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Войти в исследования Hernia : the journal of hernias and abdominal wall surgery · 2025
Comparative approach for abdominal wall reconstruction after ventral hernia: open versus minimally invasive surgery.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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González De Godos Andrea, Sánchez González Javier, López Rodríguez Beatriz, Lizarralde Capelastegui Andrea Carlota, Estébanez Peláez Guillermo, Pacheco Sánchez David, Toledano Trincado Miguel
Аннотация
INTRODUCTION: The classic open ventral hernia repair provides excellent results in recurrences. However, wound complications are the Achilles heel for a good overall clinical outcome. Laparoscopic surgery is in general associated with less pain, better esthetic results, faster recovery, and lower incidence of wound complications. Robotic procedures provide increased degrees of freedom, may improve ergonomics, and allow scaling and performance of finer movements deemed difficult through alternate surgical approaches.
PURPOSE: The aim of this study is to compare outcomes between open and minimally invasive approaches, with the primary objective of determining differences in postoperative course and hospitalization.
METHODS: Patients underwent any of the three procedures: open Rives-Stoppa, laparoscopic eTEP or robotic eTEP between June 2020 and January 2024 for the treatment of one or more midline abdominal wall hernias alongside rectus abdominis diástasis. The width diameter of the hernias was between 3 and 10 cm and techniques that did not place the mesh in a retromuscular position or required component separation are excluded.
RESULTS: Robotic surgery had a lower score on the visual analogue scale for pain at discharge (p-value < 0.00). Minimally invasive surgery allows for the placement of larger meshes compared to the open approach (p < 0.05), although the surgical time is longer (p-value < 0.00). There were no statistically significant differences for hospital stay (p-value = 0.46), complications (p-value = 0.52) or recurrence (p-value = 0.70).
CONCLUSION: Minimally invasive surgery allows for the placement of larger meshes compared to the open approach without increasing the morbidity of the procedure or the immediate postoperative pain, despite generally having longer operative times.
PURPOSE: The aim of this study is to compare outcomes between open and minimally invasive approaches, with the primary objective of determining differences in postoperative course and hospitalization.
METHODS: Patients underwent any of the three procedures: open Rives-Stoppa, laparoscopic eTEP or robotic eTEP between June 2020 and January 2024 for the treatment of one or more midline abdominal wall hernias alongside rectus abdominis diástasis. The width diameter of the hernias was between 3 and 10 cm and techniques that did not place the mesh in a retromuscular position or required component separation are excluded.
RESULTS: Robotic surgery had a lower score on the visual analogue scale for pain at discharge (p-value < 0.00). Minimally invasive surgery allows for the placement of larger meshes compared to the open approach (p < 0.05), although the surgical time is longer (p-value < 0.00). There were no statistically significant differences for hospital stay (p-value = 0.46), complications (p-value = 0.52) or recurrence (p-value = 0.70).
CONCLUSION: Minimally invasive surgery allows for the placement of larger meshes compared to the open approach without increasing the morbidity of the procedure or the immediate postoperative pain, despite generally having longer operative times.