Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year Analysis

IntroductionTo compare laparoscopic and ventral hernia repair (VHR) in the last 5 years in the United States utilizing the Abdominal Core Health Quality Collaborative (ACHQC) database.Materials and MethodsA retrospective review of prospectively collected data from the ACHQC database was performed to...

Full description

Saved in:
Bibliographic Details
Main Authors: Diego L. Lima, Raquel Nogueira, Joao P. G. Kasakewich, Carlos Andre Balthazar da Silveira, Ana Caroline Dias Rasador, Sharon Phillips, Flavio Malcher
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Journal of Abdominal Wall Surgery
Subjects:
Online Access:https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.13352/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850069285286707200
author Diego L. Lima
Raquel Nogueira
Joao P. G. Kasakewich
Carlos Andre Balthazar da Silveira
Ana Caroline Dias Rasador
Sharon Phillips
Flavio Malcher
author_facet Diego L. Lima
Raquel Nogueira
Joao P. G. Kasakewich
Carlos Andre Balthazar da Silveira
Ana Caroline Dias Rasador
Sharon Phillips
Flavio Malcher
author_sort Diego L. Lima
collection DOAJ
description IntroductionTo compare laparoscopic and ventral hernia repair (VHR) in the last 5 years in the United States utilizing the Abdominal Core Health Quality Collaborative (ACHQC) database.Materials and MethodsA retrospective review of prospectively collected data from the ACHQC database was performed to include all adult patients that underwent laparoscopic and robotic VHR in the last 5 years. Univariate analysis was performed to compare outcomes from laparoscopic and robotic-assisted approaches across perioperative and postoperative outcomes.ResultsACHQC database identified 11,096 patients with midline hernias who underwent VHR with mesh. The Laparoscopic group with patients from 2018 to 2023 (LAP) had 2,063 patients, and the robotic group (ROBO) had 9,033 patients. There was no difference in sex, age, BMI, DM, smoking status and COPD between groups. Median hernia width was 4 cm (IQR 2–6) in the ROBO group and 3 cm (IQR 2–5) in the LAP group (p < 0.001). Incisional hernia was higher in the ROBO group 5,259 (58%) versus 1,099 (53%) in the LAP group (p < 0.001). Recurrent hernia was more common in the ROBO group when compared with the LAP group (p < 0.001). Both groups had more permanent synthetic mesh. Retromuscular repair was higher in the ROBO group, 3,201 (37.6%) versus 68 (4.2%) in the LAP group (p < 0.001). The intraperitoneal repair was higher in the LAP group 1,363 (83%) versus 2,925 (34%) in the ROBO group (p < 0.001) Transversus Abdominis Release (TAR) was higher in the ROBO group 1,314 (14.5%) versus 5 (0.2%) in the LAP group (p < 0.001). Fascial closure was higher in the ROBO group (8,649; 96.5% versus 1,359; 67.3% in the LAP group p < 0.001). Regarding mesh fixation, regular suture was higher in the ROBO group 92% versus 61% in the LAP group (p < 0.001). Tacks (p < 0.001) was higher in the LAP group. The ROBO group had more patients with an operative time of 240+ minutes when compared with the LAP group (p < 0.001). There was no difference in 30-days readmission rates, recurrence, reoperation, overall postoperative complications, 30-day SSI, SSO, seroma and SSOPI between the groups.ConclusionThe Robotic approach was associated with more technically challenging ventral hernia repairs with low complication rates over time. However, no differences in postoperative complications were found between the groups.
format Article
id doaj-art-aecb6b5a7a2f4ea5a7ffa3a53ba7d179
institution DOAJ
issn 2813-2092
language English
publishDate 2025-03-01
publisher Frontiers Media S.A.
record_format Article
series Journal of Abdominal Wall Surgery
spelling doaj-art-aecb6b5a7a2f4ea5a7ffa3a53ba7d1792025-08-20T02:47:49ZengFrontiers Media S.A.Journal of Abdominal Wall Surgery2813-20922025-03-01410.3389/jaws.2025.1335213352Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year AnalysisDiego L. Lima0Raquel Nogueira1Joao P. G. Kasakewich2Carlos Andre Balthazar da Silveira3Ana Caroline Dias Rasador4Sharon Phillips5Flavio Malcher6Department of Surgery, Montefiore Medical Center, The Bronx, NY, United StatesDepartment of Surgery, Montefiore Medical Center, The Bronx, NY, United StatesDepartment of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United StatesBahiana School of Medicine and Public Health, Salvador, Bahia, BrazilBahiana School of Medicine and Public Health, Salvador, Bahia, BrazilDepartment of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, United StatesDivision of General Surgery, NYU Langone, New York, NY, United StatesIntroductionTo compare laparoscopic and ventral hernia repair (VHR) in the last 5 years in the United States utilizing the Abdominal Core Health Quality Collaborative (ACHQC) database.Materials and MethodsA retrospective review of prospectively collected data from the ACHQC database was performed to include all adult patients that underwent laparoscopic and robotic VHR in the last 5 years. Univariate analysis was performed to compare outcomes from laparoscopic and robotic-assisted approaches across perioperative and postoperative outcomes.ResultsACHQC database identified 11,096 patients with midline hernias who underwent VHR with mesh. The Laparoscopic group with patients from 2018 to 2023 (LAP) had 2,063 patients, and the robotic group (ROBO) had 9,033 patients. There was no difference in sex, age, BMI, DM, smoking status and COPD between groups. Median hernia width was 4 cm (IQR 2–6) in the ROBO group and 3 cm (IQR 2–5) in the LAP group (p < 0.001). Incisional hernia was higher in the ROBO group 5,259 (58%) versus 1,099 (53%) in the LAP group (p < 0.001). Recurrent hernia was more common in the ROBO group when compared with the LAP group (p < 0.001). Both groups had more permanent synthetic mesh. Retromuscular repair was higher in the ROBO group, 3,201 (37.6%) versus 68 (4.2%) in the LAP group (p < 0.001). The intraperitoneal repair was higher in the LAP group 1,363 (83%) versus 2,925 (34%) in the ROBO group (p < 0.001) Transversus Abdominis Release (TAR) was higher in the ROBO group 1,314 (14.5%) versus 5 (0.2%) in the LAP group (p < 0.001). Fascial closure was higher in the ROBO group (8,649; 96.5% versus 1,359; 67.3% in the LAP group p < 0.001). Regarding mesh fixation, regular suture was higher in the ROBO group 92% versus 61% in the LAP group (p < 0.001). Tacks (p < 0.001) was higher in the LAP group. The ROBO group had more patients with an operative time of 240+ minutes when compared with the LAP group (p < 0.001). There was no difference in 30-days readmission rates, recurrence, reoperation, overall postoperative complications, 30-day SSI, SSO, seroma and SSOPI between the groups.ConclusionThe Robotic approach was associated with more technically challenging ventral hernia repairs with low complication rates over time. However, no differences in postoperative complications were found between the groups.https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.13352/fullrobotic surgeryventral herniaminimally invasive surgerylaparoscopic surgeryincisional hernia
spellingShingle Diego L. Lima
Raquel Nogueira
Joao P. G. Kasakewich
Carlos Andre Balthazar da Silveira
Ana Caroline Dias Rasador
Sharon Phillips
Flavio Malcher
Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year Analysis
Journal of Abdominal Wall Surgery
robotic surgery
ventral hernia
minimally invasive surgery
laparoscopic surgery
incisional hernia
title Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year Analysis
title_full Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year Analysis
title_fullStr Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year Analysis
title_full_unstemmed Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year Analysis
title_short Laparoscopic Versus Robotic Ventral Hernia Repair – An ACHQC Database 5-Year Analysis
title_sort laparoscopic versus robotic ventral hernia repair an achqc database 5 year analysis
topic robotic surgery
ventral hernia
minimally invasive surgery
laparoscopic surgery
incisional hernia
url https://www.frontierspartnerships.org/articles/10.3389/jaws.2025.13352/full
work_keys_str_mv AT diegollima laparoscopicversusroboticventralherniarepairanachqcdatabase5yearanalysis
AT raquelnogueira laparoscopicversusroboticventralherniarepairanachqcdatabase5yearanalysis
AT joaopgkasakewich laparoscopicversusroboticventralherniarepairanachqcdatabase5yearanalysis
AT carlosandrebalthazardasilveira laparoscopicversusroboticventralherniarepairanachqcdatabase5yearanalysis
AT anacarolinediasrasador laparoscopicversusroboticventralherniarepairanachqcdatabase5yearanalysis
AT sharonphillips laparoscopicversusroboticventralherniarepairanachqcdatabase5yearanalysis
AT flaviomalcher laparoscopicversusroboticventralherniarepairanachqcdatabase5yearanalysis