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01-02-2019 | Review

Robot-assisted abdominal wall surgery: a systematic review of the literature and meta-analysis

Authors: N. A. Henriksen, K. K. Jensen, F. Muysoms

Published in: Hernia | Issue 1/2019

Abstract

Purpose

The number of robot-assisted hernia repairs is increasing, but the potential benefits have not been well described. The aim of this study was to evaluate the available literature reporting on outcomes after robot-assisted hernia repairs.

Methods

This is a qualitative review and meta-analysis of papers evaluating short-term outcomes after inguinal or ventral robot-assisted hernia repair compared with either open or laparoscopic approach. The primary outcome was postoperative complications and secondary outcomes were duration of surgery, postoperative length of stay and financial costs.

Results

Fifteen studies were included. Postoperative complications were significantly decreased after robot-assisted inguinal hernia repair compared with open repair. There were no differences in complications between robot-assisted and laparoscopic inguinal hernia repair. For ventral hernia repair, sutured closure of the defect, retromuscular mesh placement and transversus abdominis release is feasible when using the robot. Length of stay was decreased by a mean of 3 days for robot-assisted repairs compared with open approach. There were no differences in postoperative complications and the operative time was significantly longer for robot-assisted ventral hernia repair compared with laparoscopic or open approach.

Conclusions

For ventral hernias that would normally require an open procedure, a robot-assisted repair may be a good option, as the use of a minimally invasive approach for these procedures decreases length of stay significantly. For inguinal hernias, the benefit of the robot is questionable. Randomized controlled trials and prospective studies are needed.

Telem DA (2018) Is robotic surgery the future for abdominal wall hernia repair? Not so fast. Ann Surg 267(2):218–219. https://doi.org/10.1097/SLA.0000000000002336 CrossRefPubMed

Huang X, Wang L, Zheng X, Wang X (2017) Comparison of perioperative, functional, and oncologic outcomes between standard laparoscopic and robotic-assisted radical prostatectomy: a systemic review and meta-analysis. Surg Endosc 31(3):1045–1060. https://doi.org/10.1007/s00464-016-5125-1 CrossRefPubMed

Coakley KM, Sims SM, Prasad T, Lincourt AE, Augenstein VA, Sing RF, Heniford BT, Colavita PD (2017) A nationwide evaluation of robotic ventral hernia surgery. Am J Surg 214(6):1158–1163. https://doi.org/10.1016/j.amjsurg.2017.08.022 CrossRefPubMed

Bittner JG, Alrefai S, Vy M, Mabe M, Del Prado PAR, Clingempeel NL (2017) Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair. Surg Endosc. https://doi.org/10.1007/s00464-017-5729-0 CrossRefPubMedPubMedCentral

Sanchez A, Rodriguez O, Jara G, Sanchez R, Vegas L, Rosciano J, Estrada L (2018) Robot-assisted surgery and incisional hernia: a comparative study of ergonomics in a training model. J Robot Surg. https://doi.org/10.1007/s11701-017-0777-y CrossRefPubMed

https://www.cebm.net/2009/06/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/. Accessed 28 Aug 2018

Charles EJ, Mehaffey JH, Tache-Leon CA, Hallowell PT, Sawyer RG, Yang Z (2017) Inguinal hernia repair: is there a benefit to using the robot? Surg Endosc. https://doi.org/10.1007/s00464-017-5911-4 PubMedCentralCrossRefPubMed

Kudsi OY, McCarty JC, Paluvoi N, Mabardy AS (2017) Transition from laparoscopic totally extraperitoneal inguinal hernia repair to robotic transabdominal preperitoneal inguinal hernia repair: a retrospective review of a single surgeon’s experience. World J Surg. https://doi.org/10.1007/s00268-017-3998-3 PubMedCrossRef

Tran H (2011) Robotic single-port hernia surgery. J Soc Laparoendosc Surg 15(3):309–314. https://doi.org/10.4293/108680811X13125733356198 CrossRef

10.

Waite KE, Herman MA, Doyle PJ (2016) Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. J Robot Surg 10(3):239–244. https://doi.org/10.1007/s11701-016-0580-1 CrossRefPubMed

11.

Kolachalam R, Dickens E, D’Amico L, Richardson C, Rabaza J, Gamagami R, Gonzalez A (2017) Early outcomes of robotic-assisted inguinal hernia repair in obese patients: a multi-institutional, retrospective study. Surg Endosc. https://doi.org/10.1007/s00464-017-5665-z PubMedCrossRef

12.

Bittner Iv JG, Cesnik LW, Kirwan T, Wolf L, Guo D (2018) Patient perceptions of acute pain and activity disruption following inguinal hernia repair: a propensity-matched comparison of robotic-assisted, laparoscopic, and open approaches. J Robot Surg. https://doi.org/10.1007/s11701-018-0790-9 PubMedCentralCrossRefPubMed

13.

Armijo P, Pratap A, Wang Y, Shostrom V, Oleynikov D (2017) Robotic ventral hernia repair is not superior to laparoscopic: a national database review. Surg Endosc. https://doi.org/10.1007/s00464-017-5872-7 CrossRefPubMed

14.

Prabhu AS, Dickens EO, Copper CM, Mann JW, Yunis JP, Phillips S, Huang LC, Poulose BK, Rosen MJ (2017) Laparoscopic vs robotic intraperitoneal mesh repair for incisional hernia: an americas hernia society quality collaborative analysis. J Am Coll Surg. https://doi.org/10.1016/j.jamcollsurg.2017.04.011 CrossRefPubMed

15.

Gonzalez AM, Romero RJ, Seetharamaiah R, Gallas M, Lamoureux J, Rabaza JR (2015) Laparoscopic ventral hernia repair with primary closure versus no primary closure of the defect: potential benefits of the robotic technology. Int J Med Robot 11(2):120–125. https://doi.org/10.1002/rcs.1605 CrossRefPubMed

16.

Chen YJ, Huynh D, Nguyen S, Chin E, Divino C, Zhang L (2017) Outcomes of robot-assisted versus laparoscopic repair of small-sized ventral hernias. Surg Endosc 31(3):1275–1279. https://doi.org/10.1007/s00464-016-5106-4 CrossRefPubMed

17.

Walker PA, May AC, Mo J, Cherla DV, Santillan MR, Kim S, Ryan H, Shah SK, Wilson EB, Tsuda S (2018) Multicenter review of robotic versus laparoscopic ventral hernia repair: is there a role for robotics? Surg Endosc 32(4):1901–1905. https://doi.org/10.1007/s00464-017-5882-5 CrossRefPubMed

18.

Carbonell AM, Warren JA, Prabhu AS, Ballecer CD, Janczyk RJ, Herrera J, Huang LC, Phillips S, Rosen MJ, Poulose BK (2017) Reducing length of stay using a robotic-assisted approach for retromuscular ventral hernia repair: a comparative analysis from the Americas Hernia Society Quality Collaborative. Ann Surg. https://doi.org/10.1097/SLA.0000000000002244 PubMedCrossRef

19.

Warren JA, Cobb WS, Ewing JA, Carbonell AM (2017) Standard laparoscopic versus robotic retromuscular ventral hernia repair. Surg Endosc 31(1):324–332. https://doi.org/10.1007/s00464-016-4975-x CrossRefPubMed

20.

Martin-Del-Campo LA, Weltz AS, Belyansky I, Novitsky YW (2018) Comparative analysis of perioperative outcomes of robotic versus open transversus abdominis release. Surg Endosc 32(2):840–845. https://doi.org/10.1007/s00464-017-5752-1 CrossRefPubMed

21.

Tran H (2011) Safety and efficacy of single incision laparoscopic surgery for total extraperitoneal inguinal hernia repair. J Soc Laparoendosc Surg 15(1):47–52. https://doi.org/10.4293/108680811X13022985131174 CrossRef

22.

Scheuermann U, Niebisch S, Lyros O, Jansen-Winkeln B, Gockel I (2017) Transabdominal preperitoneal (TAPP) versus Lichtenstein operation for primary inguinal hernia repair—a systematic review and meta-analysis of randomized controlled trials. BMC Surg 17(1):55. https://doi.org/10.1186/s12893-017-0253-7 CrossRefPubMedPubMedCentral

23.

Baker JJ, Oberg S, Andresen K, Klausen TW, Rosenberg J (2018) Systematic review and network meta-analysis of methods of mesh fixation during laparoscopic ventral hernia repair. Br J Surg 105(1):37–47. https://doi.org/10.1002/bjs.10720 CrossRefPubMed

24.

Tandon A, Pathak S, Lyons NJ, Nunes QM, Daniels IR, Smart NJ (2016) Meta-analysis of closure of the fascial defect during laparoscopic incisional and ventral hernia repair. Br J Surg 103(12):1598–1607. https://doi.org/10.1002/bjs.10268 CrossRefPubMed

25.

Belyansky I, Zahiri HR, Park A (2016) Laparoscopic transversus abdominis release, a novel minimally invasive approach to complex abdominal wall reconstruction. Surg Innov 23(2):134–141. https://doi.org/10.1177/1553350615618290 CrossRefPubMed

26.

Turchetti G, Palla I, Pierotti F, Cuschieri A (2012) Economic evaluation of da Vinci-assisted robotic surgery: a systematic review. Surg Endosc 26(3):598–606. https://doi.org/10.1007/s00464-011-1936-2 CrossRefPubMed

27.

Kudsi OY, McCarty JC, Paluvoi N, Mabardy AS (2017) Transition from laparoscopic totally extraperitoneal inguinal hernia repair to robotic transabdominal preperitoneal inguinal hernia repair: a retrospective review of a single surgeon’s experience. World J Surg 41(9):2251–2257. https://doi.org/10.1007/s00268-017-3998-3 CrossRefPubMed

Title: Robot-assisted abdominal wall surgery: a systematic review of the literature and meta-analysis
Authors: N. A. Henriksen
K. K. Jensen
F. Muysoms
Publication date: 01-02-2019
Publisher: Springer Paris
Published in: Hernia / Issue 1/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-018-1872-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Robot-assisted abdominal wall surgery: a systematic review of the literature and meta-analysis

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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