Peer-reviewed veterinary case report
Long-term results of laparoscopic vs robotic hernia repair with mesh
By Remulla D et al.·2026·Department of Surgery, United States·View original on Europe PMC →
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Original publication title: Long-term propensity-matched outcomes comparing laparoscopic with robotic ventral hernia repair with intraperitoneal mesh.
Plain-English summary
This study looked at the long-term results of two surgical methods for fixing ventral hernias (a type of bulge in the abdominal wall) using a special mesh. Researchers compared robotic surgery to laparoscopic surgery in patients who had their hernias repaired and followed them for at least three years. They found that both methods had similar rates of hernia recurrence, meaning the hernia came back in about 39% of robotic cases and 38.5% of laparoscopic cases, which is not a significant difference. While patients who had robotic surgery took longer to operate on, they were more likely to go home the same day and reported slightly better quality of life, although this difference wasn't large enough to be considered meaningful. Overall, both surgical approaches showed similar long-term success in repairing hernias.
Abstract
<h4>Background</h4>Recent evidence has challenged the long-term durability of robotic ventral hernia repairs. However, long-term outcomes between laparoscopic and robotic approaches for intraperitoneal mesh repairs (IPOM) remain limited, underscoring a critical need to evaluate outcomes over extended follow-up periods.<h4>Methods</h4>We conducted a propensity-matched analysis of patients who underwent laparoscopic or robotic IPOM ventral hernia repair with permanent synthetic mesh. All patients completed a minimum 3-year follow-up in the Abdominal Core Health Quality Collaborative registry. The primary outcome was long-term hernia recurrence. Secondary outcomes included patient-reported pain, quality of life, and reoperations.<h4>Results</h4>Following propensity score matching, 362 robotic IPOM and 362 laparoscopic patients were analyzed. Robotic IPOM patients experienced longer operative times (36 vs. 17% exceeding 2 h, P < 0.001) but more same-day discharges (63 vs. 53%, P = 0.02). Six-year risk of recurrence was 39.0% in the robotic group and 38.5% in the laparoscopic group, with no significant differences between approaches (P = 0.95). This finding persisted on multivariate analysis adjusting for residual baseline differences, fascial closure status and mesh fixation technique (HR 1.01; 95% CI 0.60-1.68; P = 0.973). Objective radiographic or clinical evaluation confirmed 14.3% of R-IPOM and 12.5% of L-IPOM recurrences, with patient-reported outcomes comprising the remainder. Despite identical pain scores (PROMIS 3A: 31 vs. 31, P = 1.00), robotic IPOM patients demonstrated statistically higher quality-of-life scores (HerQLes: 92 vs. 88, P = 0.03) at three years, though this 4-point difference does not exceed the minimal clinically important difference (MCID) of 15.6 points. No differences were observed in long-term wound morbidity or reoperation rates.<h4>Conclusions</h4>Robotic IPOM demonstrates equivalent long-term durability compared to laparoscopic approaches at a minimum 3-year follow-up. Robotic IPOM was associated with longer operative times but higher same-day discharge rates and marginally higher quality-of-life scores that do not meet clinically meaningful thresholds.
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Search related cases →Original publication on Europe PMC: https://europepmc.org/article/MED/41466143