Oc-047 enhanced recovery after robotic ventral hernia repair

Abstract Aim Enhanced recovery after surgery (ERAS) protocols lead to reduced postoperative stay and improved outcomes after most types of abdominal surgery. Little is known about the optimal postoperative protocol after robotic ventral hernia repair (RVHR), including the potential limits of outpatient surgery. We report the results of an ERAS protocol after RVHR aiming to identify predictors of overnight stay in-hospital, as well as patient-reported pain levels in the immediate postoperative period. Material & Methods This was a prospective cohort study of consecutive patients undergoing RVHR. Patients were included in a prospective database, registering patient characteristics, operative details, pain and fatigue during the first three postoperative days and pre- and 30-day postoperative hernia-related quality of life, using the EURA-HS questionnaire. Results A total of 109 patients were included, of which 66 (61%) underwent incisional hernia repair. The most performed procedure was TARUP (Robotic Transabdominal Retromuscular Umbilical Prosthetic Hernia Repair) (60.6%) followed by bilateral roboTAR (robotic Transversus Abdominis Release) (19.3%). The mean horizontal fascial defect was 4.8 cm and the mean duration of surgery was 141 minutes. In total, 78 (71.6%) patients were discharged on the day of surgery, and confounders associated with overnight stay were increasing fascial defect area, duration of surgery, and addition of TAR. There was no association between postoperative pain and overnight hospital stay. The mean EuraHS score decreased significantly from 38.4 to 6.4 (P < 0.001). Conclusions The application of an ERAS protocol after RVHR enabled a high rate of outpatient procedures with low patient-reported pain scores.