A direct comparison of robotic and laparoscopic hernia repair: patient-reported outcomes and cost analysis
- PDF / 828,089 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 181 Views
ORIGINAL ARTICLE
A direct comparison of robotic and laparoscopic hernia repair: patient‑reported outcomes and cost analysis N. E. Zayan1 · M. P. Meara2 · J. S. Schwartz2 · V. K. Narula2 Received: 13 January 2019 / Accepted: 27 March 2019 © Springer-Verlag France SAS, part of Springer Nature 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. Keywords Laparoscopic hernia repair · Robotic hernia repair · Cost analysis · Hernia outcomes
Introduction Hernia repair is one of the most commonly performed surgeries in the United States, with an estimated 1 million repairs taking place every year [1]. While the incidence of primary hernias has remained about the same, the incidence of incisional hernias has increased as abdominal surgery becomes more prevalent; in fact, it is estimated that about 20% of the 4000,000 laparotomies performed annually result in an incisional hernia [1, 2]. Prior to the 1990s, all hernia repairs were performed via an open procedure. Primary suture is one of the oldest hernia repair techniques, but is associated with an especially high risk of hernia recurrence. * V. K. Narula [email protected] 1
Ohio State University College of Medicine, 370 W 9th Ave, Columbus, OH 43210, USA
Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH 43210, USA
2
With the introduction of a mesh, which allows the intraabdominal pressure to be distributed across the area of the mesh instead of only on the defect, the recurrence rate has decreased to around 24% in a 3-year follow-up period [2]. With
Data Loading...
