Robotic transversus abdominis release (TAR) for ventral hernia repairs is associated with low surgical site occurrence rates and length of stay despite increasing modifiable comorbidities.

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  • Additional Information
    • Source:
      Publisher: Springer Country of Publication: France NLM ID: 9715168 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1248-9204 (Electronic) Linking ISSN: 12489204 NLM ISO Abbreviation: Hernia Subsets: MEDLINE
    • Publication Information:
      Original Publication: Paris, France : Springer, c1997-
    • Subject Terms:
      Hernia, Ventral*/surgery ; Robotic Surgical Procedures* ; Length of Stay*/statistics & numerical data ; Herniorrhaphy*/methods ; Abdominal Muscles*; Humans ; Male ; Female ; Middle Aged ; Retrospective Studies ; Aged ; Surgical Mesh ; Comorbidity ; Obesity/complications
    • Abstract:
      Purpose: Modifiable comorbidities (MCMs) have previously been shown to complicate postoperative wound healing occasionally leading to surgeon hesitancy to repair ventral hernias prior to preoperative optimization of comorbidities. This study describes the effects of MCMs on surgical site occurrences (SSOs) and hospital length of stay (LOS) following robotic transversus abdominis release (TAR) with poly-4-hydroxybutyrate (P4HB) resorbable biosynthetic mesh retromuscular sublay for ventral hernia repair in patients who had not undergone preoperative optimization.
      Methods: A single-surgeon retrospective review was performed for patients who underwent the robotic TAR procedure with P4HB mesh between January 2015 and May 2022. Patients were stratified by the amount of MCMs present: 0, 1, or 2 + . MCMs included obesity, diabetes, and current tobacco use. Patient data was analyzed for the first 60 days following their operation. Primary outcomes included 60-day SSO rates and hospital LOS.
      Results: Three hundred and thirty-four subjects met the inclusion criteria for SSO and prolonged LOS analysis. 16.8% had no MCM, 56.1% had 1 MCM, and 27% had 2 + MCMs. No significant difference in SSO was seen between the 3 groups; however, having 2 + MCMs was significantly associated with increased odds of SSO (odds ratio 3.25, P = .019). When the groups were broken down, only having a history of diabetes plus obesity was associated with significantly increased odds of SSO (odds ratio 3.54, P = .02). No group showed significantly increased odds of prolonged LOS.
      Conclusion: 2 + MCMs significantly increase the odds of SSO, specifically in patients who have a history of diabetes and obesity. However, the presence of any number of MCMs was not associated with increased odds of prolonged LOS.
      (© 2024. The Author(s).)
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    • Contributed Indexing:
      Keywords: Comorbidities; Hernia; Hospital length of stay; Surgical outcomes; Surgical site infections
    • Publication Date:
      Date Created: 20240501 Date Completed: 20241003 Latest Revision: 20241015
    • Publication Date:
      20241015
    • Accession Number:
      PMC11449944
    • Accession Number:
      10.1007/s10029-024-03044-6
    • Accession Number:
      38693351