Emily Benzer, DO, J. Stephen Scott, MD, FACS. University of Missouri
Introduction: The objective of our study was to evaluate our experience with robotically repaired non-midline abdominal wall hernias at a high-volume robotic surgery program. We also will discuss the technical advantages of the use of robotic technology in repair of these unusual hernias which have typically had higher recurrence rates then midline hernias. Laparoscopic approach for lateral ventral abdominal wall hernia (spigelian) and lumbar hernia has been described, however the success of robotic assisted repair for these hernias has yet to be determined.
Methods: A retrospective case analysis of all robotic abdominal hernia cases between June 2016 and June 2017 at an academic institution with a single high volume robotic surgeon was performed. The operative details of robotic repair of non-midline abdominal hernias, patient demographics, length of stay and smoking status were recorded and analyzed. The technical advantages of the use of robotic technology for example circumferential fixation of the mesh, ease of intracorporeal suturing, and the use of wristed instruments to gain better angles for posterior fascial release were evaluated.
Results: A total of 11 cases were identified. The average age of the patients was 54.3 years (range 25-74 years) and patients were predominantly female (91%). Spigelian hernias represented 73% (n=8) and lumbar hernias 27%(n=3). All patients had primary closure of their defect and 7 patients (64%) had a posterior myofascial release performed. Mesh types placed included polypropylene uncoated (n=7), polypropylene coated (n=3), and biologic (n=1). With uncoated polypropylene mesh placed had peritoneum closed over the mesh. The average length of stat was 1.9 days (Range 0-6 days). There were no recurrences identified over a mean follow up period of 3.1 months (range 0.5-13.2 months).
Conclusion: Robotic assisted repair of non-midline abdominal wall hernias is a viable option in the elective setting with no recurrences noted in this case series. The technical advantages of using robotic technology were identified and discussed in detail. These advantages theoretically improve outcomes in these patients however further analysis on long-term outcome and costs will have to be determined in future studies.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88049
Program Number: P784
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster