Cargando…

Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center

Robotic-assisted abdominal wall repair (RAWR) has seen an exponential adoption over the last 5 years. Skepticism surrounding the safety, efficacy, and cost continues to limit a more widespread adoption of the platform. We describe our initial experience of 312 patients undergoing RAWR at a large aca...

Descripción completa

Detalles Bibliográficos
Autores principales: Pereira, Xavier, Lima, Diego L., Friedmann, Patricia, Romero-Velez, Gustavo, Mandujano, Cosman C., Ramos-Santillan, Vicente, Garcia-Cabrera, Ana, Malcher, Flavio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer London 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136367/
https://www.ncbi.nlm.nih.gov/pubmed/34018122
http://dx.doi.org/10.1007/s11701-021-01251-2
_version_ 1783695428066213888
author Pereira, Xavier
Lima, Diego L.
Friedmann, Patricia
Romero-Velez, Gustavo
Mandujano, Cosman C.
Ramos-Santillan, Vicente
Garcia-Cabrera, Ana
Malcher, Flavio
author_facet Pereira, Xavier
Lima, Diego L.
Friedmann, Patricia
Romero-Velez, Gustavo
Mandujano, Cosman C.
Ramos-Santillan, Vicente
Garcia-Cabrera, Ana
Malcher, Flavio
author_sort Pereira, Xavier
collection PubMed
description Robotic-assisted abdominal wall repair (RAWR) has seen an exponential adoption over the last 5 years. Skepticism surrounding the safety, efficacy, and cost continues to limit a more widespread adoption of the platform. We describe our initial experience of 312 patients undergoing RAWR at a large academic center. A retrospective review of all patients undergoing any RAWR from July 1, 2016 to March 18, 2020 was completed. Patient specific, operation specific, and 30-day outcomes specific data were collected. Univariate analysis and multivariate logistic regression were used to assess factors associated with 30-day complications. There was a steady adoption of RAWR over the study period. A total of 312 patient were included, 138 (44%) were abdominal wall repairs and 174 (56%) were inguinal repairs. The mean age of the cohort was 54.2 years (SD 16), 69% were males, and the mean BMI was 29 kg/m(2) (SD 4.8). There were two reported intraoperative events and nine operative conversions. 60 patients had at least one complication at 30-days. These include: 52 seromas, 4 hematomas, 2 surgical-site infections, 1 deep venous thrombus, and 1 recurrence at 30-days. BMI, type of hernia, and sex were not associated with complications at 30-days. The use of absorbable mesh, longer hospital stay, operative conversion, previous repair, and expert hernia surgeon were significant predictors of 30-day complications. Age, operative conversion, and previous repair were the only predictors of 30-day complications on multivariate regression. Our initial experience of 312 patients demonstrates the adoption and comparable short-term outcomes for a wide variety of robotic-assisted hernia repairs.
format Online
Article
Text
id pubmed-8136367
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Springer London
record_format MEDLINE/PubMed
spelling pubmed-81363672021-05-21 Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center Pereira, Xavier Lima, Diego L. Friedmann, Patricia Romero-Velez, Gustavo Mandujano, Cosman C. Ramos-Santillan, Vicente Garcia-Cabrera, Ana Malcher, Flavio J Robot Surg Original Article Robotic-assisted abdominal wall repair (RAWR) has seen an exponential adoption over the last 5 years. Skepticism surrounding the safety, efficacy, and cost continues to limit a more widespread adoption of the platform. We describe our initial experience of 312 patients undergoing RAWR at a large academic center. A retrospective review of all patients undergoing any RAWR from July 1, 2016 to March 18, 2020 was completed. Patient specific, operation specific, and 30-day outcomes specific data were collected. Univariate analysis and multivariate logistic regression were used to assess factors associated with 30-day complications. There was a steady adoption of RAWR over the study period. A total of 312 patient were included, 138 (44%) were abdominal wall repairs and 174 (56%) were inguinal repairs. The mean age of the cohort was 54.2 years (SD 16), 69% were males, and the mean BMI was 29 kg/m(2) (SD 4.8). There were two reported intraoperative events and nine operative conversions. 60 patients had at least one complication at 30-days. These include: 52 seromas, 4 hematomas, 2 surgical-site infections, 1 deep venous thrombus, and 1 recurrence at 30-days. BMI, type of hernia, and sex were not associated with complications at 30-days. The use of absorbable mesh, longer hospital stay, operative conversion, previous repair, and expert hernia surgeon were significant predictors of 30-day complications. Age, operative conversion, and previous repair were the only predictors of 30-day complications on multivariate regression. Our initial experience of 312 patients demonstrates the adoption and comparable short-term outcomes for a wide variety of robotic-assisted hernia repairs. Springer London 2021-05-20 2022 /pmc/articles/PMC8136367/ /pubmed/34018122 http://dx.doi.org/10.1007/s11701-021-01251-2 Text en © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2021 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
Pereira, Xavier
Lima, Diego L.
Friedmann, Patricia
Romero-Velez, Gustavo
Mandujano, Cosman C.
Ramos-Santillan, Vicente
Garcia-Cabrera, Ana
Malcher, Flavio
Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center
title Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center
title_full Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center
title_fullStr Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center
title_full_unstemmed Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center
title_short Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center
title_sort robotic abdominal wall repair: adoption and early outcomes in a large academic medical center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136367/
https://www.ncbi.nlm.nih.gov/pubmed/34018122
http://dx.doi.org/10.1007/s11701-021-01251-2
work_keys_str_mv AT pereiraxavier roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter
AT limadiegol roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter
AT friedmannpatricia roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter
AT romerovelezgustavo roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter
AT mandujanocosmanc roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter
AT ramossantillanvicente roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter
AT garciacabreraana roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter
AT malcherflavio roboticabdominalwallrepairadoptionandearlyoutcomesinalargeacademicmedicalcenter