Lower recurrence rate after groin and primary ventral hernia repair performed by high-volume surgeons: a systematic review

Abstract Aims Robotic incisional/ventral hernia repair (R-IVHR) is gaining popularity due to higher safety as well as feasibility profile. The objective of this study is to present a systematic review exploring the role of robotics compared to laparoscopic approach in the management of incisional/ventral hernia. Methods A systematic review of all types of comparative studies until January 2021 published on Embase, Medline, PubMed, PubMed Central and Cochrane databases reporting the clinical outcomes in patients undergoing either R-IVHR versus Laparoscopic (L-IVHR) was performed. Results A total of 8289 patients in 7 studies were included. There was minimal heterogeneity (Tau2 = 0.29, chi2 = 9.10, df, I2 = 45 %) among included studies for the variables of recurrence rate and post-operative complications, but statistically significant heterogeneity (Tau2 = 1.05, chi2 = 132.81, I2 = 96 %) was observed for the duration of operation. In the random effects model analysis using the statistical software Review Manager, statistically the R-IVHR prolonged the duration of operation (Standardized mean difference, 2.24; 95% CI, 1.37, 3.11; z = 5.06; P = 0.00001) but the post-operative complication rate (OR 0.63; 95% CI, 0.30, 1.34; z = 1.20; P = 0.23) as well as the recurrence rate (OR 0.63; 95% CI, 0.14, 2.74; z = 0.62; P = 0.53) were similar. Conclusion R-IVH repair is feasible and safe, but the duration of operation is significantly longer. Major multi-center randomized controlled trial is mandatory to assess the long terms outcomes and cost effectiveness before the routine use of R-IVHR.

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Robotic versus laparoscopic ventral hernia repair: a systematic review and meta-analysis of randomised controlled trials and propensity score matched studies

Hernia ◽

10.1007/s10029-021-02501-w ◽

2021 ◽

Author(s):

Ramkumar Mohan ◽

Marcus Yeow ◽

Joel Yat Seng Wong ◽

Nicholas Syn ◽

Sujith Wijerathne ◽

...

Keyword(s):

Systematic Review ◽

Propensity Score ◽

Hernia Repair ◽

Ventral Hernia ◽

Randomised Controlled Trials ◽

Ventral Hernia Repair ◽

Meta Analysis ◽

Laparoscopic Ventral Hernia Repair ◽

Controlled Trials ◽

Randomised Controlled

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Local Anesthetic Use for Pain Relief Following Laparoscopic Ventral Hernia Repair: A Systematic Review

World Journal of Laparoscopic Surgery with DVD ◽

10.5005/jp-journals-10033-1349 ◽

2019 ◽

Vol 12 (1) ◽

pp. 33-38

Author(s):

Vaaiga Autagavaia ◽

Jamie-Lee Rahiri ◽

Melanie Lauti ◽

Lydia Poole ◽

Garth Poole ◽

...

Keyword(s):

Systematic Review ◽

Pain Relief ◽

Hernia Repair ◽

Ventral Hernia ◽

Local Anesthetic ◽

Ventral Hernia Repair ◽

Laparoscopic Ventral Hernia Repair

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Absorbable versus non-absorbable tacks for mesh fixation in laparoscopic ventral hernia repair: A systematic review and meta-analysis

International Journal of Surgery ◽

10.1016/j.ijsu.2018.03.042 ◽

2018 ◽

Vol 53 ◽

pp. 184-192 ◽

Cited By ~ 4

Author(s):

Rao Muhammad Asaf Khan ◽

Mumtaz Bughio ◽

Baqar Ali ◽

Shahin Hajibandeh ◽

Shahab Hajibandeh

Keyword(s):

Systematic Review ◽

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Meta Analysis ◽

Mesh Fixation ◽

Laparoscopic Ventral Hernia Repair ◽

Absorbable Tacks

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An Evaluation of Fascial Closure Techniques in Open Ventral Hernia Repair: Practice Patterns and Short-Term Outcomes

The American Surgeon ◽

10.1177/000313481908501125 ◽

2019 ◽

Vol 85 (11) ◽

pp. 1213-1218

Author(s):

Sarah S. Fox ◽

Li-Ching Huang ◽

W. Borden Hooks ◽

John P. Fischer ◽

William W. Hope

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Recurrence Rate ◽

Ventral Hernia Repair ◽

Fascial Closure ◽

Absorbable Suture ◽

Short Term ◽

Closure Technique ◽

Interrupted Suture ◽

Open Ventral Hernia Repair

The best method for fascial closure during hernia repair remains unknown. This study evaluates the impact of fascial closure techniques on short-term outcomes. All patients undergoing open ventral hernia repair were queried using the Americas Hernia Society Quality Collaborative database. Analysis was stratified by suture type (absorbable and permanent) and technique (figure-of-eight, running, and interrupted). Outcome measures included SSI, surgical site occurrence (SSO), SSO requiring intervention, recurrence rate, and quality of life. Descriptive statistics and logistic regression were used. The study included 6544 patients. Two-thirds of surgeons closed fascia during ventral hernia repair with absorbable suture and one-third with permanent suture. In the absorbable group, 17 per cent used figure-of-eight, 46 per cent running, and 4 per cent interrupted suture. In the permanent group, 13 per cent used figure-of-eight, 8 per cent running, and 11 per cent interrupted suture. There was no significant association between SSO and closure technique ( P = 0.2). However, SSO and suture type were significant ( P < 0.001) with the odds of SSO for closure with absorbable suture being 62 per cent higher than the odds of permanent. Fascial closure technique and suture type had no significant association ( P > 0.5) with SSI, SSO requiring intervention, hernia recurrence rate, or HerQLes or NIH PROMIS 3a scores at 30 days or 6 months. Fascial closure technique and suture material do not have a major impact on outcomes in ventral hernia repair. Despite a significantly higher rate of SSO for absorbable sutures than permanent, this did not increase the rate of interventions.

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Postoperative Prophylactic Antibiotics Reduce Surgical Site Infection Rates after Ventral Hernia Repair: A Systematic Review

The American Surgeon ◽

10.1177/000313481908501128 ◽

2019 ◽

Vol 85 (11) ◽

pp. 1228-1233

Author(s):

Pablo A. Baltodano ◽

Anmol Chattha ◽

Philip K. Johnson ◽

Justin Kittredge ◽

Joseph A. Ricci ◽

...

Keyword(s):

Systematic Review ◽

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Prophylactic Antibiotics ◽

Control Group ◽

Infection Rates ◽

The Impact ◽

Independent Assessment

SSIs after ventral hernia repair (VHR) represent a significant complication. The impact of postoperative prophylactic antibiotics on the SSI rates after VHRs is unclear. A systematic review of PubMed and Web of Science databases from inception through March 2016 investigating the effect of postoperative prophylactic antibiotics after VHRs was performed. Strict inclusion and exclusion criteria were implemented, and the methodological quality of the included studies was assessed. After systematic independent assessment of 216 citations, four studies, involving 344 patients, met the inclusion criteria. Among the included studies, 164 patients received >24 hours of postoperative prophylactic antibiotics, whereas 180 patients were controls. The overall incidence of SSI among patients receiving postoperative antibiotics was 14.6 per cent (95% confidence interval [CI], 9.9 to 20.9) which compares favorably with the control group: 35.5 per cent (95% CI, 28.9 to 42.7) (odds ratio: 0.3, 95% CI: 0.2 to 0.5, P < 0.01). Among patient's receiving postoperative antibiotics, the pooled average duration of postoperative antibiotic treatment was 6.2 ± 0.4 days. Based on the available evidence, the use of postoperative prophylactic antibiotics seems to be associated with lower SSI rates after VHRs. Future prospective randomized controlled trials should be conducted to further confirm the efficacy of this prophylactic intervention.

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