Outcomes from 306 consecutive robotic ventral hernia repairs in the community setting.

Abstract

Robotic assisted laparoscopy is increasingly popular for primary ventral and incisional hernia repair. A variety of robotic techniques have been described. More data is needed to evaluate the indications and benefits of these approaches. This is a retrospective analysis of patients who underwent robotic hernia repair over a 2-year period in the community setting. Techniques included: intraperitoneal onlay mesh repair with fascial defect closure (IPOM +), ventral transabdominal preperitoneal repair (vTAPP), and retrorectus (RR) repairs with or without transverse abdominis release (TAR). Follow up was obtained at minimum 6 months postoperatively. Outcomes data included complications, readmissions, reoperations, and hernia recurrences. This study included 306 consecutive robotic ventral hernia repairs: 63 IPOM + , 199 vTAPP, and 44 RR of which 25 (57%) required TAR. Average console times were similar between IPOM + and vTAPP groups (63 vs. 62 min, p = 0.71) and longer for RR repairs without vs. with TAR (107.8 vs. 184.4 min, p < 0.001). There were few intraoperative (0.6%) and immediate postoperative (0.3%) complications. Same day discharge was feasible in most patients (95%). Follow up was completed in 81.0% of patients with an average follow up time of 13.3 months (range 6-27 months). Rates of complications (1.3%), readmissions (1.0%), and reoperations (1.0%) were recorded. There were no hernia recurrences. Robotic ventral hernia repair is a safe and effective strategy for treatment of most abdominal wall hernias with low complication and recurrence rates in medium term follow up.