Robotic-assisted ventral hernia repair with surgical mesh: how I do it and case series of early experience

Abstract Aim Robotic-assisted ventral hernia repair (rVHR) has emerged as an alternative to current open and laparoscopic procedures. The present study aims to determine the effect of rVHR on postoperative quality of life. Material and Methods Patients undergoing elective rVHR from 01/01 2017 until 12/6 2020 were identified from the hospitaĺs electronic medical record system. Patient demographic, clinical presentation, location of the hernial defect and postoperative complications were obtained from the case notes. A phone interview was also conducted to assess postoperative life quality using the EuraHS-QoL questionnaire. The pre and postoperative life quality assessment was performed to determine the effect of robotic-assisted ventral hernia repair on 1. Pain at the site of the hernia, 2. Restrictions of activities due to pain or discomfort at the site of the hernia and 3. Esthetical discomfort. Moreover, patients were asked whether they felt their overall quality of life had improved, deteriorated or was unaltered after the procedure. A Wilcoxon signed rank test was conducted to determine the effect of the repair on postoperative life quality. Results 85 out of 99 patients completed the interview and were included in this case series. The survey revealed a highly significant improvement of life quality in all categories (P < 0. 01). 86% of the participants reported that their overall quality of life had improved, 13% reported no change and 1% felt that it had deteriorated. Conclusions Robotic-assisted retromuscular ventral hernia repair is a safe procedure that is associated with a significant improvement of patient quality of life.

Download Full-text

P140 OBSERVATIONAL STUDY WITH ONE YEAR FOLLOW-UP ON ROBOTIC ASSISTED RETRO-RECTUS VENTRAL HERNIA REPAIR (RTARUP) WITH A SELF-FIXATING MESH

British Journal of Surgery ◽

10.1093/bjs/znab395.132 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Filip Muysoms ◽

Maxime Dewulf ◽

Femke Nachtergaele ◽

Pieter Pletinckx

Keyword(s):

Hernia Repair ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Mesh Fixation ◽

Case Series ◽

Robotic Platform ◽

Mesh Placement ◽

Robotic Assisted ◽

The Mean

Abstract Aim Laparoscopic retro-rectus ventral hernia repair avoids the need for intra-peritoneal mesh placement and penetrating mesh fixation. The robotic platform facilitates the execution of this technique. Material and Methods From a prospective consecutive single center database all patients that underwent a robotic assisted trans-abdominal retro-rectus ventral hernia repair (rTARUP) via lateral single docking using a self-fixating mesh (ProGrip) were identified. Results Between September 2016 and December 2019, 203 patients were included. There were 89 (44%) umbilical hernias, 34 (17%) epigastric hernias and 80 (39%) incisional midline hernias. Patients had a mean BMI of 29 kg/m2. The mean hernia diameter was 3.2 cm and mainly located in zone M2-M3-M4 of the EHS classification. The mean operative time was 85 min (SD: 33 min) and all except one were clean operations. The self-fixating mesh was mostly 15 cm wide with a variable length between 15 and 30 cm. No intra-operative complications or conversions to open surgery. Intra-hospital complications were seen in 12 patients (6%) and one patient needed a reoperation for bleeding. The operation was performed in day care in 37% of patients and hospital stay was less than 24 hours in 80%. There were 6 readmissions within 30 days of surgery (3%). At 12 months clinical follow-up 3 patients were documented with a recurrence and 2 underwent an laparoscopic intra-peritoneal hernia repair. Due to COVID-19 restrictions a clinical follow-up was only possible in 73 % of patients and needs updating. Conclusions This case series reports favorable early clinical outcome of an innovative retro-rectus repair using the robotic platform.

Download Full-text