Quality of life and surgical outcomes of robotic retromuscular ventral hernia repair using a new hybrid mesh reinforcement.

Abstract

Purpose: The purpose of this study is to prospectively evaluate surgical and quality of life (QoL) outcomes of robotic retromuscular ventral hernia repair (rRMVHR) using a new hybrid mesh in high-risk patients.

Methods: Data was prospectively collected for patients classified as high-risk based on the modified ventral hernia working group (VHWG) grading system, who underwent rRMVHR using Synecor™ Pre hybrid mesh in a single center, between 2019 and 2020. Pre-, intra- and postoperative variables including hernia recurrence, surgical site events (SSE), hernia-specific quality of life (QoL), and financial costs were analyzed. QoL assessments were obtained from preoperative and postoperative patient visits. Kaplan-Meier survival analysis was performed to analyze the estimated recurrence-free time.

Results: Fifty-two high-risk patients, with a mean (±SD) age of 58.6 ± 13.7 years and BMI of 36.9 ± 6.6 kg/m², were followed for a mean (±SD) period of 22.4 ± 7.1 months. A total of 11 (21.2%) patients experienced postoperative complications, out of which eight were SSEs, including 7 (13.5%) seromas, 1 (1.9%) hematoma, and no infections. Procedural interventions were required for 2 (3.8%) surgical site occurrences. Recurrence was seen in 1 (1.9%) patient. The estimated mean (95% confidence interval) recurrence-free time was 33 (32.3-34.5) months. Postoperative QoL assessments demonstrated significant improvements in comparison to preoperative QoL, with a minimum ∆mean (±SD) of -15.5 ± 2.2 at one month (p < 0.001). The mean (±SD) procedure cost was $13,924.18 ± 7856.95 which includes the average mesh cost ($5390.12 ± 3817.03).

Conclusion: Our study showed favorable early and mid-term outcomes, in addition to significant improvements in QoL, after rRMVHR using Synecor™ hybrid mesh in high-risk patients.