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Erschienen in: Surgical Endoscopy 1/2021

14.09.2020 | Dynamic Manuscript

The current state of robotic retromuscular repairs—a qualitative review of the literature

verfasst von: David A. Santos, Angela R. Limmer, Heather M. Gibson, Celia R. Ledet

Erschienen in: Surgical Endoscopy | Ausgabe 1/2021

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Abstract

Background

The management of ventral incisional hernias (VIH) has undergone many iterations over the last 5 years due to evolution in surgical techniques and advancement in robotic surgery. Four general principles have emerged: mesh usage, retromuscular mesh placement, primary fascial closure, and usage of minimally invasive techniques when possible. The application of robotic retromuscular repairs in VIH allow these principles to be applied simultaneously. This qualitative review attempts to answer what robotic retromuscular repairs are described, which patients are selected for these techniques, and what are current outcomes.

Methods

Using the key words: “robotic retromuscular repair”, “robotic Rives Stoppa”, and “robotic transversus abdominis release”, a PubMed search of articles written up to December 2019 was critically reviewed.

Results

44 articles were encountered, 9 high-quality articles were analyzed for this manuscript. Level of evidence ranged from 2B to 2C. Robotic TAR patients had BMI of 33 kg/m2, defect sizes ranging from 7–14 cm wide to 12–19 cm long, longer OR times, no difference in surgical site events, and shorter length of stay (LOS). The techniques to perform robotic Rives Stoppa (RS) were heterogeneous; however, extended totally extraperitoneal (ETEP) approach is most described. Defect width for RS repairs ranged 4–7 cm and LOS was less than 1 day. Complication rates were low, there is no long-term data on hernia recurrence, and information on cost is limited.

Conclusion

In short-term follow-up, robotic retromuscular repairs show promise that VIH can be repaired with intramuscular mesh, few complications, and shorter LOS. Data on hernia recurrence, long-term complications, and rigorous cost analysis are needed to demonstrate generalizability.
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Metadaten
Titel
The current state of robotic retromuscular repairs—a qualitative review of the literature
verfasst von
David A. Santos
Angela R. Limmer
Heather M. Gibson
Celia R. Ledet
Publikationsdatum
14.09.2020
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 1/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-020-07957-y

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