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Hybrid robotic-assisted transversus abdominis release versus open transversus abdominis release: a comparison of short-term outcomes

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Abstract

Background

Although the open transversus abdominis release (oTAR) is an effective operation for large ventral hernias, it is historically associated with a relatively long length of stay. Robotic retromuscular transversus abdominis release (rTAR) allows minimally invasive repair of complex ventral hernias with shorter length of stay (LOS) compared to open repairs (TAR), but hybrid robotic TAR (hrTAR), partial open intervention via incision through the overlying hernia sac for fascial closure, may be required to accomplish effective repair of large defects. We compare LOS and short-term outcomes of a cohort of our hrTAR patients to our historical oTAR patients.

Methods

All hrTAR performed in our institution between November 2015 and July 2017 contained in a prospectively maintained robotic database and/or in the Americas Hernia Society Quality Collaborative (AHSQC) database were analyzed. Additionally, open TAR patients maintained in a prospective personal database and/or in the AHSQC from September 2013 to August 2016 were similarly analyzed and compared with hrTAR patients.

Results

134 TAR patients and 49 hrTAR patients were analyzed. Age, gender, BMI, HTN, DM, and proportion of recurrent hernia were not significantly different. Hernia width (14.3 cm vs 14.0 cm, p = 0.80) and length (21.9 vs 20.0 cm, p = 0.10) were similar between groups. Mean operative times did not differ significantly between groups (274 min vs 304 min p = 0.06). Thirty day wound events including SSI and SSOPI were not significantly different between groups. LOS was significantly shorter in the hrTAR group (3 vs 7 days, p ≤ 0.001).

Conclusion

Hybrid robotic transversus abdominis release (hrTAR) may be performed with significantly lower LOS, similar wound morbidity and complication profile compared to open TAR. This novel surgical technique provides a minimally invasive option for a challenging subset of large ventral hernias which cannot be treated effectively with a purely robotic approach and would traditionally require and open operation.

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Authors and Affiliations

  1. William Beaumont Hospital, Royal Oak Michigan, 3601 West 13 Mile Rd, Royal Oak, MI, 48067, USA

    J. T. Halka, A. Vasyluk, A. Demare, A. Iacco & R. Janczyk

Authors
  1. J. T. Halka
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  2. A. Vasyluk
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  3. A. Demare
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  4. A. Iacco
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  5. R. Janczyk
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Corresponding author

Correspondence to J. T. Halka.

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Conflict of interest

Randy J. Janczyk, MD: Has received honoraria from Intuitive Surgical. Anthony A. Iacco, MD: Has received honoraria from Intuitive Surgical. Joshua T. Halka, MD: Declares no conflict of interest. Andrew Vasyluk, MD: Declares no conflict of interest. Alexander DeMare, MD: Declares no conflict of interest.

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This article does not contain any studies with human participants performed by any of the authors.

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Halka, J.T., Vasyluk, A., Demare, A. et al. Hybrid robotic-assisted transversus abdominis release versus open transversus abdominis release: a comparison of short-term outcomes. Hernia 23, 37–42 (2019). https://doi.org/10.1007/s10029-018-1858-1

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  • DOI: https://doi.org/10.1007/s10029-018-1858-1

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