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A direct comparison of robotic and laparoscopic hernia repair: patient-reported outcomes and cost analysis

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A Letter to the Editor to this article was published on 04 July 2019

Abstract

Purpose

Hernia repair is one of the most commonly performed surgeries in the United States. Since the introduction of the Da Vinci robot, robot-assisted hernia repairs have become more common. In this study we aim to directly compare robotic and laparoscopic hernia repairs as well as explore potential cost differences. We hypothesize that robot-assisted hernia repairs are associated with better patient-reported outcomes.

Methods

We conducted retrospective review to create a cohort study of 53 robotic (37 inguinal and 16 ventral) and 101 laparoscopic (68 inguinal and 33 ventral) hernia repairs. Patient-reported outcomes were measured using the Carolinas Comfort Scale (CCS). Operative details were examined, and a cost analysis was performed.

Results

Combining both hernia types together as well as looking at inguinal and ventral repairs separately, we found that there was no difference in hernia recurrence or 1-year CCS between robotic and laparoscopic hernia repair. For ventral hernia repairs alone, robotic procedure was associated with a decreased length of stay. We found that our robotic cases did have longer operative times and higher costs. The operative times did decrease to a length comparable to that of the laparoscopic cases as experience operating with the robot increased.

Conclusion

In comparison to laparoscopic hernia repair, robotic hernia repair does not improve long-term patient-reported surgical outcomes. However, it does increase the cost of the operation and, in general, result in longer operative times.

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Authors and Affiliations

  1. Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH, 43210, USA

    N. E. Zayan

  2. Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH, 43210, USA

    M. P. Meara, J. S. Schwartz & V. K. Narula

Authors
  1. N. E. Zayan
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  2. M. P. Meara
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  3. J. S. Schwartz
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  4. V. K. Narula
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Corresponding author

Correspondence to V. K. Narula.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

This study was approved by the Institutional Review Board of The Ohio State University.

Human and animal rights

All procedures performed were in accordance with ethical standards of the institutional research committee, and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual patients as necessary.

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Zayan, N.E., Meara, M.P., Schwartz, J.S. et al. A direct comparison of robotic and laparoscopic hernia repair: patient-reported outcomes and cost analysis. Hernia 23, 1115–1121 (2019). https://doi.org/10.1007/s10029-019-01943-7

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  • DOI: https://doi.org/10.1007/s10029-019-01943-7

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