title: Robotic-assisted ventral hernia repair: a multicenter evaluation of clinical outcomes.
abstract: The open approach continues to be widely performed for ventral hernia repair, while the minimally invasive laparoscopic approach has grown adoption over the last decade. Recently, robotic operation was described as a new modality due to the ease for performing intracorporeal closure of the hernia defect. This study is one of the first multi-institutional case series evaluating robotic-assisted laparoscopic ventral hernia repairs, with the goal of describing robotic-assisted surgical techniques for ventral and incisional hernia repair and the outcomes in teaching and community hospital settings.
  
  
  
  Medical records of consecutive patients (including surgeon's learning curve cases) who underwent ventral or incisional hernia repair utilizing the da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale CA) were retrospectively reviewed. Data collected included preoperative history and perioperative outcomes.
  
  
  
  Data for a total of 368 patients from four institutions involving five surgeons were analyzed. They were predominantly females (60.3 %), and the mean age was 51 years. The majority of the patients were obese or morbidly obese (47.8 and 20.9 %), and 83.2 % of the patients had a history of prior abdominal operation. Conversion rate was 0.8 %, and mean length of stay was 1 day. Total postoperative complications rate up to 30 days was 8.4 %, of which incidence of paralytic ileus was 2.4 %.
  
  
  
  This large case series of 368 patients demonstrates reproducibility of safety and performance associated with robotic-assisted ventral hernia repairs performed by five surgeons at four institutions. In addition, the results of short term perioperative outcomes for surgeons during their early experience for robotic-assisted cases are in the range of what is reported in the existing published data on laparoscopic and open ventral hernia repairs. Further comparative evidence initiatives are being pursued to determine the benefits of robotic-assisted technique and technology for long-term and patient-reported outcomes.
authors: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Ave. Suite B210, Miami, FL, 33173, USA. anthonyg@baptisthealth.net.
authors: Anthony
authors: A
authors: Gonzalez
authors: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Ave. Suite B210, Miami, FL, 33173, USA.
authors: Ernesto
authors: E
authors: Escobar
authors: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Ave. Suite B210, Miami, FL, 33173, USA.
authors: Rey
authors: R
authors: Romero
authors: Population Health and Outcomes Research, Center for Research and Grants, Baptist Health South Florida, Miami, FL, USA.
authors: Gail
authors: G
authors: Walker
authors: Population Health and Outcomes Research, Center for Research and Grants, Baptist Health South Florida, Miami, FL, USA.
authors: Jacqueline
authors: J
authors: Mejias
authors: Population Health and Outcomes Research, Center for Research and Grants, Baptist Health South Florida, Miami, FL, USA.
authors: Michelle
authors: M
authors: Gallas
authors: Hillcrest Medical Center and Oklahoma Physician Group, Tulsa, OK, USA.
authors: Eugene
authors: E
authors: Dickens
authors: Mid-Florida Surgical Associates, Clermont, FL, USA.
authors: Christopher J
authors: CJ
authors: Johnson
authors: Department of General and Bariatric Surgery, Baptist Health South Florida, 7800 SW 87th Ave. Suite B210, Miami, FL, 33173, USA.
authors: Jorge
authors: J
authors: Rabaza
authors: Steward Good Samaritan Medical Center, Brockton, MA, USA.
authors: Omar Yusef
authors: OY
authors: Kudsi
mesh_terms: D000328:Adult; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D014481:United States / Q000453:epidemiology
keywords: Incisional hernia; Laparoscopic hernia repair; Open hernia; Robotic incisional hernia; Robotic ventral hernia; Ventral hernia