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 abdominal wall function specific quality of life metrics comparing open to robotic-assisted retromuscular hernia repair
Retromuscular ventral hernia repairs are a common surgical technique for the management of incisional hernias. The placement of mesh in a well vascularized plane, free from abdominal viscera, with wide overlap of the hernia defect, have led to lower recurrence rates and durability that make it arguably the gold standard for small to moderate sized hernias.
Robotic–assisted retromuscular repairs have been shown to have similar objective outcomes to the open approach. However, a comparison between the two groups in terms of abdominal wall function. The Hernia Related Quality of Life Survey (HerQLes) was developed to address this, as a patient-centered method for the evaluation of abdominal wall function.
METHODS AND PROCEDURES: This is a retrospective review of prospectively collected data using the Americas Hernia Society Quality Collaborative data between 2013 – 2018. Included subjects were >18 years old, had an open or robotic-assisted retromuscular ventral hernia repair performed with HerQLes summary scores available. The HerQLes score is scored out of 100, where a higher number indicates a better quality of life. Wilcoxon rank sum test and Pearson chi-square test were used. A 3:1 propensity-matched analysis was performed with the groups matched on baseline HerQLes scores, age, sex, BMI, smoking status, ASA Class, diabetes and hernia size.
RESULTS: The propensity-matched analysis included 120 patients, stratified 3:1 into open (N= 90) and robotic (N=30) cohorts. The median age was 61 [52-68] and 58 [51-63] years for open and robotic, respectively. Sixty-nine percent of the open population were female compared to 73% in the robotic arm. The median hernia width was 6cm and 7cm for the open and robotic groups, respectively. Post-operative complications rates were similar in both groups (p=0.29). One-year recurrence rates were not statistically different(19% vs. 23%) in the open and robotic groups, respectively(p=0.6).
The median HerQLes summary scores at 30-days(48 vs 48) and I year(81 vs. 82) were not significantly different between the open and robotic groups, respectively(p=0.54, p=0.86). This resulted in a median change from baseline to 1 year of 21.7 for both(p=0.6).
CONCLUSION: Both open and robotic-assisted retromuscular ventral hernia repairs are associated with improved patient reported quality of life outcomes, with no significant outcome differences between the techniques. Larger study populations are still needed to further evaluate this topic.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95519
Program Number: P563
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster