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Surgical Endoscopy

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01-08-2020 | Seroma

Transabdominal (TA) versus totally extraperitoneal (TEP) robotic retromuscular ventral hernia repair: a propensity score matching analysis

Authors: Omar Yusef Kudsi, Karen Chang, Naseem Bou-Ayash, Fahri Gokcal

Published in: Surgical Endoscopy | Issue 8/2020

Abstract

Purpose

Retromuscular mesh placement positioning utilizing the robotic platform can be performed using either a transabdominal or an extraperitoneal approach. The aim of this study is to compare short-term outcomes of robotic transabdominal access retromuscular (rTA-RM) repair and robotic totally extraperitoneal access retromuscular (rTEP-RM) repair for ventral hernias

Methods

Patients who underwent robotic retromuscular repair between February 2013–October 2019 were included in the study. A one-to-one propensity score matching (PSM) analysis was conducted to obtain two balanced groups. A comparative analysis was performed in terms of perioperative and early post-operative outcomes.

Results

A total of 214 patients were included for PSM analysis. 82 patients were allocated into each study group. Operative times were longer in rTA-RM group. Adhesiolysis was more frequently required in the rTA-RM group. Intra-operative complications occurred more frequently in patients who underwent rTA-RM repair (p = 0.120; 4.9% in rTA-RM vs. 0% in rTEP-RM). The rate of major complications during the first 90 days did not differ between groups (p = 0.277; 7.3% vs. 2.4%, respectively). The proportion of patients with minor perioperative complications was statistically higher in the rTA-RM group than the rTEP-RM group (p = 0.003; 30.5% vs. 11%, respectively). Overall rate of surgical site events was higher in the rTA-RM group than the rTEP-RM group (p = 0.049; 17.1% vs. 6.1%, respectively). Seroma frequency was higher after rTA-RM repair (p = 0.047; 13.4% vs. 3.7%).

Conclusion

Our data suggest that rTEP-RM repair was associated with shorter surgery duration and improved early post-operative outcomes in comparison with rTA-RM repair.

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Title: Transabdominal (TA) versus totally extraperitoneal (TEP) robotic retromuscular ventral hernia repair: a propensity score matching analysis
Authors: Omar Yusef Kudsi
Karen Chang
Naseem Bou-Ayash
Fahri Gokcal
Publication date: 01-08-2020
Publisher: Springer US
Keyword: Seroma
Published in: Surgical Endoscopy / Issue 8/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07574-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Transabdominal (TA) versus totally extraperitoneal (TEP) robotic retromuscular ventral hernia repair: a propensity score matching analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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