Transabdomnial (TA) versus totally extraperitoneal (TEP) robotic retromuscular ventral hernia repair: a propensity score matching analysis

42nd Annual European Hernia Society Congress, Barcelona, İspanya, 28 - 29 Mayıs 2020, cilt.24, ss.2, (Özet Bildiri)

Background: Robotic hernia repair with retromuscular mesh placement

can be performed with either a transabdominal or

extraperitoneal trocar access.

Purpose: The aim of this study is to investigate the differences

between these two access techniques while evaluating short-term

outcomes of robotic transabdominal retromuscular (rTA-RM) repair

and robotic totally extraperitoneal retromuscular (rTEP-RM) repair

for ventral hernias.

Methods: Patients who underwent robotic retromuscular repair over a

6-year period were included in the study. A one-to-one propensity

score matching (PSM) analysis was conducted to obtain two balanced

groups. A comparative analysis of perioperative and early postoperative

outcomes (up to 90-days) was performed.

Results: From a total of 589 patients, 214 patients were included for

the PSM analysis. 82 patients were allocated to each study group.

Operative times and the need for adhesiolysis were higher in the rTARM

group. Intraoperative complications occurred more frequently in

patients who underwent rTA-RM repair (p = 0.120; 4.9% in rTA-RM

vs. 0% in rTEP-RM). The rate of major complications during the first

90 days did not differ between groups (p = 0.277; 7.3% vs. 2.4%,

respectively). The proportion of patients with minor perioperative

complications was statistically higher in the rTA-RM group than the

rTEP-RM group (p = 0.003; 30.5% vs. 11%, respectively). The

overall rate of surgical site events was higher in the rTA-RM group

than the rTEP-RM group (p = 0.049; 17.1% vs, 6.1%, respectively).

Conclusion: Our data suggest that rTEP-RM repair was associated

with shorter surgery duration and improved early postoperative outcomes

in comparison with rTA-RM repair.