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Clinical outcomes and cost of robotic ventral hernia repair: systematic review

BACKGROUND: Robotic ventral hernia repair (VHR) has seen rapid adoption, but with limited data assessing clinical outcome or cost. This systematic review compared robotic VHR with laparoscopic and open approaches. METHODS: This systematic review was undertaken in accordance with PRISMA guidelines. P...

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Autores principales: Ye, Linda, Childers, Christopher P, de Virgilio, Michael, Shenoy, Rivfka, Mederos, Michael A, Mak, Selene S, Begashaw, Meron M, Booth, Marika S, Shekelle, Paul G, Wilson, Mark, Gunnar, William, Girgis, Mark D, Maggard-Gibbons, Melinda
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599882/
https://www.ncbi.nlm.nih.gov/pubmed/34791049
http://dx.doi.org/10.1093/bjsopen/zrab098
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author Ye, Linda
Childers, Christopher P
de Virgilio, Michael
Shenoy, Rivfka
Mederos, Michael A
Mak, Selene S
Begashaw, Meron M
Booth, Marika S
Shekelle, Paul G
Wilson, Mark
Gunnar, William
Girgis, Mark D
Maggard-Gibbons, Melinda
author_facet Ye, Linda
Childers, Christopher P
de Virgilio, Michael
Shenoy, Rivfka
Mederos, Michael A
Mak, Selene S
Begashaw, Meron M
Booth, Marika S
Shekelle, Paul G
Wilson, Mark
Gunnar, William
Girgis, Mark D
Maggard-Gibbons, Melinda
author_sort Ye, Linda
collection PubMed
description BACKGROUND: Robotic ventral hernia repair (VHR) has seen rapid adoption, but with limited data assessing clinical outcome or cost. This systematic review compared robotic VHR with laparoscopic and open approaches. METHODS: This systematic review was undertaken in accordance with PRISMA guidelines. PubMed, MEDLINE, Embase, and Cochrane databases were searched for articles with terms relating to ‘robot-assisted’, ‘cost effectiveness’, and ‘ventral hernia’ or ‘incisional hernia’ from 1 January 2010 to 10 November 2020. Intraoperative and postoperative outcomes, pain, recurrence, and cost data were extracted for narrative analysis. RESULTS: Of 25 studies that met the inclusion criteria, three were RCTs and 22 observational studies. Robotic VHR was associated with a longer duration of operation than open and laparoscopic repairs, but with fewer transfusions, shorter hospital stay, and lower complication rates than open repair. Robotic VHR was more expensive than laparoscopic repair, but not significantly different from open surgery in terms of cost. There were no significant differences in rates of intraoperative complication, conversion to open surgery, surgical-site infection, readmission, mortality, pain, or recurrence between the three approaches. CONCLUSION: Robotic VHR was associated with a longer duration of operation, fewer transfusions, a shorter hospital stay, and fewer complications compared with open surgery. Robotic VHR had higher costs and a longer operating time than laparoscopic repair. Randomized or matched data with standardized reporting, long-term outcomes, and cost-effectiveness analyses are still required to weigh the clinical benefits against the cost of robotic VHR.
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spelling pubmed-85998822021-11-18 Clinical outcomes and cost of robotic ventral hernia repair: systematic review Ye, Linda Childers, Christopher P de Virgilio, Michael Shenoy, Rivfka Mederos, Michael A Mak, Selene S Begashaw, Meron M Booth, Marika S Shekelle, Paul G Wilson, Mark Gunnar, William Girgis, Mark D Maggard-Gibbons, Melinda BJS Open Systematic Review BACKGROUND: Robotic ventral hernia repair (VHR) has seen rapid adoption, but with limited data assessing clinical outcome or cost. This systematic review compared robotic VHR with laparoscopic and open approaches. METHODS: This systematic review was undertaken in accordance with PRISMA guidelines. PubMed, MEDLINE, Embase, and Cochrane databases were searched for articles with terms relating to ‘robot-assisted’, ‘cost effectiveness’, and ‘ventral hernia’ or ‘incisional hernia’ from 1 January 2010 to 10 November 2020. Intraoperative and postoperative outcomes, pain, recurrence, and cost data were extracted for narrative analysis. RESULTS: Of 25 studies that met the inclusion criteria, three were RCTs and 22 observational studies. Robotic VHR was associated with a longer duration of operation than open and laparoscopic repairs, but with fewer transfusions, shorter hospital stay, and lower complication rates than open repair. Robotic VHR was more expensive than laparoscopic repair, but not significantly different from open surgery in terms of cost. There were no significant differences in rates of intraoperative complication, conversion to open surgery, surgical-site infection, readmission, mortality, pain, or recurrence between the three approaches. CONCLUSION: Robotic VHR was associated with a longer duration of operation, fewer transfusions, a shorter hospital stay, and fewer complications compared with open surgery. Robotic VHR had higher costs and a longer operating time than laparoscopic repair. Randomized or matched data with standardized reporting, long-term outcomes, and cost-effectiveness analyses are still required to weigh the clinical benefits against the cost of robotic VHR. Oxford University Press 2021-11-17 /pmc/articles/PMC8599882/ /pubmed/34791049 http://dx.doi.org/10.1093/bjsopen/zrab098 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Systematic Review
Ye, Linda
Childers, Christopher P
de Virgilio, Michael
Shenoy, Rivfka
Mederos, Michael A
Mak, Selene S
Begashaw, Meron M
Booth, Marika S
Shekelle, Paul G
Wilson, Mark
Gunnar, William
Girgis, Mark D
Maggard-Gibbons, Melinda
Clinical outcomes and cost of robotic ventral hernia repair: systematic review
title Clinical outcomes and cost of robotic ventral hernia repair: systematic review
title_full Clinical outcomes and cost of robotic ventral hernia repair: systematic review
title_fullStr Clinical outcomes and cost of robotic ventral hernia repair: systematic review
title_full_unstemmed Clinical outcomes and cost of robotic ventral hernia repair: systematic review
title_short Clinical outcomes and cost of robotic ventral hernia repair: systematic review
title_sort clinical outcomes and cost of robotic ventral hernia repair: systematic review
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8599882/
https://www.ncbi.nlm.nih.gov/pubmed/34791049
http://dx.doi.org/10.1093/bjsopen/zrab098
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