Ward T L, Al-Amiedy Z, Robinson P, Sharma A, McClean S, Walsh C J, Simpson G S
Wirral University Teaching Hospitals, Birkenhead, United Kingdom.
J Abdom Wall Surg. 2025 Mar 13;4:13710. doi: 10.3389/jaws.2025.13710. eCollection 2025.
There is strong evidence that robotic abdominal wall reconstruction (AWR) reduces length of stay and postoperative complications. Despite this, it remains significantly limited in publicly funded healthcare systems due to reported costs and limited access to robotic surgical platforms.
Cases were reviewed from a prospectively maintained database of AWR patients in a single unit undergoing Robotic Rives-Stoppa repair or open Rives-Stoppa repair. A prospectively maintained database was accessed and analysed. Data analysed included demographics, comorbidities, hernia characteristics, operative times and surgical outcomes. Cost analysis was performed based on length of stay, critical care bed days, and cost of consumables.
Data were collected from 28 robotic Rives-Stoppa repairs and 18 open Rives-Stoppa repairs. There was no difference in operative time between the two groups (199 min vs. 186 min, = 0.147). The anaesthetic time was shorter in the robotic group (36 min vs. 56 min, = <0.001), and the length of stay was longer in the open group (2 days vs. 7 days, = <0.001). There were five critical care unit bed days in the open group, vs. 0 in the robotic group ( = <0.001). Complications were not significantly different (10.7% vs. 22.0%, = 0.407), and there were no cases of postoperative mortality. Cost analysis showed an average saving of £1,807.58 per case.
Our series demonstrates that robotic Rives-Stoppa AWR can be delivered in a safe manner with financial savings and equivalent operative time compared with open surgery.
有充分证据表明，机器人腹壁重建术（AWR）可缩短住院时间并减少术后并发症。尽管如此，由于报告的成本以及机器人手术平台的使用受限，在公共资助的医疗系统中，该技术的应用仍极为有限。
对一个前瞻性维护的数据库中的病例进行回顾，该数据库记录了在单一科室接受机器人Rives-Stoppa修补术或开放性Rives-Stoppa修补术的腹壁重建患者。访问并分析了前瞻性维护的数据库。分析的数据包括人口统计学、合并症、疝气特征、手术时间和手术结果。基于住院时间、重症监护病床天数和耗材成本进行成本分析。
收集了28例机器人Rives-Stoppa修补术和18例开放性Rives-Stoppa修补术的数据。两组手术时间无差异（199分钟对186分钟，P = 0.147）。机器人组的麻醉时间较短（36分钟对56分钟，P = <0.001），开放组的住院时间较长（2天对7天，P = <0.001）。开放组有5个重症监护病房床日，而机器人组为0（P = <0.001）。并发症无显著差异（10.7%对22.0%，P = 0.407），且无术后死亡病例。成本分析显示，每例平均节省1,807.58英镑。
我们的系列研究表明，与开放手术相比，机器人Rives-Stoppa腹壁重建术能够安全实施，节省费用且手术时间相当。
