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Published in: Hernia 6/2019

01-12-2019 | Inguinal Hernia | Original Article

A direct comparison of robotic and laparoscopic hernia repair: patient-reported outcomes and cost analysis

Authors: N. E. Zayan, M. P. Meara, J. S. Schwartz, V. K. Narula

Published in: Hernia | Issue 6/2019

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Abstract

Purpose

Hernia repair is one of the most commonly performed surgeries in the United States. Since the introduction of the Da Vinci robot, robot-assisted hernia repairs have become more common. In this study we aim to directly compare robotic and laparoscopic hernia repairs as well as explore potential cost differences. We hypothesize that robot-assisted hernia repairs are associated with better patient-reported outcomes.

Methods

We conducted retrospective review to create a cohort study of 53 robotic (37 inguinal and 16 ventral) and 101 laparoscopic (68 inguinal and 33 ventral) hernia repairs. Patient-reported outcomes were measured using the Carolinas Comfort Scale (CCS). Operative details were examined, and a cost analysis was performed.

Results

Combining both hernia types together as well as looking at inguinal and ventral repairs separately, we found that there was no difference in hernia recurrence or 1-year CCS between robotic and laparoscopic hernia repair. For ventral hernia repairs alone, robotic procedure was associated with a decreased length of stay. We found that our robotic cases did have longer operative times and higher costs. The operative times did decrease to a length comparable to that of the laparoscopic cases as experience operating with the robot increased.

Conclusion

In comparison to laparoscopic hernia repair, robotic hernia repair does not improve long-term patient-reported surgical outcomes. However, it does increase the cost of the operation and, in general, result in longer operative times.
Literature
1.
go back to reference Earle DB (2012) Biomaterials in hernia repair. In: Prevention & management of complications in minimally invasive esophageal surgery, 3rd edn, Chap 36. Society of Laparoendoscopic Surgeons Earle DB (2012) Biomaterials in hernia repair. In: Prevention & management of complications in minimally invasive esophageal surgery, 3rd edn, Chap 36. Society of Laparoendoscopic Surgeons
2.
go back to reference Vorst AL, Kaoutzanis C, Carbonell AM, Franz MG (2015) Evolution and advances in laparoscopic ventral and incisional hernia repair. World J of Gastrointestin Surg 7(11):293–305CrossRef Vorst AL, Kaoutzanis C, Carbonell AM, Franz MG (2015) Evolution and advances in laparoscopic ventral and incisional hernia repair. World J of Gastrointestin Surg 7(11):293–305CrossRef
3.
go back to reference Alexander AM, Scott DJ (2013) Laparoscopic ventral hernia repair. Surg Clin North Am 93(5):1091–1110CrossRef Alexander AM, Scott DJ (2013) Laparoscopic ventral hernia repair. Surg Clin North Am 93(5):1091–1110CrossRef
4.
go back to reference Sajic MS, Bokhari SA, Mallick AS, Cheek E, Baig MK (2009) Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg 197(1):64–72CrossRef Sajic MS, Bokhari SA, Mallick AS, Cheek E, Baig MK (2009) Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg 197(1):64–72CrossRef
5.
go back to reference McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E, Vale L, Grant A (2005) Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation. Health Technol Assess 9(14):1–203CrossRef McCormack K, Wake B, Perez J, Fraser C, Cook J, McIntosh E, Vale L, Grant A (2005) Laparoscopic surgery for inguinal hernia repair: systematic review of effectiveness and economic evaluation. Health Technol Assess 9(14):1–203CrossRef
6.
go back to reference Narkhede R, Shah NM, Dalal PR, Mangukia C, Dholaria S (2015) Postoperative mesh infection-still a concern in laparoscopic era. Indian J Surg 77(4):322–326CrossRef Narkhede R, Shah NM, Dalal PR, Mangukia C, Dholaria S (2015) Postoperative mesh infection-still a concern in laparoscopic era. Indian J Surg 77(4):322–326CrossRef
7.
go back to reference Ballantyne GH, Hourmont K, Wasielewski A (2003) Telerobotic laparoscopic repair of incisional ventral hernias using intraperitoneal prosthetic mesh. JSLS 7(1):7–14PubMedPubMedCentral Ballantyne GH, Hourmont K, Wasielewski A (2003) Telerobotic laparoscopic repair of incisional ventral hernias using intraperitoneal prosthetic mesh. JSLS 7(1):7–14PubMedPubMedCentral
8.
go back to reference Engan C, Engan M, Bonilla V, Dyer DC, Randall BR (2015) Description of robotically assisted single-site transabdominal preperitoneal (RASS–TAPP) inguinal hernia repair and presentation of clinical outcomes. Hernia 19(3):423–428CrossRef Engan C, Engan M, Bonilla V, Dyer DC, Randall BR (2015) Description of robotically assisted single-site transabdominal preperitoneal (RASS–TAPP) inguinal hernia repair and presentation of clinical outcomes. Hernia 19(3):423–428CrossRef
9.
go back to reference Ito F, Jarrard D, Gould JC (2008) Transabdominal preperitoneal robotic inguinal hernia repair. J Laparoendosc Adv Surg Tech A 18(3):397–399CrossRef Ito F, Jarrard D, Gould JC (2008) Transabdominal preperitoneal robotic inguinal hernia repair. J Laparoendosc Adv Surg Tech A 18(3):397–399CrossRef
10.
go back to reference Allison N, Tieu K, Snyder B, Pigazzi A, Wilson E (2012) Technical feasibility of robot-assisted ventral hernia repair. World J Surg 36(2):447–452CrossRef Allison N, Tieu K, Snyder B, Pigazzi A, Wilson E (2012) Technical feasibility of robot-assisted ventral hernia repair. World J Surg 36(2):447–452CrossRef
11.
go back to reference Tayar C, Karoui M, Cherjui D, Fagniez PL (2007) Robot-assisted laparoscopic mesh repair of incisional hernias with exclusive intracorporeal suturing: a pilot study. Surg Endosc 21(10):1786–1789CrossRef Tayar C, Karoui M, Cherjui D, Fagniez PL (2007) Robot-assisted laparoscopic mesh repair of incisional hernias with exclusive intracorporeal suturing: a pilot study. Surg Endosc 21(10):1786–1789CrossRef
12.
go back to reference Escobar Dominguez JE, Ramos MG, Seetharamaiah R, Donkor C, Rabaza J, Gonzalez A (2016) Feasibility of robotic inguinal hernia repair, a single-institution experience. Surg Endosc 30(9):4042–4048CrossRef Escobar Dominguez JE, Ramos MG, Seetharamaiah R, Donkor C, Rabaza J, Gonzalez A (2016) Feasibility of robotic inguinal hernia repair, a single-institution experience. Surg Endosc 30(9):4042–4048CrossRef
13.
go back to reference Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Firozzi F, Caiazzo P (2005) Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience. Surg Endosc 19(1):117–119CrossRef Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Firozzi F, Caiazzo P (2005) Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience. Surg Endosc 19(1):117–119CrossRef
14.
go back to reference Strosberg DS, Nguyen MC, Muscarella P, Narula VK (2017) A retrospective comparison of robotic cholecystectomy versus laparoscopic cholecystectomy: operative outcomes and cost analysis. Surg Endosc 31:1436CrossRef Strosberg DS, Nguyen MC, Muscarella P, Narula VK (2017) A retrospective comparison of robotic cholecystectomy versus laparoscopic cholecystectomy: operative outcomes and cost analysis. Surg Endosc 31:1436CrossRef
15.
go back to reference Narula VK, Watson WC, Davis SS, Hinshaw K, Needleman BJ, Mikami DJ, Hazey JW, Winston JH, Muscarella P, Rubin M, Patel V, Melvin WS (2007) A computerized analysis of robotic versus laparoscopic task performance. Surg Endosc 21(12):2258–2261CrossRef Narula VK, Watson WC, Davis SS, Hinshaw K, Needleman BJ, Mikami DJ, Hazey JW, Winston JH, Muscarella P, Rubin M, Patel V, Melvin WS (2007) A computerized analysis of robotic versus laparoscopic task performance. Surg Endosc 21(12):2258–2261CrossRef
16.
go back to reference Narula VK, Mikami DJ, Melvin W (2010) Robotic and laparoscopic pancreaticoduodenectomy: a hybrid approach. Pancreas 39(2):160–164CrossRef Narula VK, Mikami DJ, Melvin W (2010) Robotic and laparoscopic pancreaticoduodenectomy: a hybrid approach. Pancreas 39(2):160–164CrossRef
Metadata
Title
A direct comparison of robotic and laparoscopic hernia repair: patient-reported outcomes and cost analysis
Authors
N. E. Zayan
M. P. Meara
J. S. Schwartz
V. K. Narula
Publication date
01-12-2019
Publisher
Springer Paris
Keyword
Inguinal Hernia
Published in
Hernia / Issue 6/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-019-01943-7

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