Early Adoption of Complex Robotic Ventral Hernia Repair in a Low-Volume Center: A Retrospective Comparative Analysis with Consecutive Open Cases

Le résumé fourni par la source

Background/Objectives: Robotic-assisted abdominal wall reconstruction is increasingly used for complex ventral hernias; however, implementation in low-volume settings and early adoption of complex cases remain controversial. This study aimed to evaluate perioperative outcomes of robotic ventral hernia repair with early inclusion of complex cases and to compare these results with open surgery. Methods: Prospectively collected data were retrospectively analyzed for consecutive complex robotic ventral hernia repairs performed between September 2021 and December 2025. A cohort of consecutive open Rives–Stoppa repairs was included for comparison (n = 21 per group). Outcomes included operative time, length of hospital stay (LOS), and perioperative complications. Results: Operative time was significantly longer in the robotic group (median 310 vs. 118 minutes, p < 0.001). The median LOS was significantly shorter following robotic repair (3 vs. 5 days, p = 0.0018). Postoperative complications occurred in 10% of robotic cases and 24% of open cases (p = 0.41). Major complications and reoperation rates were low and comparable between groups. Complex robotic cases, including procedures requiring component separation, were introduced early without evidence of worse short-term outcomes. Conclusions: Robotic ventral hernia repair was associated with significantly shorter hospital stay compared with open surgery, despite longer operative times and higher procedural complexity. Complication rates were comparable between groups. Early inclusion of technically complex cases did not compromise short-term outcomes.

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