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Comparison of BMI on operative time and complications of robotic inguinal hernia repair at a VA medical center

  • 2021 SAGES Oral
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

BMI is a risk factor for recurrence and post-operative complications in both open and laparoscopic totally extraperitoneal approach (TEP) repair. Robotic surgery using the transabdominal preperitoneal approach (TAPP) is a safe and viable option for inguinal hernia repair (IHR). The objective of this study is to determine how difference in BMI influences rate of operative time, complications, and rate of recurrence in a robotic TAPP IHR.

Methods

We performed a retrospective review of patients who underwent robotic inguinal hernia repair between 2012 and 2019 at a Veterans Health Administration facility (N = 304). The operating time, outcomes, and overall morbidity and mortality for robotic IHR were compared between three different BMI Groups. These groups were divided into: “Underweight/Normal Weight” (BMI < 25) n = 102, “Pre-Obese” (BMI 25–29.9) n = 120, and “Obese” (BMI 30 +) n = 82.

Results

The average operating time of a bilateral IHR by BMI group was 83.5, 98.4, and 97.8 min for BMIs < 25, 25–29.9, and 30 +, respectively. Operating time was lower in the Underweight/Normal BMI group compared to the Pre-Obese group (p = 0.006) as well as the Obese group (p = 0.001). For unilateral repair, the average operation length by group was 65.2, 70.9, and 85.6 min for BMIs < 25, 25–29.9, and 30 +, respectively, demonstrating an increased time for Obese compared to Underweight/Normal BMI (p = 0.001) and for Obese compared to Pre-Obese (p = 0.01). Demographic/comorbidity variables were not significantly different, except for a higher percentage of white patients in the Underweight/Normal BMI group compared to the Pre-Obese and Obese groups (p = 0.02 and p = 0.0003). There was no significant difference in complications or recurrence.

Conclusion

BMI has a significant impact on the operating time of both unilateral and bilateral robotic hernia repair. Despite this increased operative time, BMI group did not differ significantly in postoperative outcomes or in recurrence rates.

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Authors and Affiliations

  1. Department of Surgery, University of California, Irvine Medical Center, 333 City Bldg. West, Suite 1600, Orange, CA, 92868, USA

    Rene Tellez, Cyrus Farzaneh, Ashton Christian, Brian Smith & Marcelo W. Hinojosa

  2. VA Long Beach Healthcare System, Long Beach, CA, USA

    Hubert Kim, Brian Smith & Marcelo W. Hinojosa

Authors
  1. Justine Chinn
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  2. Rene Tellez
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  3. Bunchhin Huy
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  4. Cyrus Farzaneh
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  5. Ashton Christian
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  6. Jay Ramsay
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  7. Hubert Kim
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  8. Brian Smith
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  9. Marcelo W. Hinojosa
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Correspondence to Marcelo W. Hinojosa.

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Justine Chinn, Rene Tellez, Bunchhin Huy, Cyrus Farzaneh, Ashton Christian, Jay Ramsay, Hubert Kim, Brian Smith, Marcelo Hinojosa: nothing to disclose.

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Chinn, J., Tellez, R., Huy, B. et al. Comparison of BMI on operative time and complications of robotic inguinal hernia repair at a VA medical center. Surg Endosc 36, 9398–9402 (2022). https://doi.org/10.1007/s00464-022-09259-x

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  • DOI: https://doi.org/10.1007/s00464-022-09259-x

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