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Robotic‐assisted ventral hernia repair with surgical mesh: how I do it and case series of early experience
Author(s) -
Kozman Mathew A.,
Tonkin Darren,
Eteuati Jimmy,
Karatassas Alex,
McDonald Christopher R.
Publication year - 2019
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15071
Subject(s) - medicine , seroma , interquartile range , surgery , hernia , hernia repair , surgical mesh , ventral hernia , general surgery , complication
Background Laparoscopic ventral hernia repair provides several benefits over the open approach. Intraperitoneal surgical mesh placement without fascial defect closure is associated with increased seroma formation and other adverse hernia‐site outcomes. Transfascial sutures and tacs for fascial closure and surgical mesh fixation are associated with greater post‐operative pain. Robotic‐assisted ventral hernia repair (rVHR) may afford benefits of the laparoscopic approach while facilitating a more robust and less painful repair. Methods Consecutive patients managed by rVHR from May 2015 to August 2018 were identified from a prospectively maintained robotic database. Retrospective review of this data was performed. Results Fifty patients underwent rVHR during the study period. Median body mass index was 31 (interquartile range (IQR) 29–34). Forty‐eight had previous abdominal surgery. Forty‐seven hernias were midline and three were lateral. Regarding hernia width, 15 were <4 cm wide, 32 were 4–10 cm and three were >10 cm. Median total anaesthetic time, docking time and surgical console time were 214 min (IQR 182–252), 5 min (IQR 4–8) and 144 min (IQR 104–174), respectively. No major intra‐operative complications occurred. No documented cases of adhesional complications or chronic post‐operative pain have occurred. To date, two recurrences have occurred in our series. Median length of hospital stay was 3 days (IQR 2–4). Conclusion We describe our rVHR technique and report on our series and early experience, showing that rVHR can be performed safely with good patient outcomes. We demonstrate a team approach to achieving a safe transition to new technology.