Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials
ObjectiveThe objective of this meta-analysis is to compare the perioperative surgical outcomes and cost-effectiveness of robotic ventral hernia repair (RVHR) versus laparoscopic ventral hernia repair (LVHR) with intraperitoneal mesh.MethodsRandomised control trials (RCTs) reporting perioperative out...
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Frontiers Media S.A.
2025-01-01
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| Series: | Journal of Abdominal Wall Surgery |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/jaws.2024.13809/full |
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| author | Anurag Singh Wei H. Toh Nada Elzahed Goldie Khera Mirza K. Baig Andrei Mihailescu Muhammad S. Sajid |
| author_facet | Anurag Singh Wei H. Toh Nada Elzahed Goldie Khera Mirza K. Baig Andrei Mihailescu Muhammad S. Sajid |
| author_sort | Anurag Singh |
| collection | DOAJ |
| description | ObjectiveThe objective of this meta-analysis is to compare the perioperative surgical outcomes and cost-effectiveness of robotic ventral hernia repair (RVHR) versus laparoscopic ventral hernia repair (LVHR) with intraperitoneal mesh.MethodsRandomised control trials (RCTs) reporting perioperative outcomes and costs in patients undergoing RVHR versus LVHR were selected from medical electronic databases and meta-analysis was conducted in accordance with the guidelines of the Cochrane Collaboration using statistical software RevMan version 5.ResultsFour RCTs on 337 patients reporting perioperative outcomes and cost comparison were included. In the random effect model analysis, the duration of operation was shorter, and cost was lower in the LVHR group but with significant statistical heterogeneity [standardized mean difference (SMD) −48.07, 95%, CI (−78.06, −18.07), Z = 3.14, P = 0.002], [SMD 0.82, 95%, CI (−1.48, −0.16), Z = 2.45, P = 0.01]. However, the variables of hernia recurrence and surgical site complications were statistically similar in both groups without any statistical heterogeneity among the included studies [Risk Ratio (RR) 1.05, 95%, CI (0.22, 4.99), Z = 0.06, P = 0.95], [RR 0.85, 95%, CI (0.48, 1.50), Z = 0.55, P = 0.58].ConclusionThis systematic review demonstrates that RVHR does not offer any superiority among the compared perioperative variables (Duration of operation, hernia recurrence and surgical site complications) and it is not cost-effective when compared to LVHR. Due to the paucity of the RCTs and significant heterogeneity among the compared variables, a major multi-centre RCT is needed to validate these findings. |
| format | Article |
| id | doaj-art-b838e13a3b7e432989a02c1464ca6e31 |
| institution | Kabale University |
| issn | 2813-2092 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Journal of Abdominal Wall Surgery |
| spelling | doaj-art-b838e13a3b7e432989a02c1464ca6e312025-01-22T04:11:05ZengFrontiers Media S.A.Journal of Abdominal Wall Surgery2813-20922025-01-01310.3389/jaws.2024.1380913809Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled TrialsAnurag Singh0Wei H. Toh1Nada Elzahed2Goldie Khera3Mirza K. Baig4Andrei Mihailescu5Muhammad S. Sajid6Department of General Surgery, Tameside General Hospital, Ashton-Under-Lyne, United KingdomDepartment of Gastrointestinal Surgery, Royal Sussex County Hospital, Brighton, United KingdomDepartment of Gastrointestinal Surgery, Royal Sussex County Hospital, Brighton, United KingdomDepartment of Gastrointestinal Surgery, Royal Sussex County Hospital, Brighton, United KingdomDepartment of Colo-Rectal Surgery, Worthing Hospital, Worthing, United KingdomDepartment of General Surgery, Tameside General Hospital, Ashton-Under-Lyne, United KingdomDepartment of Gastrointestinal Surgery, Royal Sussex County Hospital, Brighton, United KingdomObjectiveThe objective of this meta-analysis is to compare the perioperative surgical outcomes and cost-effectiveness of robotic ventral hernia repair (RVHR) versus laparoscopic ventral hernia repair (LVHR) with intraperitoneal mesh.MethodsRandomised control trials (RCTs) reporting perioperative outcomes and costs in patients undergoing RVHR versus LVHR were selected from medical electronic databases and meta-analysis was conducted in accordance with the guidelines of the Cochrane Collaboration using statistical software RevMan version 5.ResultsFour RCTs on 337 patients reporting perioperative outcomes and cost comparison were included. In the random effect model analysis, the duration of operation was shorter, and cost was lower in the LVHR group but with significant statistical heterogeneity [standardized mean difference (SMD) −48.07, 95%, CI (−78.06, −18.07), Z = 3.14, P = 0.002], [SMD 0.82, 95%, CI (−1.48, −0.16), Z = 2.45, P = 0.01]. However, the variables of hernia recurrence and surgical site complications were statistically similar in both groups without any statistical heterogeneity among the included studies [Risk Ratio (RR) 1.05, 95%, CI (0.22, 4.99), Z = 0.06, P = 0.95], [RR 0.85, 95%, CI (0.48, 1.50), Z = 0.55, P = 0.58].ConclusionThis systematic review demonstrates that RVHR does not offer any superiority among the compared perioperative variables (Duration of operation, hernia recurrence and surgical site complications) and it is not cost-effective when compared to LVHR. Due to the paucity of the RCTs and significant heterogeneity among the compared variables, a major multi-centre RCT is needed to validate these findings.https://www.frontierspartnerships.org/articles/10.3389/jaws.2024.13809/fulllaparoscopic ventral hernia repairrobotic ventral hernia repairperioperative outcomescost comparisonIPOM |
| spellingShingle | Anurag Singh Wei H. Toh Nada Elzahed Goldie Khera Mirza K. Baig Andrei Mihailescu Muhammad S. Sajid Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials Journal of Abdominal Wall Surgery laparoscopic ventral hernia repair robotic ventral hernia repair perioperative outcomes cost comparison IPOM |
| title | Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials |
| title_full | Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials |
| title_fullStr | Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials |
| title_full_unstemmed | Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials |
| title_short | Laparoscopic Versus Robotic Ventral Hernia Repair With Intraperitoneal Mesh: A Systematic Review and Meta-Analysis Comparing the Perioperative Outcomes Randomised Controlled Trials |
| title_sort | laparoscopic versus robotic ventral hernia repair with intraperitoneal mesh a systematic review and meta analysis comparing the perioperative outcomes randomised controlled trials |
| topic | laparoscopic ventral hernia repair robotic ventral hernia repair perioperative outcomes cost comparison IPOM |
| url | https://www.frontierspartnerships.org/articles/10.3389/jaws.2024.13809/full |
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