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20-11-2023 | Laparoscopy | Review Article

Robotic surgery for inguinal and ventral hernia repair: a systematic review and meta-analysis

Authors: Nicola de’Angelis, Carlo Alberto Schena, David Moszkowicz, Cyril Kuperas, Régis Fara, Sébastien Gaujoux, Jean-François Gillion, Caroline Gronnier, Jérôme Loriau, Muriel Mathonnet, Olivier Oberlin, Manuela Perez, Yohann Renard, Benoît Romain, Guillaume Passot, Patrick Pessaux, the Association Française de Chirurgie (AFC) and the Société Française de Chirurgie Pariétale - Club Hernie (SFCP-CH)

Published in: Surgical Endoscopy

Abstract

Background

This systematic review and meta-analysis assessed the effectiveness of robotic surgery compared to laparoscopy or open surgery for inguinal (IHR) and ventral (VHR) hernia repair.

Methods

PubMed and EMBASE were searched up to July 2022. Meta-analyses were performed for postoperative complications, surgical site infections (SSI), seroma/hematoma, hernia recurrence, operating time (OT), intraoperative blood loss, intraoperative bowel injury, conversion to open surgery, length of stay (LOS), mortality, reoperation rate, readmission rate, use of opioids, time to return to work and time to return to normal activities.

Results

Overall, 64 studies were selected and 58 were used for pooled data analyses: 35 studies (227 242 patients) deal with IHR and 32 (158 384 patients) with VHR. Robotic IHR was associated with lower hernia recurrence (OR 0.54; 95%CI 0.29, 0.99; I²: 0%) compared to laparoscopic IHR, and lower use of opioids compared to open IHR (OR 0.46; 95%CI 0.25, 0.84; I²: 55.8%). Robotic VHR was associated with lower bowel injuries (OR 0.59; 95%CI 0.42, 0.85; I²: 0%) and less conversions to open surgery (OR 0.51; 95%CI 0.43, 0.60; I²: 0%) compared to laparoscopy. Compared to open surgery, robotic VHR was associated with lower postoperative complications (OR 0.61; 95%CI 0.39, 0.96; I²: 68%), less SSI (OR 0.47; 95%CI 0.31, 0.72; I²: 0%), less intraoperative blood loss (− 95 mL), shorter LOS (− 3.4 day), and less hospital readmissions (OR 0.66; 95%CI 0.44, 0.99; I²: 24.7%). However, both robotic IHR and VHR were associated with significantly longer OT compared to laparoscopy and open surgery.

Conclusion

These results support robotic surgery as a safe, effective, and viable alternative for IHR and VHR as it can brings several intraoperative and postoperative advantages over laparoscopy and open surgery.

Graphical abstract

Available only for authorised users

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Title: Robotic surgery for inguinal and ventral hernia repair: a systematic review and meta-analysis
Authors: Nicola de’Angelis
Carlo Alberto Schena
David Moszkowicz
Cyril Kuperas
Régis Fara
Sébastien Gaujoux
Jean-François Gillion
Caroline Gronnier
Jérôme Loriau
Muriel Mathonnet
Olivier Oberlin
Manuela Perez
Yohann Renard
Benoît Romain
Guillaume Passot
Patrick Pessaux
the Association Française de Chirurgie (AFC) and the Société Française de Chirurgie Pariétale - Club Hernie (SFCP-CH)
Publication date: 20-11-2023
Publisher: Springer US
Keywords: Laparoscopy
Inguinal Hernia
Published in: Surgical Endoscopy
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-10545-5

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Robotic surgery for inguinal and ventral hernia repair: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

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