Robotic versus Laparoscopic Ventral Hernia Repair: One-year Results from a Prospective, Multicenter, Blinded Randomized Controlled Trial.

OBJECTIVE The aim of this study was to compare clinical and patient-reported outcomes of robotic versus laparoscopic ventral hernia repair (LVHR) at one-year post-operative. SUMMARY BACKGROUND DATA Despite a relative lack of research at low risk for bias assessing robotic ventral hernia repair (RVHR), the growth of RVHR has been rapid. We previously reported short-term results of the first randomized control trial (RCT) comparing RVHR versus LVHR; there was no clear difference in clinical outcomes but increased operative time and cost with robotic repair. METHODS Patients from a multicenter, blinded RCT comparing RVHR versus LVHR were followed at one year. Outcomes included wound complication (surgical site infection, surgical site occurrence, wound dehiscence), hernia occurrence including recurrence and port site hernia, readmission, reoperation, and patient-reported outcomes (functional status, pain, and satisfaction with repair and cosmesis). RESULTS A total of 124 patients were randomized and 113 patients (91%; 60 robot, 53 laparoscopic) completed one-year follow-up. Baseline demographics were similar in both groups. No differences were seen in wound complication (15% vs 15%; p = 0.899), hernia recurrence (7% vs 9%; p = 0.576), or readmission (2% vs 6%; p = 0.251). No patients underwent reoperation in the robotic arm, whereas five (9%) did in the laparoscopic arm (p = 0.020). No differences were seen in patient-reported outcomes. Both arms reported clinically significant improvements in functional status, low pain scores and high satisfaction scores at one-year post repair. CONCLUSION This study confirms that robotic ventral hernia repair is safe when compared to laparoscopy. Further studies are needed to confirm these findings.