Abstract
Background
The da Vinci robotic laparoscopic incisional hernia repair with intracorporeal closure of the fascial defect and circumferential suturing of the mesh may offer an alternative to current fascial closure and transabdominal sutures and tackers.
Methods
From 2009 to 2011, a retrospective review of 13 patients with a mean age of 51 years, median body mass index (BMI) of 31.53 kg/m2, and small and medium-sized ventral hernias (mean fascial defect 37.39 cm2) were treated with the da Vinci robot system using intracorporeal primary closure of the fascial defect with a running O-absorbable suture followed by underlay mesh fixation using a continuous running, circumferential, nonabsorbable suture. This study aimed to assess the technical feasibility of the procedure. In addition, the operating time and specific morbidity of postoperative pain, and long-term recurrence were recorded.
Results
The mean operating time was 131 min. There were no conversions to open or standard laparoscopic techniques. There were no postoperative deaths. The overall morbidity rate was 13%. One patient remained in hospital for pain control, and another experienced urinary retention that required a Foley catheter. The mean hospital stay was 2.4 days. During a median follow-up period of 23 months, one of the patients experienced a recurrent hernia. None experienced chronic suture site pain or discomfort.
Conclusions
This is a retrospective series review of robot-assisted ventral hernia repair using intracorporeal primary closure followed by continuous running, circumferential fixation. The findings show that this technique is feasible and may not be associated with chronic postoperative pain. Further evaluation is needed, and long-term data are lacking to assess the benefit to the patient, but this series can be the basis for future studies.
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Conflict of interest
Drs. Erik Wilson and Brad Snyder have agreements with Intuitive Surgical for contract fees when giving national and international robotic lectures or proctoring other surgeons for credentialing of robotic privileges. In addition, the minimally invasive fellowship at the University of Texas is partially funded by Intuitive Surgical, Ethicon Endosurgery, and Gore. This work is independent of any of these industries, and no endowments were provided for this manuscript.
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Allison, N., Tieu, K., Snyder, B. et al. Technical Feasibility of Robot-Assisted Ventral Hernia Repair. World J Surg 36, 447–452 (2012). https://doi.org/10.1007/s00268-011-1389-8
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DOI: https://doi.org/10.1007/s00268-011-1389-8