Preliminary robotic abdominal wall reconstruction experience: single-centre outcomes of the first 150 cases

Langenbecks Arch Surg. 2023 Jul 14;408(1):276. doi: 10.1007/s00423-023-03004-1.

Abstract

Purpose: Robotic surgery offers new possibilities in repairing complex hernias with a minimally invasive approach. This study aimed to analyze our preliminary results.

Methods: Between November 2015 and February 2020, 150 patients underwent robotic reconstruction for abdominal wall defects (77 primary and 73 incisional). A retrospective analysis of a prospectively maintained database was conducted to evaluate the short-term outcomes.

Results: The mean operative time was 176.9 ± 72.1 min. No conversion to open or laparoscopic approach occurred. The mean hospital length of stay was 2.6 ± 1.6. According to Clavien-Dindo classification, two (grade III) complications following retromuscular mesh placement (1.3%) occurred. One patient (0.7%) required surgical revision due to small bowel occlusion following an intraparietal hernia. The 30-day readmission rate was 0.6%, and the mortality was nihil.

Conclusions: Robotic surgery is valuable for safely completing challenging surgical procedures like complex abdominal wall reconstruction, with low conversion and complication rates. A stepwise approach to the different surgical techniques is essential to optimize the outcomes and maximize the benefits of the robotic approach.

Keywords: Robotic IPOM; Robotic TAPP; Robotic surgery; Robotic ventral hernia; Robotic-TAR; TARUP.

Publication types

  • Review

MeSH terms

  • Abdominal Wall* / surgery
  • Hernia, Ventral* / surgery
  • Herniorrhaphy / methods
  • Humans
  • Incisional Hernia* / surgery
  • Laparoscopy* / methods
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Surgical Mesh