Y. Julia Chen, MD, Desmond Huynh, BS, Kam Hei Tsuei, BA, MA, Celia M Divino, MD, Edward Chin, MD, Scott Nguyen, MD, Linda Zhang, MD. Mount Sinai Medical Center
Introduction: The aim of the study is to investigate the outcomes of the da Vinci robotic-assisted laparoscopic hernia repair of small size ventral hernias with circumferential suturing of the mesh compared to the traditional laparoscopic repair with trans-fascial suturing.
Methods and Procedures: A retrospective review was performed at our institution between 2013 and 2015 of all robotic-assisted umbilical, epigastric, and incisional hernia repairs compared to laparoscopic umbilical or epigastric hernia repairs. Patient characteristics, operative details, and postoperative complications were collected and analyzed using univariate analysis. Three primary minimally invasive fellowship trained surgeons performed all of the procedures included in the analysis.
Results: 72 patients were identified during the study period. 39 patients underwent robotic-assisted repair (RR) (21 umbilical, 14 epigastric, 4 incisional) and 33 patients laparoscopic repair (LR) (27 umbilical, 6 epigastric). 7 were recurrent hernias (RR: 4, LR: 3). There were no significant differences in preoperative characteristics between the two groups. Average operative time was 156 minutes for RR and 65 minutes for LR (p<0.0001). The average defect size was significantly larger for the RR group [3.07 cm (1 – 9 cm)] than the LR group [2.02 cm (0.5 – 5 cm)], (p<0.0001) although there was no significant difference in the average size of mesh used (13 cm vs. 13 cm). There was no difference in patients requiring post-operative admission or length of stay between the two groups. The average duration of follow up was 21.7 days. There was no difference in complication rate during this time and no recurrences were reported.
Conclusion: Small size ventral hernias repaired using the robotic-assisted technique demonstrates equivalent safety and efficacy when compared to the standard laparoscopic hernia repair.