Oc-024 the impact of the introduction of robot-assisted surgery on a dedicated ventral hernia program

Abstract Aim The role of a robot-assisted approach in hernia surgery remains controversial due to the high costs associated with robotic surgery and the proposed equal outcomes compared to open surgery. In the current study, we report the 30-day results of the introduction of robot-assisted approach in a dedicated regional ventral hernia repair center. Material & Methods This was a retrospective single-center cohort study, including consecutive patients undergoing ventral hernia repair from 2017 to 2022. To reduce the risk of bias, patients undergoing robotic and open repair were matched by propensity scores in a 1:2 ratio on the variables age, type of hernia (primary/ventral) and horizontal fascial defect size. Multivariable logistic regression was performed. Results A total of 109 patients undergoing robotic repair were compared to 231 undergoing open repair, of which 61.2% were incisional and 38.8% primary hernias. Mean hernia defect size was 4.9×6.5 cm (horizontal x vertical). The mean length of stay was lower after robotic repair (0.1 vs. 1.9 days, P < 0.001) as was the incidence of readmission (3.7% vs. 15.2%, P < 0.001). The incidence of reoperation was insignificantly lower after robotic repair (0.9% vs. 4.8%, P = 0.139), however after adjusting for confounders there was a significantly reduced risk of reoperation after robotic compared to open repair (OR 0.08, CI 0.01–0.92, P = 0.043). Conclusions The introduction of a robotic approach was associated with significantly improved postoperative outcomes.