Highlights
- •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.
Abstract
Background
As robotic ventral hernia repair(VHR) adoption increases, real-world evidence is needed
to ensure appropriate utilization.
Methods
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.
Results
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).
Conclusion
Although hospital costs were higher, post-discharge expenses favored RVHR due to the
lower postoperative complications, which lead to comparable total costs to OVHR.
Keywords
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Article info
Publication history
Published online: February 01, 2023
Accepted:
January 31,
2023
Received in revised form:
January 11,
2023
Received:
November 30,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
