Department of Surgery, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
Department of Surgery, University of Eastern Finland and Mikkeli Central Hospital, Mikkeli, Finland.
Acta Chir Belg. 2023 Aug;123(4):411-417. doi: 10.1080/00015458.2022.2069656. Epub 2022 May 4.
Laparoscopic ventral hernia repair (LVHR) may be associated with chronic pain, seroma formation, bulging and failure to restore abdominal wall function. These outcomes are risk factors for hernia recurrence and poor quality of life (QoL). Our study evaluates whether robotic-assisted ventral hernia repair (rVHR) diminishes these complications compared to LVHR with primary closure of the defect (hybrid).
Thirty-eight consecutive patients undergoing incisional ventral hernia operation with fascial defect size from 3 to 6 cm were recruited between November 2019 and October 2020. Nineteen patients underwent rVHR and nineteen underwent hybrid operation. The main outcome measure was postoperative pain, evaluated with a visual analogue scale (VAS: 0-10) at 1-month and at 1-year. Hernia recurrence was evaluated with ultrasound examination and QoL using the generic SF-36 short form questionnaire.
At the 1-month control visit, VAS scores were significantly lower in the rVHR group; 2.5 in the hybrid group and 0.3 in the rVHR group ( < 0.001). At the 1-year control, the difference in VAS scores was still significant, 2.8 vs 0.1 ( = 0.023). There was one hernia recurrence in the hybrid group ( = 0.331). QoL did not differ significantly between the study groups when compared to preoperative physical status at 1-year follow-up ( = 0.121). However, emotional status ( = 0.049) and social functioning ( = 0.039) improved significantly in the rVHR group.
Robotic-assisted ventral hernia repair (rVHR) was less painful compared to hybrid repair at 1-month and at 1-year follow-up. In addition, improvement in social functioning status was reported with rVHR.
腹腔镜下腹膜切开疝修补术（LVHR）可能与慢性疼痛、血清肿形成、膨出和腹壁功能恢复失败有关。这些结果是疝复发和生活质量（QoL）差的危险因素。我们的研究评估了与使用混合方法（LVHR 中对缺损进行原发性闭合）相比，机器人辅助下腹膜切开疝修补术（rVHR）是否减少了这些并发症。
2019 年 11 月至 2020 年 10 月期间，连续招募了 38 例接受切口疝手术的患者，其筋膜缺损大小为 3 至 6 cm。19 例患者接受 rVHR 手术，19 例患者接受混合手术。主要观察指标是术后疼痛，使用视觉模拟量表（VAS：0-10）在 1 个月和 1 年时进行评估。使用超声检查和 SF-36 通用简表问卷评估疝复发和生活质量。
在 1 个月的随访中，rVHR 组的 VAS 评分显著较低，混合组为 2.5，rVHR 组为 0.3（ < 0.001）。在 1 年的随访中，VAS 评分的差异仍然显著，分别为 2.8 和 0.1（ = 0.023）。混合组有 1 例疝复发（ = 0.331）。与 1 年随访时术前身体状况相比，两组间的生活质量差异无统计学意义（ = 0.121）。然而，rVHR 组的情绪状态（ = 0.049）和社会功能（ = 0.039）显著改善。
与混合修补术相比，机器人辅助下腹膜切开疝修补术（rVHR）在 1 个月和 1 年随访时疼痛较轻。此外，rVHR 还报告了社会功能状态的改善。
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