A Real-World Experience of the Short-Term Clinical Outcomes of Laparoscopic and Robotic-Assisted Ventral Hernia Repairs

摘要

BACKGROUND: This study aims to provide the first comparative real-world evidence of laparoscopic and robotic-assisted ventral hernia repairs performed in India, regardless of defect size or technique used. METHODS: The primary objective was to compare postoperative pain, analgesic use, and quality of life (QOL) between the two groups. Additionally, data on length of hospital stay, operating time, incidence of intra- and postoperative complications, re-admission rates, and use of tacks were collected and analyzed. RESULTS: The study included 290 cases: 111 (38.28%) in the robotic group and 179 (61.72%) in the laparoscopic group. Incisional hernias were more common in the robotic group (65 patients, 58.56%), while primary ventral hernias were more prevalent in the laparoscopic group (113 patients, 63.13%). The most common robotic repair approach was extended totally extraperitoneal Rives-Stoppa (eTEP-RS) with or without transversus abdominis release (TAR), performed in 75 (67.56%) cases. In the laparoscopic group, intraperitoneal onlay mesh (IPOM) plus was the most frequently performed procedure, used in 115 (64.25%) cases. The robotic group reported significantly lower pain levels after 6 hours, 24 hours, and 14 days following surgery. The number and duration of analgesic use were significantly reduced in the robotic group. Additionally, the robotic group had significantly better health perception scores. Compared to the laparoscopic group, the robotic group experienced significantly fewer postoperative complications (2 vs. 16; p = 0.013). Notably, the robotic group did not use tacks for mesh fixation, while tacks were employed in roughly 116 (64.8%) of the laparoscopic cases. CONCLUSION: In real-world Indian settings, this study demonstrates the feasibility of robotic-assisted ventral hernia repairs, regardless of defect size or technique used.