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From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes

PURPOSE: While robotic-assisted hernia repair has increased the popularity of minimally invasive hernia surgery, selecting between the types of approaches is a challenge for both experts and novices alike. In this study, we compared a single surgeon’s early experience transitioning from transabdomin...

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Autores principales: Zaman, J., Teixeira, L., Patel, P. B., Ridler, G., Ata, A., Singh, T. P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Paris 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042403/
https://www.ncbi.nlm.nih.gov/pubmed/36973467
http://dx.doi.org/10.1007/s10029-023-02767-2
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author Zaman, J.
Teixeira, L.
Patel, P. B.
Ridler, G.
Ata, A.
Singh, T. P.
author_facet Zaman, J.
Teixeira, L.
Patel, P. B.
Ridler, G.
Ata, A.
Singh, T. P.
author_sort Zaman, J.
collection PubMed
description PURPOSE: While robotic-assisted hernia repair has increased the popularity of minimally invasive hernia surgery, selecting between the types of approaches is a challenge for both experts and novices alike. In this study, we compared a single surgeon’s early experience transitioning from transabdominal hernia repair with sublay mesh in either the pre-peritoneal or retrorectus space (TA-SM) and enhanced-view totally extra-peritoneal (eTEP) ventral hernia repair in the peri-operative and long-term post-operative time periods. METHODS: We conducted a retrospective review of 50 eTEP and 108 TA-SM procedures to collect demographics, intraoperative details, and 30-day and 1-year post-operative outcomes. Statistical analysis was performed utilizing Chi-square analysis, Fisher’s test, and two sample t-tests with equal variances. RESULTS: There were no significant differences in patient demographics or comorbidities. eTEP patients had larger defects (109.1 cm(2) vs. 31.8 cm(2), p = 0.043) and mesh used (432.8 cm(2) vs. 137.9 cm(2), p = 0.001). Operative times were equivalent (158.3 ± 90.6 min eTEP and 155.8 ± 65.2 min TA-SM, p = 0.84), but conversion to alternate procedure type was higher for the transabdominal approach (4% eTEP vs. 22% TA-SM, p < 0.05). Hospital stay was less in the eTEP cohort (1.3 days vs. 2.2 days, p < 0.05). Within 30 days, there were no significant differences in emergency visits or hospital readmissions. There was a greater propensity for eTEP patients to develop seromas (12.0% vs. 1.9%, p < 0.05). At 1 year, there was no statistically significant difference in recurrence rate (4.56% eTEP vs. 12.2% TA-SM, p = 0.28) respective to average time to recurrence (9.17 months eTEP vs. 11.05 months TA-SM). CONCLUSION: The eTEP approach can be adopted safely and efficiently, and may have superior peri-operative outcomes including fewer conversions and reduced hospital stay.
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spelling pubmed-100424032023-03-28 From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes Zaman, J. Teixeira, L. Patel, P. B. Ridler, G. Ata, A. Singh, T. P. Hernia Original Article PURPOSE: While robotic-assisted hernia repair has increased the popularity of minimally invasive hernia surgery, selecting between the types of approaches is a challenge for both experts and novices alike. In this study, we compared a single surgeon’s early experience transitioning from transabdominal hernia repair with sublay mesh in either the pre-peritoneal or retrorectus space (TA-SM) and enhanced-view totally extra-peritoneal (eTEP) ventral hernia repair in the peri-operative and long-term post-operative time periods. METHODS: We conducted a retrospective review of 50 eTEP and 108 TA-SM procedures to collect demographics, intraoperative details, and 30-day and 1-year post-operative outcomes. Statistical analysis was performed utilizing Chi-square analysis, Fisher’s test, and two sample t-tests with equal variances. RESULTS: There were no significant differences in patient demographics or comorbidities. eTEP patients had larger defects (109.1 cm(2) vs. 31.8 cm(2), p = 0.043) and mesh used (432.8 cm(2) vs. 137.9 cm(2), p = 0.001). Operative times were equivalent (158.3 ± 90.6 min eTEP and 155.8 ± 65.2 min TA-SM, p = 0.84), but conversion to alternate procedure type was higher for the transabdominal approach (4% eTEP vs. 22% TA-SM, p < 0.05). Hospital stay was less in the eTEP cohort (1.3 days vs. 2.2 days, p < 0.05). Within 30 days, there were no significant differences in emergency visits or hospital readmissions. There was a greater propensity for eTEP patients to develop seromas (12.0% vs. 1.9%, p < 0.05). At 1 year, there was no statistically significant difference in recurrence rate (4.56% eTEP vs. 12.2% TA-SM, p = 0.28) respective to average time to recurrence (9.17 months eTEP vs. 11.05 months TA-SM). CONCLUSION: The eTEP approach can be adopted safely and efficiently, and may have superior peri-operative outcomes including fewer conversions and reduced hospital stay. Springer Paris 2023-03-27 2023 /pmc/articles/PMC10042403/ /pubmed/36973467 http://dx.doi.org/10.1007/s10029-023-02767-2 Text en © The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Original Article
Zaman, J.
Teixeira, L.
Patel, P. B.
Ridler, G.
Ata, A.
Singh, T. P.
From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes
title From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes
title_full From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes
title_fullStr From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes
title_full_unstemmed From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes
title_short From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes
title_sort from transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042403/
https://www.ncbi.nlm.nih.gov/pubmed/36973467
http://dx.doi.org/10.1007/s10029-023-02767-2
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