Kevin Bain, DO, Erika King, Vadim Meytes, DO, Sharique Nazir, MD. NYU Langone Hospital – Brooklyn
Background: The foundation of innovation in surgery is driven by the inherent desire to yield an increasingly efficient surgical approached with decreased morbidity and mortality. The advancements of laparoscopy have made a tremendous impact in hernia surgery, and it has largely replaced open surgical repair. In this regard, a novel technical approach is being explored through the robotic platform. This study compares a single physician’s experience with inguinal and ventral hernias, being repaired laparoscopically and robotically, with respect to duration of surgery, intraoperative costs, length of stay (LOS), and postoperative complications.
Methods: A single center, single surgeon retrospective review was conducted sampling data from January 2017 to August 2017 examining ventral and inguinal hernia repairs.
Results: Data was extrapolated from 13 inguinal hernia repairs, 6 were robotic (RIH) and 7 were laparoscopic (LIH). Average OR time for RIH was 127 minutes compared to LIH which was 85 minutes. Average intraoperative cost for RIH was $1,110 compared to LIH which was $890. Of note, one LIH was converted to open, whereas none of the RIH required conversion. Average LOS was 9.16 hours for RIH compared to 11.6 hours for LIH. Postoperative pain at one week follow up was the same between both groups. Two postoperative surgical site occurrences (SSO) occurred in the LIH group (2 groin seromas), whereas no SSOs occurred in the RIH group. Eleven ventral hernia repairs were examined, 7 were robotic (RVH) and 4 were laparoscopic (LVH). Average OR time for RVH was 132 minutes compared to 65 minutes for LVH. Average intraoperative cost for RVH was $1,492 compared to LVH which was $1,264. No procedure from either group required conversion to open. Average LOS was 9.86 hours for RVH, and 13.5 hours for LVH. Again, postoperative pain was the same at one week follow up for both groups. There were no postoperative complications noted in either cohort.
Conclusion: Operative time and procedural costs for RVH and RIH repairs were shown to be longer and more expensive when compared to their laparoscopic counterparts. However, with increased operative experience using the robotic platform, surgical time did show a decreasing trend. Length of stay was similar between robotic and laparoscopic cohorts. Postoperative pain and complications were comparable between robotic and laparoscopic groups. In conclusion, we found that the robotic platform offers an acceptable approach to inguinal and ventral hernia repairs.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86234
Program Number: P793
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster