Open vs. robot-assisted preperitoneal inguinal hernia repair. Are they truly clinically different?
Rodrigues-Gonçalves, V. (Hospital Universitari Vall d'Hebron)
Verdaguer-Tremolosa, M. (Hospital Universitari Vall d'Hebron)
Martínez-López, Pilar (Hospital Universitari Vall d'Hebron)
Fernandes, Nair (Hospital Universitari Vall d'Hebron)
Bel, R. (Hospital Universitari Vall d'Hebron)
López Cano, Manuel (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	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.
Nota:	Altres ajuts: acords transformatius de la UAB
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Inguinal hernia repair ; Open preperitoneal inguinal hernia repair ; Posterior mesh inguinal hernia repair ; Robotic inguinal hernia repair
Publicado en:	Hernia, 2024 , ISSN 1248-9204

DOI: 10.1007/s10029-024-03050-8
PMID: 38704470

9 p, 498.3 KB

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