Original Research Article|Articles in Press

A comparison of clinical outcomes and costs between robotic and open ventral hernia repair

Published:February 01, 2023DOI:


      • A retrospective review of open and robotic ventral hernia repairs (OVHR, RVHR).
      • Clinical outcomes and detailed costs of 675 OVHRs and 609 RVHRs were compared.
      • The robotic group had lower postoperative adverse events.
      • Hospital costs were higher for RVHR, but post-discharge expenses favored RVHR.
      • RVHR could generate comparable total costs to OVHR.



      As robotic ventral hernia repair(VHR) adoption increases, real-world evidence is needed to ensure appropriate utilization.


      Data for open and robotic VHR(OVHR, RVHR) was retrospectively analyzed. Outcomes and costs were compared via inverse probability treatment weighting using propensity scores to estimate the average treatment effect on the treated for RVHR.


      675 open and 609 robotic ventral hernia repairs were included. Demographics and hernia characteristics were comparable. Complications rates were lower in RVHR(p < 0.001). Clavien-Dindo grade-III complications were lower in RVHR(13.2% vs. 4.9%, p < 0.001). RVHR resulted in fewer surgical site events(21.5% vs. 12.2%, p < 0.001). Recurrence rates were greater in OVHR(8.9% vs. 2.8%, p < 0.001). The higher RVHR hospital costs (Δ = $2456, p = 0.005) were balanced by the lower post-discharge costs, compared to OVHR(Δ = $799, p = 0.023). Total costs did not differ(Δ = $1656 p = 0.081).


      Although hospital costs were higher, post-discharge expenses favored RVHR due to the lower postoperative complications, which lead to comparable total costs to OVHR.


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