Abstract
Background
Outcomes of incisional hernia repair (IHR) include recurrence and quality of life (QOL). Operative approaches include laparoscopic, open, and robotic approaches. Data regarding comparative QOL outcomes among these repair types are unknown. Our study evaluates quality of life after three approaches to IHR.
Study design
Patients undergoing open (OHR), laparoscopic (LIHR), and robotic extra-peritoneal (RIHR) at a single institution from 2009 to 2019 were reviewed from a prospectively managed quality database. Short-term QOL was compared among the three procedures using the Surgical Outcomes Measurement System (SOMS) and Carolinas Comfort Scale (CCS), objective pain scores and postoperative narcotic use. Data regarding length of stay (LOS), emergency department (ED) visits, readmission, reoperations and surgical site infection (SSI) were also collected.
Results
A total of 795 patients undergoing IHR were analyzed (418 open, 300 laparoscopic and 77 robotic). Patient were similar in age, gender and co-morbidities. LIHR patients had higher BMI and RIHR patients had larger hernia and mesh size. LOS was longer and rate of SSI was higher for OIHR compared to laparoscopic and RIHR. Patients undergoing LIHR reported increased narcotic use, Visual Analogue Scale (VAS) and CCS pain scores compared to open and robotic repair. Return to daily activity was 4 days shorter for robotic than open and laparoscopic repair; ED visits, readmissions, reoperations, and other QOL domains were similar.
Conclusion
Our data suggests that short-term quality of life after robotic extra-peritoneal IHR is improved compared to open and laparoscopic repair. Additional follow up is required to determine differences in long-term QOL after IHR.
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Abbreviations
- IH:
-
Incisional hernia
- IHR:
-
Incisional hernia repair
- OIHR:
-
Open incisional hernia repair
- LIHR:
-
Laparoscopic incisional hernia repair
- RIHR:
-
Robotic extra-peritoneal incisional hernia repair
- LOS:
-
Length of stay
- BMI:
-
Body mass index
- ASA:
-
American Society of Anesthesiologist
- ADL:
-
Return to activities of daily living
- NSQIP:
-
National Surgical Quality Improvement Program
- SOMS:
-
Surgical Outcomes Measurement System
- CCS:
-
Carolinas Comfort Scale
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Dr. Ray Joehl critically reviewed the study proposal.
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Dr. Linn reports personal fees from WL Gore and Associates, outside the submitted work; Dr. Ujiki reports personal fees from Boston, Olympus and Cook, personal fees from Gore and Scientific, outside the submitted work. Beau Forester, Dr. Attaar, Kara Donovan, Kristine Kuchta, Dr. Denham, Dr. Haggerty, JoAnn Carbray have no conflicts of interest or financial ties to disclose.
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Forester, B., Attaar, M., Donovan, K. et al. Short-term quality of life comparison of laparoscopic, open, and robotic incisional hernia repairs. Surg Endosc 35, 2781–2788 (2021). https://doi.org/10.1007/s00464-020-07711-4
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DOI: https://doi.org/10.1007/s00464-020-07711-4