Caution Warranted in Robotic Ventral Hernia Repair

Surgical approach and techniques for ventral hernia repair are constantly evolving. For example, laparoscopic repair, which is mostly performed by placing an intraperitoneal mesh with or without defect closure, has evolved in the hands of a few expert surgeons to preperitoneal or retro-muscular mesh placement with or without components separation. Transfer of these advanced techniques from laparoscopic to robotic-assisted repairs has gained momentum due to better visualization and ergonomics. Open hernia repair, in its various technical permutations, remains the standard against which all other repairs are evaluated but is losing ground in favor of minimally invasive approaches. This study presents one of the longest follow-ups reported in ventral hernia surgery but falls short as it uses a surrogate measure of reoperation that underestimates clinical recurrence.