A Retrospective Cohort Study of robotic-assisted surgery in elderly surgical patients with incisional hernia

Orla O'Brien; D. Byrne; C. Gallagher

doi:10.5281/zenodo.22813439

Authors

Orla O'Brien Department of General Surgery, Tajo Institute of Surgical Research Author https://orcid.org/3718-6105-3282-5488
D. Byrne Division of General Surgery, Yamuna Research Center for Surgical Research Author https://orcid.org/7800-3867-5215-8762
C. Gallagher Department of Clinical General Surgery, Yamuna Research Center for Surgical Research Author https://orcid.org/5423-5478-3556-6417

DOI:

https://doi.org/10.5281/zenodo.22813439

Keywords:

robotic surgery, incisional hernia, elderly, retrospective cohort study, surgical outcomes

Abstract

Graphical abstract

Background: Robotic-assisted platforms have been adopted increasingly for ventral and incisional hernia repair, but outcome data specific to elderly patients, in whom the trade-off between operative time and wound morbidity may weigh differently, remain limited [14,16].

Objective: To compare perioperative and postoperative outcomes between robotic-assisted and open repair of incisional hernia in patients aged 65 years and older.

Methods: We performed a retrospective cohort study of 180 consecutive patients aged ≥65 years undergoing elective midline incisional hernia repair (90 robotic-assisted, 90 open) at three affiliated centers between 2018 and 2023, with a minimum 12-month follow-up and comparison of length of stay, wound complications, and recurrence [31,35].

Results: Robotic-assisted repair was associated with significantly shorter hospital stay (2.1 vs 5.4 days, p<0.001) and lower rates of 30-day surgical site infection (4.4% vs 15.6%, p=0.010) than open repair, at the cost of longer operative time (158 vs 112 minutes, p<0.001); hernia recurrence did not differ significantly between groups (5.6% vs 12.2%, p=0.12) [18,19].

Conclusions: In this elderly cohort, robotic-assisted incisional hernia repair reduced wound morbidity and length of stay relative to open repair without compromising recurrence, supporting its use in carefully selected older patients pending larger prospective, age-stratified trials [20,32].

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