Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic

The surgical complexities of our current population have pushed the technological limits of healthcare, urging for minimally invasive approaches. For ventral hernias, in particular, robotic assisted laparoscopic repairs have been met with conflict. Cost and longer operative times are among the argum...

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Autores principales: Nguyen, Barbara, David, Bryan, Shiozaki, Teisha, Gosch, Kensey, Sorensen, G. Brent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044101/
https://www.ncbi.nlm.nih.gov/pubmed/33850165
http://dx.doi.org/10.1038/s41598-021-86093-6
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author Nguyen, Barbara
David, Bryan
Shiozaki, Teisha
Gosch, Kensey
Sorensen, G. Brent
author_facet Nguyen, Barbara
David, Bryan
Shiozaki, Teisha
Gosch, Kensey
Sorensen, G. Brent
author_sort Nguyen, Barbara
collection PubMed
description The surgical complexities of our current population have pushed the technological limits of healthcare, urging for minimally invasive approaches. For ventral hernias, in particular, robotic assisted laparoscopic repairs have been met with conflict. Cost and longer operative times are among the arguments against robotic surgery, although thorough evaluation of patient outcomes could potentially advocate for use of this tool. We attempted to approach this by retrospectively reviewing our own data. We reviewed charts between September 2016 and February 2017 of patients receiving complex hernia repairs, either a standard open repair (SOR) or robotic-assisted repair (RAR). Data collected included preoperative, perioperative, and postoperative care. Of the 43 patients reviewed, 16 were SOR, versus 27 RAR. Patients were comparable in age, gender, BMI, diabetes as a comorbidity; average hernia defect size was similar between the two groups. Although operative times were longer in the RAR group, estimated blood loss (EBL) was less. Hospital stay was also shorter in the RAR group, at 3.0 ± 1.9 days versus 9.6 ± 8.4 days for the OAR group. Of those requiring critical care management, only one patient had a robotic assisted repair, versus half of the patients who received an open repair. Of the patients who presented to the emergency department within 30 days of surgery, each group had four patients, and two from the OAR group required admission. Our data is consistent with other literature supporting shorter lengths of stays. Although the robotic approach did required a longer operative time, the resulting improved patient outcomes support this technique for complex ventral hernia repairs.
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spelling pubmed-80441012021-04-14 Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic Nguyen, Barbara David, Bryan Shiozaki, Teisha Gosch, Kensey Sorensen, G. Brent Sci Rep Article The surgical complexities of our current population have pushed the technological limits of healthcare, urging for minimally invasive approaches. For ventral hernias, in particular, robotic assisted laparoscopic repairs have been met with conflict. Cost and longer operative times are among the arguments against robotic surgery, although thorough evaluation of patient outcomes could potentially advocate for use of this tool. We attempted to approach this by retrospectively reviewing our own data. We reviewed charts between September 2016 and February 2017 of patients receiving complex hernia repairs, either a standard open repair (SOR) or robotic-assisted repair (RAR). Data collected included preoperative, perioperative, and postoperative care. Of the 43 patients reviewed, 16 were SOR, versus 27 RAR. Patients were comparable in age, gender, BMI, diabetes as a comorbidity; average hernia defect size was similar between the two groups. Although operative times were longer in the RAR group, estimated blood loss (EBL) was less. Hospital stay was also shorter in the RAR group, at 3.0 ± 1.9 days versus 9.6 ± 8.4 days for the OAR group. Of those requiring critical care management, only one patient had a robotic assisted repair, versus half of the patients who received an open repair. Of the patients who presented to the emergency department within 30 days of surgery, each group had four patients, and two from the OAR group required admission. Our data is consistent with other literature supporting shorter lengths of stays. Although the robotic approach did required a longer operative time, the resulting improved patient outcomes support this technique for complex ventral hernia repairs. Nature Publishing Group UK 2021-04-13 /pmc/articles/PMC8044101/ /pubmed/33850165 http://dx.doi.org/10.1038/s41598-021-86093-6 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Nguyen, Barbara
David, Bryan
Shiozaki, Teisha
Gosch, Kensey
Sorensen, G. Brent
Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic
title Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic
title_full Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic
title_fullStr Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic
title_full_unstemmed Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic
title_short Comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic
title_sort comparisons of abdominal wall reconstruction for ventral hernia repairs, open versus robotic
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044101/
https://www.ncbi.nlm.nih.gov/pubmed/33850165
http://dx.doi.org/10.1038/s41598-021-86093-6
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