Sameer Alrefai, MD, Micah Mabe, BS, Michelle Vy, James G Bittner IV, MD. Virginia Commonwealth University
Background: A minimally invasive approach to abdominal wall reconstruction with posterior component separation (AWR/PCS) may offer benefits compared to open procedures in select patients with ventral and incisional hernia. The use of robotics to facilitate AWR/PCS is growing in popularity with minimal data to support its adoption. The purpose of this study was to compare short-term outcomes of open and robotic AWR/PCS.
Methods: The study was performed as a retrospective, matched cohort analysis of all consecutive patients who underwent open or robotic AWR/PCS by a single surgeon in a university hospital from January 2015 to August 2016. Patients were matched for demographics and co-morbidities as well as hernia type and size. Data collected were patient demographics and hernia classification and size, perioperative factors, hospital length of stay (LOS), 30-day outcomes, and hernia-related readmission rates. Variables were compared using nonparametric tests.
Results: Ninety-two patients underwent open (n=75) or robotic (n=17) AWR/PCS. Matched cohorts had similar age, body mass index, co-morbidities, and hernia classification and size. Compared to open, patients who underwent robotic AWR/PCS had longer average operative time (open 288.8 vs. robotic 365.2 min, P=0.032) but shorter LOS (open 7.1 vs. robotic 4 days, P=0.045). Perioperative and 30-day outcomes were similar between cohorts, readmission rates (open 5.9% vs. robo 1%, P=0.27).
Conclusions: For surgeons experienced in AWR, a robot-assisted laparoscopic approach to ventral and incisional hernias may be a safe, feasible option for select patients who require PCS. One potential benefit of a minimally invasive approach may be shorter LOS.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80900
Program Number: P029
Presentation Session: Poster (Non CME)
Presentation Type: Poster
