Comparative Analysis of Perioperative Outcomes of Robotic Versus Open Transversus Abdominis Release

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2017 Jul 23

PMID 28733746

Citations 52

Authors

Luis A Martin-Del-Campo

Adam S Weltz

Igor Belyansky

Yuri W Novitsky

Affiliations

Soon will be listed here.

Abstract

Background: Transversus abdominis release (TAR) has evolved as an effective approach to complex abdominal wall reconstructions. Although the role of robotics in hernia surgery is rapidly expanding, the benefits of a robotic approach for abdominal wall reconstruction have not been established well. We aimed to compare the impact of the application of robotics to the TAR procedure on the perioperative outcomes when compared to the open TAR repairs.

Methods: Case-matched comparison of patients undergoing robotic TAR (R-TAR) at two specialized hernia centers to a matched historic cohort of open TAR (O-TAR) patients was performed. Outcome measures included patient demographics, operative details, postoperative complications, and length of hospitalization.

Results: 38 consecutive patients undergoing R-TAR were compared to 76 matched O-TAR. Patient demographics were similar between the groups, but ASA III status was more prevalent in the O-TAR group. The average operative time was significantly longer in the R-TAR group (299 ± 95 vs.. 211 ± 63 min, p < 0.001) and blood loss was significantly lower for the R-TAR group (49 ± 60 vs. 139 ± 149 mL, p < 0.001). Wound morbidity was minimal in the R-TAR, but the rate of surgical site events and surgical site infection was not different between groups. Systemic complications were significantly less frequent in the R-TAR group (0 vs. 17.1%, p = 0.026). The length of hospitalization was significantly reduced in the R-TAR group (1.3 ± 1.3 vs. 6.0 ± 3.4 days, p < 0.001).

Conclusions: In our early experience, robotic TAR was associated with longer operative times. However, we found that the use of robotics was associated with decreased intraoperative blood loss, fewer systemic complications, shorter hospitalizations, and eliminated readmissions. While long-term outcomes and patient selection criteria for robotic TAR repair are under investigations, we advocate selective use of robotics for TAR reconstructions in patients undergoing AWR.

Citing Articles

Comparing Open and Robotic Unilateral Transversus Abdominis Release in Incisional Hernias With a Lateral Component: A Single Center Retrospective Study.

Van Hoef S, Eker H, Berrevoet F, Allaeys M J Abdom Wall Surg. 2025; 3:13256.

PMID: 39963336 PMC: 11831277. DOI: 10.3389/jaws.2024.13256.

The Clinical Impact of the Introduction of a Robot-Assisted Program in a Specialized Hernia Center: A Propensity Score Matched Cohort Study on Short-Term Outcomes.

Marckmann M, Christoffersen M, Henriksen N, Kiim K World J Surg. 2025; 49(3):617-625.

PMID: 39814689 PMC: 11903252. DOI: 10.1002/wjs.12477.

Robotic trans-abdominal retromuscular hernia repair for medium-sized midline hernias: midterm outcomes and surgical site occurrence (SSO) analysis in 120 patients.

Ferraro L, Formisano G, Salaj A, Giuratrabocchetta S, Petz W, Toti F J Robot Surg. 2024; 19(1):26.

PMID: 39680358 DOI: 10.1007/s11701-024-02184-2.

Open versus robotic transversus abdominis release for ventral hernia repair: an updated systematic review, meta-analysis, and meta-regression.

Lima D, Balthazar da Silveira C, de Oliveira C, Rasador A, Kasakewitch J, Nogueira R Surg Endosc. 2024; 38(12):7083-7092.

PMID: 39528659 DOI: 10.1007/s00464-024-11382-w.

Short-Term Outcomes of Transabdominal Preperitoneal Ventral Hernia Repair With Rectus Aponeuroplasty (TAPPRA) for the Management of Incisional Hernias.

Bosley M, Felix Z, Salgado-Garza G, Lansing S, Nikolian V J Abdom Wall Surg. 2024; 3:13195.

PMID: 39324170 PMC: 11422084. DOI: 10.3389/jaws.2024.13195.

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