Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different?
Introduction Inguinal hernia repair lacks a standard repair technique, with laparo-endoscopic and open preperitoneal methods showing similar outcomes. Despite higher costs, the popularity of robotic surgery is on the rise, driven by technological advantages. Controversies persist in comparing open r...
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| Veröffentlicht in: | Hernia : the journal of hernias and abdominal wall surgery 2024-08, Vol.28 (4), p.1355-1363 |
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| creator | Rodrigues-Gonçalves, V. Verdaguer-Tremolosa, M. Martínez-López, P. Fernandes, N. Bel, R. López-Cano, M. |
| description | Introduction
Inguinal hernia repair lacks a standard repair technique, with laparo-endoscopic and open preperitoneal methods showing similar outcomes. Despite higher costs, the popularity of robotic surgery is on the rise, driven by technological advantages. Controversies persist in comparing open repair techniques with the robotic approach, given contradictory results. The objective of this study was to compare postoperative outcomes, including complications, chronic pain, and recurrence, between open and robotic-assisted preperitoneal inguinal hernia repair.
Methods
This single-center retrospective study encompassed patients undergoing elective inguinal hernia repair in a specialized unit, employing both open preperitoneal and robotic-assisted laparoscopic approaches from September 2018 to May 2023. Comparative analysis of short- and long-term outcomes between these techniques was conducted. Additionally, multivariate logistic regression was employed to explore predictors of postoperative complications.
Results
A total of 308 patients met the inclusion criteria. 198 (64%) patients underwent surgery using an open preperitoneal approach and 110 (36%) using robot-assisted laparoscopy. Patients in the robot-assisted group were younger (P = 0.006) and had fewer comorbidities (P |
| doi_str_mv | 10.1007/s10029-024-03050-8 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11297094</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3087436962</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-1214f7b655919a2743804d257ea9d53ce5b24d81114f9f0c7b62bc0af6222c063</originalsourceid><addsrcrecordid>eNp9kU1P3DAQhq2KqlDoH-gBWeLCJdux4yT2CSFEaSUkLnC2HGeya5S1g50g7b_H2-WrHLjYI80z73y8hPxksGAAza-UX64K4KKAEioo5BdywLiQheIg9t7F--R7SvcAIEUtv5H9UjYgRAMHpL0Z0dPHtKAxtGEqTEouTdjRMeKI0U3Boxmo88vZ-RysMHpnaE4aFxf0PCKdVrihU5yHDbWD886aIYed63uM6KezI_K1N0PCH8__Ibn7fXl78ae4vrn6e3F-XVjB66lgnIm-aeuqUkwZ3ohSguh41aBRXVVarFouOslYxlQPNqO8tWD6mnNuoS4PydlOd5zbNXY2945m0GN0axM3Ohin_894t9LL8KgZ46oBJbLC6bNCDA8zpkmvXbI4DMZjmJPeHlkJaOS22ckH9D7MMV9oS8k8fK1qnim-o2wMKUXsX6dhoLce6p2HOnuo_3moZS46fr_Ha8mLaRkod0DKKb_E-Nb7E9knuTSnvQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3087436962</pqid></control><display><type>article</type><title>Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different?</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Rodrigues-Gonçalves, V. ; Verdaguer-Tremolosa, M. ; Martínez-López, P. ; Fernandes, N. ; Bel, R. ; López-Cano, M.</creator><creatorcontrib>Rodrigues-Gonçalves, V. ; Verdaguer-Tremolosa, M. ; Martínez-López, P. ; Fernandes, N. ; Bel, R. ; López-Cano, M.</creatorcontrib><description>Introduction
Inguinal hernia repair lacks a standard repair technique, with laparo-endoscopic and open preperitoneal methods showing similar outcomes. Despite higher costs, the popularity of robotic surgery is on the rise, driven by technological advantages. Controversies persist in comparing open repair techniques with the robotic approach, given contradictory results. The objective of this study was to compare postoperative outcomes, including complications, chronic pain, and recurrence, between open and robotic-assisted preperitoneal inguinal hernia repair.
Methods
This single-center retrospective study encompassed patients undergoing elective inguinal hernia repair in a specialized unit, employing both open preperitoneal and robotic-assisted laparoscopic approaches from September 2018 to May 2023. Comparative analysis of short- and long-term outcomes between these techniques was conducted. Additionally, multivariate logistic regression was employed to explore predictors of postoperative complications.
Results
A total of 308 patients met the inclusion criteria. 198 (64%) patients underwent surgery using an open preperitoneal approach and 110 (36%) using robot-assisted laparoscopy. Patients in the robot-assisted group were younger (P = 0.006) and had fewer comorbidities (P < 0.001). There were no differences between the groups in terms of postoperative complications (P = 0.133), chronic pain (P = 0.463) or recurrence (P = 0.192). Multivariate analysis identified ASA ≥ III (OR, 1.763; 95%CI, 1.068–3.994; P = 0.027) and inguinoscrotal hernias (OR, 2.371, 95%CI, 1.407–3.944; P = 0.001) as risk factors of postoperative complications.
Conclusions
Both open preperitoneal and robotic-assisted laparoscopic approaches show similar outcomes for complications, chronic pain, and recurrence when performed by experienced surgeons. The open preperitoneal approach, with its quicker operative time, may be advantageous for high-comorbidity cases. Treatment choice should consider patient factors, surgeon experience, and healthcare resources.</description><identifier>ISSN: 1248-9204</identifier><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-024-03050-8</identifier><identifier>PMID: 38704470</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdominal Surgery ; Adult ; Aged ; Chronic pain ; Comorbidity ; Comparative analysis ; Complications ; Female ; Hernia ; Hernia, Inguinal - surgery ; Hernias ; Herniorrhaphy - adverse effects ; Herniorrhaphy - methods ; Humans ; Laparoscopy ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Original ; Original Article ; Patients ; Postoperative ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Recurrence ; Retrospective Studies ; Risk factors ; Robotic surgery ; Robotic Surgical Procedures - adverse effects ; Robotic Surgical Procedures - methods ; Robotics ; Robots ; Surgical Mesh ; Treatment Outcome</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2024-08, Vol.28 (4), p.1355-1363</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-1214f7b655919a2743804d257ea9d53ce5b24d81114f9f0c7b62bc0af6222c063</cites><orcidid>0000-0001-8998-2327</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-024-03050-8$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-024-03050-8$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38704470$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodrigues-Gonçalves, V.</creatorcontrib><creatorcontrib>Verdaguer-Tremolosa, M.</creatorcontrib><creatorcontrib>Martínez-López, P.</creatorcontrib><creatorcontrib>Fernandes, N.</creatorcontrib><creatorcontrib>Bel, R.</creatorcontrib><creatorcontrib>López-Cano, M.</creatorcontrib><title>Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different?</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Introduction
Inguinal hernia repair lacks a standard repair technique, with laparo-endoscopic and open preperitoneal methods showing similar outcomes. Despite higher costs, the popularity of robotic surgery is on the rise, driven by technological advantages. Controversies persist in comparing open repair techniques with the robotic approach, given contradictory results. The objective of this study was to compare postoperative outcomes, including complications, chronic pain, and recurrence, between open and robotic-assisted preperitoneal inguinal hernia repair.
Methods
This single-center retrospective study encompassed patients undergoing elective inguinal hernia repair in a specialized unit, employing both open preperitoneal and robotic-assisted laparoscopic approaches from September 2018 to May 2023. Comparative analysis of short- and long-term outcomes between these techniques was conducted. Additionally, multivariate logistic regression was employed to explore predictors of postoperative complications.
Results
A total of 308 patients met the inclusion criteria. 198 (64%) patients underwent surgery using an open preperitoneal approach and 110 (36%) using robot-assisted laparoscopy. Patients in the robot-assisted group were younger (P = 0.006) and had fewer comorbidities (P < 0.001). There were no differences between the groups in terms of postoperative complications (P = 0.133), chronic pain (P = 0.463) or recurrence (P = 0.192). Multivariate analysis identified ASA ≥ III (OR, 1.763; 95%CI, 1.068–3.994; P = 0.027) and inguinoscrotal hernias (OR, 2.371, 95%CI, 1.407–3.944; P = 0.001) as risk factors of postoperative complications.
Conclusions
Both open preperitoneal and robotic-assisted laparoscopic approaches show similar outcomes for complications, chronic pain, and recurrence when performed by experienced surgeons. The open preperitoneal approach, with its quicker operative time, may be advantageous for high-comorbidity cases. Treatment choice should consider patient factors, surgeon experience, and healthcare resources.</description><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Chronic pain</subject><subject>Comorbidity</subject><subject>Comparative analysis</subject><subject>Complications</subject><subject>Female</subject><subject>Hernia</subject><subject>Hernia, Inguinal - surgery</subject><subject>Hernias</subject><subject>Herniorrhaphy - adverse effects</subject><subject>Herniorrhaphy - methods</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Postoperative</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Recurrence</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - adverse effects</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robotics</subject><subject>Robots</subject><subject>Surgical Mesh</subject><subject>Treatment Outcome</subject><issn>1248-9204</issn><issn>1265-4906</issn><issn>1248-9204</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9kU1P3DAQhq2KqlDoH-gBWeLCJdux4yT2CSFEaSUkLnC2HGeya5S1g50g7b_H2-WrHLjYI80z73y8hPxksGAAza-UX64K4KKAEioo5BdywLiQheIg9t7F--R7SvcAIEUtv5H9UjYgRAMHpL0Z0dPHtKAxtGEqTEouTdjRMeKI0U3Boxmo88vZ-RysMHpnaE4aFxf0PCKdVrihU5yHDbWD886aIYed63uM6KezI_K1N0PCH8__Ibn7fXl78ae4vrn6e3F-XVjB66lgnIm-aeuqUkwZ3ohSguh41aBRXVVarFouOslYxlQPNqO8tWD6mnNuoS4PydlOd5zbNXY2945m0GN0axM3Ohin_894t9LL8KgZ46oBJbLC6bNCDA8zpkmvXbI4DMZjmJPeHlkJaOS22ckH9D7MMV9oS8k8fK1qnim-o2wMKUXsX6dhoLce6p2HOnuo_3moZS46fr_Ha8mLaRkod0DKKb_E-Nb7E9knuTSnvQ</recordid><startdate>20240801</startdate><enddate>20240801</enddate><creator>Rodrigues-Gonçalves, V.</creator><creator>Verdaguer-Tremolosa, M.</creator><creator>Martínez-López, P.</creator><creator>Fernandes, N.</creator><creator>Bel, R.</creator><creator>López-Cano, M.</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8998-2327</orcidid></search><sort><creationdate>20240801</creationdate><title>Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different?</title><author>Rodrigues-Gonçalves, V. ; Verdaguer-Tremolosa, M. ; Martínez-López, P. ; Fernandes, N. ; Bel, R. ; López-Cano, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-1214f7b655919a2743804d257ea9d53ce5b24d81114f9f0c7b62bc0af6222c063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Chronic pain</topic><topic>Comorbidity</topic><topic>Comparative analysis</topic><topic>Complications</topic><topic>Female</topic><topic>Hernia</topic><topic>Hernia, Inguinal - surgery</topic><topic>Hernias</topic><topic>Herniorrhaphy - adverse effects</topic><topic>Herniorrhaphy - methods</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Postoperative</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Recurrence</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Robotic surgery</topic><topic>Robotic Surgical Procedures - adverse effects</topic><topic>Robotic Surgical Procedures - methods</topic><topic>Robotics</topic><topic>Robots</topic><topic>Surgical Mesh</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodrigues-Gonçalves, V.</creatorcontrib><creatorcontrib>Verdaguer-Tremolosa, M.</creatorcontrib><creatorcontrib>Martínez-López, P.</creatorcontrib><creatorcontrib>Fernandes, N.</creatorcontrib><creatorcontrib>Bel, R.</creatorcontrib><creatorcontrib>López-Cano, M.</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodrigues-Gonçalves, V.</au><au>Verdaguer-Tremolosa, M.</au><au>Martínez-López, P.</au><au>Fernandes, N.</au><au>Bel, R.</au><au>López-Cano, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different?</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2024-08-01</date><risdate>2024</risdate><volume>28</volume><issue>4</issue><spage>1355</spage><epage>1363</epage><pages>1355-1363</pages><issn>1248-9204</issn><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Introduction
Inguinal hernia repair lacks a standard repair technique, with laparo-endoscopic and open preperitoneal methods showing similar outcomes. Despite higher costs, the popularity of robotic surgery is on the rise, driven by technological advantages. Controversies persist in comparing open repair techniques with the robotic approach, given contradictory results. The objective of this study was to compare postoperative outcomes, including complications, chronic pain, and recurrence, between open and robotic-assisted preperitoneal inguinal hernia repair.
Methods
This single-center retrospective study encompassed patients undergoing elective inguinal hernia repair in a specialized unit, employing both open preperitoneal and robotic-assisted laparoscopic approaches from September 2018 to May 2023. Comparative analysis of short- and long-term outcomes between these techniques was conducted. Additionally, multivariate logistic regression was employed to explore predictors of postoperative complications.
Results
A total of 308 patients met the inclusion criteria. 198 (64%) patients underwent surgery using an open preperitoneal approach and 110 (36%) using robot-assisted laparoscopy. Patients in the robot-assisted group were younger (P = 0.006) and had fewer comorbidities (P < 0.001). There were no differences between the groups in terms of postoperative complications (P = 0.133), chronic pain (P = 0.463) or recurrence (P = 0.192). Multivariate analysis identified ASA ≥ III (OR, 1.763; 95%CI, 1.068–3.994; P = 0.027) and inguinoscrotal hernias (OR, 2.371, 95%CI, 1.407–3.944; P = 0.001) as risk factors of postoperative complications.
Conclusions
Both open preperitoneal and robotic-assisted laparoscopic approaches show similar outcomes for complications, chronic pain, and recurrence when performed by experienced surgeons. The open preperitoneal approach, with its quicker operative time, may be advantageous for high-comorbidity cases. Treatment choice should consider patient factors, surgeon experience, and healthcare resources.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>38704470</pmid><doi>10.1007/s10029-024-03050-8</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-8998-2327</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Abdominal Surgery Adult Aged Chronic pain Comorbidity Comparative analysis Complications Female Hernia Hernia, Inguinal - surgery Hernias Herniorrhaphy - adverse effects Herniorrhaphy - methods Humans Laparoscopy Laparoscopy - adverse effects Laparoscopy - methods Male Medicine Medicine & Public Health Middle Aged Multivariate analysis Original Original Article Patients Postoperative Postoperative Complications - epidemiology Postoperative Complications - etiology Recurrence Retrospective Studies Risk factors Robotic surgery Robotic Surgical Procedures - adverse effects Robotic Surgical Procedures - methods Robotics Robots Surgical Mesh Treatment Outcome |
| title | Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different? |
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