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Hernia

pp 1–11 | Cite as

Short-term comparison between preperitoneal and intraperitoneal onlay mesh placement in robotic ventral hernia repair

  • F. Gokcal
  • S. Morrison
  • O. Y. KudsiEmail author
Original Article
  • 123 Downloads

Abstract

Purpose

The aim of this study was to compare perioperative results of robotic IPOM (r-IPOM) and robotic TAPP (r-TAPP) in ventral hernia repair, and to identify risk factors associated with postoperative complications.

Methods

After obtaining balanced groups with propensity score matching, the comparative analysis was performed in terms of perioperative and early outcomes. All variables were also examined in a subset analysis in patients with and without complications. Multivariable regression analysis was used to identify independent risk factors associated with the development of complications.

Results

Of 305 r-IPOM and r-TAPP procedures, 104 patients were assigned to each group after propensity score matching. There was no difference in operative times between two groups. Although postoperative complications were largely minor (Clavien–Dindo grade-I and II), the rate of complications was higher in the r-IPOM group within the first 3-weeks (33.3% in r-IPOM vs. 20% in r-TAPP, p = 0.039). At the 3-month visit, outcomes between groups were not different (p = 0.413). Emergency department re-visits within 30-days and surgical site events were also higher in the IPOM group (p = 0.028, p = 0.042, respectively). In regression analysis, the development of complications was associated with incisional hernias (p = 0.040), intraperitoneal mesh position (p = 0.046) and longer procedure duration (p = 0.049).

Conclusion

Our data suggest r-IPOM may be associated with increased complication rates in the immediate postoperative period when compared to r-TAPP. However, at 3 months, outcomes are comparable. More investigation is needed in this area, specifically with regards to long-term follow-up and multicenter data, to determine the true value of extra-peritoneal mesh placement.

Keywords

Robotic ventral hernia repair Incisional hernia Intraperitoneal onlay mesh IPOM Transabdominal preperitoneal TAPP Propensity score matching 

Notes

Acknowledgements

The authors would like to thank Dr. Elif Gokcal for helping us with this study.

Compliance with ethical standards

Conflict of interest

Drs. Gokcal and Morrison have no conflicts of interest or financial ties to disclose. Dr. Kudsi receives teaching course and/or consultancy fees from Intuitive, Bard, Medtronic, Gore, Optecks, Medrobotic, outside the submitted work.

Ethical approval

The Institutional Review Board approved this study.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study

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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Good Samaritan Medical CenterTufts University School of MedicineBrocktonUSA

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