Systematic review and meta-analysis on robotic assisted ventral hernia repair: the ROVER review.

IF 2.6 2区医学 Q1 SURGERY

Hernia Pub Date : 2025-02-18 DOI:10.1007/s10029-025-03274-2

Sara Capoccia Giovannini, Maaike Vierstraete, M Frascio, G Camerini, F Muysoms, C Stabilini

{"title":"Systematic review and meta-analysis on robotic assisted ventral hernia repair: the ROVER review.","authors":"Sara Capoccia Giovannini, Maaike Vierstraete, M Frascio, G Camerini, F Muysoms, C Stabilini","doi":"10.1007/s10029-025-03274-2","DOIUrl":null,"url":null,"abstract":"Introduction: Robotic surgery for ventral hernia repair (VHR) is gaining attention for its potential advantages over laparoscopic and open techniques. This approach combines the advantages of minimally invasive surgery with the ability to perform technically challenging procedures, often required in open surgery but difficult with conventional laparoscopy. We aim to evaluate the efficacy and safety of robotic VHR compared to other surgical approaches, focusing on postoperative complications, operative time, and costs.Material and methods: A systematic review with meta-analysis were conducted, including 67 studies from January 2010 to May 2023 on Robotic VHR compared with other techniques. Primary outcome was 30-days postoperative complications; SSI, SSO, seroma, mortality, recurrence, length of hospital stay, operative time and costs were analysed as secondary outcomes.Results: Robotic surgery was associated with longer operative times compared to both laparoscopic (MD 64.67 min; p < 0.001) and open repairs (MD 69.69 min; p < 0.001). However, it resulted, compared to open surgery, in fewer SSIs (OR 0.62; p 0.05), mortality (OR 0.44; p 0.04) and shorter hospital stay (MD -3.77 days; p < 0.001). No differences were found in overall complications or length of stay between robotic and laparoscopic approaches but higher costs and longer operative times were reported in robotic VHR.Conclusions: Based on the currently available low-quality evidence, robotic VHR appears to offer limited advantages compared to laparoscopic techniques. However, when compared to open approaches, robotic VHR may demonstrate reduced postoperative complications and shorter hospital stays even if an higher rate of seroma formation was retrieved probably related to technical details. Nevertheless, longer operative times and higher costs remain significant limitations. Further high-quality comparative studies are warranted to assess long-term outcomes and cost-effectiveness.","PeriodicalId":13168,"journal":{"name":"Hernia","volume":"29 1","pages":"95"},"PeriodicalIF":2.6000,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hernia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10029-025-03274-2","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Robotic surgery for ventral hernia repair (VHR) is gaining attention for its potential advantages over laparoscopic and open techniques. This approach combines the advantages of minimally invasive surgery with the ability to perform technically challenging procedures, often required in open surgery but difficult with conventional laparoscopy. We aim to evaluate the efficacy and safety of robotic VHR compared to other surgical approaches, focusing on postoperative complications, operative time, and costs.

Material and methods: A systematic review with meta-analysis were conducted, including 67 studies from January 2010 to May 2023 on Robotic VHR compared with other techniques. Primary outcome was 30-days postoperative complications; SSI, SSO, seroma, mortality, recurrence, length of hospital stay, operative time and costs were analysed as secondary outcomes.

Results: Robotic surgery was associated with longer operative times compared to both laparoscopic (MD 64.67 min; p < 0.001) and open repairs (MD 69.69 min; p < 0.001). However, it resulted, compared to open surgery, in fewer SSIs (OR 0.62; p 0.05), mortality (OR 0.44; p 0.04) and shorter hospital stay (MD -3.77 days; p < 0.001). No differences were found in overall complications or length of stay between robotic and laparoscopic approaches but higher costs and longer operative times were reported in robotic VHR.

Conclusions: Based on the currently available low-quality evidence, robotic VHR appears to offer limited advantages compared to laparoscopic techniques. However, when compared to open approaches, robotic VHR may demonstrate reduced postoperative complications and shorter hospital stays even if an higher rate of seroma formation was retrieved probably related to technical details. Nevertheless, longer operative times and higher costs remain significant limitations. Further high-quality comparative studies are warranted to assess long-term outcomes and cost-effectiveness.

查看原文本刊更多论文

机器人辅助腹疝修复的系统回顾和荟萃分析：ROVER回顾。

机器人腹疝修补手术（VHR）因其相对于腹腔镜和开放式技术的潜在优势而受到关注。这种方法结合了微创手术的优点和进行技术上具有挑战性的手术的能力，这些手术通常需要在开放手术中进行，但在传统腹腔镜手术中很难进行。我们的目的是评估机器人VHR与其他手术方法相比的有效性和安全性，重点关注术后并发症、手术时间和成本。材料与方法：对2010年1月至2023年5月的67项关于机器人VHR与其他技术比较的研究进行系统回顾和荟萃分析。主要结局为术后30天并发症；SSI、SSO、血肿、死亡率、复发、住院时间、手术时间和费用作为次要结局进行分析。结果：与腹腔镜手术相比，机器人手术的手术时间更长(MD 64.67分钟；结论：基于目前可获得的低质量证据，与腹腔镜技术相比，机器人VHR似乎提供有限的优势。然而，与开放式入路相比，机器人VHR可能显示出更少的术后并发症和更短的住院时间，即使更高的血清形成率可能与技术细节有关。然而，较长的操作时间和较高的成本仍然是重大限制。有必要进一步进行高质量的比较研究，以评估长期结果和成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Hernia SURGERY-

CiteScore

4.90

自引率

26.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.