technique but is comparatively expensive and has yet to show superior outcomes versus open (OHR) or laparoscopic (LHR) approaches. The utilization and clinical outcomes of RHR have not been reported within the veterans affairs (VA) system. This study analyzes trends in utilization and 30-day post-operative outcomes between OHR, LHR, and RHR in veterans.

Methods

This is a retrospective review of patients that underwent inguinal herniorrhaphy using the Veterans Affairs Quality Improvement Program database. Multivariable analysis of outcomes was performed adjusting for pre-operative confounding covariates between OHR, LHR, and RHR. Trends in utilization, complication rates, and operative times were also reported.

Results

From 2008–2019, 124,978 cases of inguinal herniorrhaphy were identified: 100,880 (80.7%) OHR, 18,035 (14.4%) LHR, and 6063 (4.9%) RHR. Compared to LHR, RHR was associated with 4.94 times higher odds of complications, 100 min longer mean operative time, and 1.5 days longer median length of stay (LOS). Compared to OHR, RHR was associated with 5.92 times higher odds of complications, 57 min longer mean operative time, and 1.1 days longer median LOS. Utilization of RHR and LHR significantly increased over time. RHR complication rates decreased over time (2008: 20.8% to 2019: 3.2%) along with mean operative times (2008: 4.9 h to 2019: 2.8 h; p < 0.05).

Conclusion

While this study demonstrated inferior outcomes after RHR, the temporal trends are encouraging. This may be due to increased surgeon experience with robotics. Further prospective data will elucidate the role of RHR as this technique increases.

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Title: Trends and outcomes of open, laparoscopic, and robotic inguinal hernia repair in the veterans affairs system
Authors: T. J. Holleran
M. A. Napolitano
A. D. Sparks
J. E. Duncan
M. Garrett
F. J. Brody
Publication date: 28-04-2021
Publisher: Springer Paris
Keyword: Inguinal Hernia
Published in: Hernia / Issue 3/2022
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-021-02419-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Trends and outcomes of open, laparoscopic, and robotic inguinal hernia repair in the veterans affairs system

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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