Laparoscopic vs Robotic Intraperitoneal Mesh Repair for Incisional Hernia: An Americas Hernia Society Quality Collaborative Analysis - 26/07/17
, Eugene O. Dickens, MD, FACS b, Chad M. Copper, MD, FACS c, John W. Mann, MD, FACS d, Jonathan P. Yunis, MD, FACS e, Sharon Phillips, MSPH f, Li-Ching Huang, PhD f, Benjamin K. Poulose, MD, MPH, FACS g, Michael J. Rosen, MD, FACS aAbstract |
Background |
Robotic intraperitoneal mesh placement (rIPOM) has emerged recently as an alternative to laparoscopic intraperitoneal mesh placement (LapIPOM) for minimally invasive incisional hernia repair. We aimed to compare LapIPOM with rIPOM in terms of hospital length of stay (LOS) and 30-day postoperative complications in patients undergoing incisional hernia repair within the Americas Hernia Society Quality Collaborative.
Study Design |
Propensity score analysis was used to compare matched groups of patients within the Americas Hernia Society Quality Collaborative undergoing LapIPOM vs rIPOM. The primary outcomes measure was hospital LOS and secondary outcomes were 30-day wound events.
Results |
Four hundred and fifty-four (71.9%) patients underwent LapIPOM and 177 (28.1%) underwent rIPOM. The laparoscopic group had an increased median LOS (1 vs 0 days; interquartile range 3.00; p < 0.001). The risk of surgical site occurrence was higher in the LapIPOM group vs the rIPOM group (14% vs 5%; p = 0.001); however, surgical site occurrence requiring procedural intervention was similar between the groups (1% vs 0%; p = 1). Operative time longer than 2 hours was more common in the rIPOM group (47% vs 31%; p < 0.05).
Conclusions |
Despite longer operative times using the rIPOM approach, patients undergoing rIPOM had a significantly shorter LOS than LapIPOM, without additional risk of wound morbidity requiring intervention. Additional studies are necessary to identify the best candidates for the rIPOM approach.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : AHSQC, IQR, LapIPOM, LOS, rIPOM, SSI, SSO, SSOPI
Plan
| Disclosure Information: Dr Prabhu receives grant money from Intuitive Surgical and receives consulting fees from MedTronic, Bard, and Cooper Surgical. Dr Rosen receives grant money from Intuitive and Miromatrix, and is a paid consultant to WL Gore and Bard. |
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| Disclosures outside of the scope of this work: Dr Mann is a paid consultant to Intuitive Surgery and receives money for travel expenses from Ethicon Endosurgery, Bard, LifeCell, Cook Inc, and Stryker. Dr Rosen is a board member to Ariste Medical. Dr Poulose is a paid consultant to Pfizer and Ariste and receives grant money from Bard-Davol. Dr Yunis receives payment for travel from BG Medical. Dr Dickens has received honoraria from MedTronic and Intuitive Surgical. |
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| Disclaimer: Drs Prabhu, Poulose, and Rosen are board members to the Americas Hernia Society Quality Collaborative (AHSQC). Dr Poulose is employed by the AHSQC. The AHSQC Foundation is supported by Bard-Davol, Acelity-LifeCell, Intuitive Surgical, and Medtronic. |
Vol 225 - N° 2
P. 285-293 - août 2017 Retour au numéro
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