Noah Switzer, Savannah Renshaw, Carla Holcomb, Susan Maurer, Courtney Collins, Michael Meara, Vimal Narula, David Renton, Benjamin Poulose. The Ohio State University
INTRODUCTION: To examine the European Hernia Society Quality of Life (EuraHS QoL) scores at 6 months post-inguinal hernia repair comparing laparoscopic versus robotic techniques.
Minimally invasive inguinal hernia repairs have been shown to be associated with decreased post-operative pain and length of stay when compared to the open approach. While laparoscopy is more common and less expensive, robotic surgery is being increasingly utilized due to its 3Dimensional visualization and wristed motion.
Few studies exist comparing robotic and laparoscopic inguinal hernia repairs, with no consensus on superiority. The importance of focusing on patient’s quality of life is being increasingly recognized. The European Hernia Society developed a validated and effective hernia specific quality of life score (EuraHS QoL) that scores patients in three domains: pain, restriction of activities and esthetical discomfort.
METHODS AND PROCEDURES: This is a retrospective review of prospectively collected data using the Americas Hernia Society Quality Collaborative data between the years 2013 and 2018. Included subjects were >18 years old, had a laparoscopic or robotic unilateral inguinal hernia repair performed electively with 6 month EuraHS information available. The EuraHS score is 9 questions in 3 domains, where a higher score from 0-10 is considered a worse state. The Wilcoxon rank sum test and Pearson chi-square test were used.
RESULTS: This study included 148 patients, separated into laparoscopic(N=115) and robotic(N=33) cohorts. The two groups had similar basic demographics with respect to age, race, smoking status, ASA class, immunosuppressant use, chronic obstructive pulmonary disease, and diabetes status.
Post-operative complication rates were also comparable, with 10(9%) patients in the laparoscopic arm and 5(15%) patients in the robotic arm (p=0.28). No hernia recurrences or mesh infections were reported, with 1 re-admission in the robotic group.
The overall median EuraHS scores at baseline were 24 and 33 for the laparoscopic and robotic cohorts, respectively(p=0.16). This was separated into the pain, restriction and cosmetic domains and at baseline the median values were 6, 9, 5 and 10, 17, and 6 for the laparoscopic and robotic groups respectively. At 6 months, the overall change from baseline was similar, -20.0 and -23.0, respectively(p=0.75). At 6 months, the median scores for pain, restriction and cosmetic domains were 0 for both groups.
CONCLUSION: Both laparoscopic and robotic inguinal hernia repairs are associated with improved patient reported quality of life outcomes at six months post-operatively, with no significant outcome differences between the techniques.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95515
Program Number: P595
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster