Robotic Assistance in Ventral Hernia Repair May Decrease the Incidence of Hernia Recurrence

Background: Since the advent of laparoscopic surgery, many studies have shown advantages of laparoscopic surgery over open surgery for ventral hernia repair. As robotic surgery is gaining popularity, we sought to compare the outcomes of this newer robotic assisted technique to the outcomes of established open and laparoscopic techniques to assess for any additional benefit.Methods: A meta-analysis research design was employed. Multiple databases were queried for publications over the past 10 years and 23 articles were selected based on predetermined selection criteria. Data was extracted and the arm-based network meta-analysis method was utilized to examine the effect difference for the 3 arms of our study: open, laparoscopic, and robotic assisted ventral hernia repair.Results: As expected, laparoscopy had an advantage over open ventral hernia repair in terms of infection rates. This advantage was also observed in the robotic group over the open group; however, there was no statistical difference between the laparoscopic and robotic groups when infection rates were compared head-to-head. The robotic group did have a significant advantage over both the open and, more importantly, the laparoscopic groups in recurrence rates. Conclusions: The results of this study suggest that robotic surgery maintains some of the advantages of laparoscopic surgery and may also provide the additional advantage of recurrence rate reduction. This may be explained by the ability to perform a more complex hernia repair with robotic assistance secondary to the ease of closure of the fascial defect. More research is needed to validate this finding.https://scholarlycommons.henryford.com/merf2019clinres/1033/thumbnail.jp