72313 - A retrospective analysis of short-term clinical outcomes after the introduction of a robotic assisted ventral hernia program at Danderyds Hospital

Introduction A robotic assisted surgery-program has been established at Danderyds Hospital in order to offer ventral hernia patients a minimal invasive approach. Method All patients undergoing either open Rives-Stoppa repair or robotic assisted minimal invasive repair for ventral hernias at Danderyds Hospital between January 2015 and April 2024 were retrospectively analyzed for short-term clinical outcomes, operation time and length of stay. Result A total of 91 consecutive open Rives-Stoppa repairs were compared to 200 consecutive robotically assisted repairs where the mesh was placed in the retrorectus compartment with minimal invasive methods. The patients in the two groups did not differ significantly regarding age, gender and hernia size. Operation time, adjusted by hernia size, was significantly longer in the robotic assisted group during the learning curve of the first 100 robotic assisted operations but did not differ from open surgery during the last 100 robotic assisted operations. Length of stay was significantly longer in the open repair group (mean 3.0 days) compared to the robotic assisted group (mean 1.3 days). Complications according to Clavien-Dindo were low in the robotically assisted group with a significan lower use of epidural anesthesia compared to open hernia surgery. Discussion Patients with ventral hernias can safely be operated using minimal invasive robotic assisted surgery. Short-term outcomes are promising with few complications and short hospital stay, indicating cost-effectiveness compared to open Rives-Stoppa repairs. Beyond the learning curve, robotic assisted ventral hernia surgery is also comparable to open surgery regarding operation time. For long-term results including recurrent hernias further studies are needed.