Robotics can decrease the rate of post-operative ventral hernia: a single centre retrospective cohort study.
Humans
Robotic Surgical Procedures
/ methods
Retrospective Studies
Hernia, Ventral
/ surgery
Female
Male
Laparoscopy
/ methods
Middle Aged
Aged
Postoperative Complications
/ prevention & control
Colectomy
/ methods
Incisional Hernia
/ prevention & control
Cohort Studies
Anastomosis, Surgical
/ methods
Incisional hernia
Laparoscopic surgery
Minimally invasive colorectal surgery
Right hemicolectomy
Robotic surgery
Surgical outcomes
Journal
Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401
Informations de publication
Date de publication:
24 Oct 2024
24 Oct 2024
Historique:
received:
13
08
2024
accepted:
04
10
2024
medline:
24
10
2024
pubmed:
24
10
2024
entrez:
23
10
2024
Statut:
epublish
Résumé
Midline incision for extra-corporeal anastomosis is common with traditional laparoscopic right hemicolectomy. Incisional hernias develop in up to 20% of these patients within a year adding considerable morbidity and healthcare costs. Robotic assisted surgery (RAS) improves technical ease of intra-corporeal anastomosis, preventing midline extraction but its benefit over laparoscopy remains debated. We aimed to determine if robotic assisted surgery and Pfannenstiel extraction decreased the rate of radiologically detected incisional hernias compared to standard laparoscopy with extra-corporeal anastomosis. The secondary outcomes aimed to evaluate incidence of port site hernias in 8 mm robotic ports for which routine closure is not followed. Our single centre retrospective cohort study included patients who had minimally invasive right hemicolectomy and had cross-sectional imaging at least 1-year later. Patient demographics, body mass index, history of smoking or previous surgery was recorded. At imaging, evidence of new extraction site or port site-site hernia, contents and clinical impact was noted. A total of 100 patients (50 robotic and 50 laparoscopic) were included. Baseline characteristics appeared equally distributed. 16% (8 patients) who had laparoscopic surgery developed midline extraction site hernias which was significantly higher to RAS group (0 patients). 3 patients developed hernias at the site of robotic ports and this was more commonly at the right iliac fossa port. RAS, by simplifying intra-corporeal anastomosis has potential to eliminate incisional hernias, particularly when Pfannenstiel extraction is used. The potential for 8 mm robotic ports to develop clinically significant hernias cannot be ignored and meticulous closure can prevent patient harm.
Identifiants
pubmed: 39443327
doi: 10.1007/s11701-024-02126-y
pii: 10.1007/s11701-024-02126-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
380Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
Références
WHO IARC. https://gco.iarc.fr/today accessed Jan 2024
Xi Y, Xu P (2021) Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol 14(10):101174. https://doi.org/10.1016/j.tranon.2021.101174
doi: 10.1016/j.tranon.2021.101174
pubmed: 34243011
pmcid: 8273208
https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/bowel-cancer/incidence#heading-Three
Weeks JC, Nelson H, Gelber S, Clinical Outcomes of Surgical Therapy (COST) Study Group et al (2002) Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 287(3):321–328. https://doi.org/10.1001/jama.287.3.321
doi: 10.1001/jama.287.3.321
pubmed: 11790211
Hazebroek EJ, Color Study Group (2002) COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer. Surg Endosc 16(6):949–953. https://doi.org/10.1007/s00464-001-8165-z
doi: 10.1007/s00464-001-8165-z
pubmed: 12163961
Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM, MRC CLASICC trial group (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365(9472):1718–1726
doi: 10.1016/S0140-6736(05)66545-2
pubmed: 15894098
de Angelis N, Piccoli M, Casoni Pattacini G et al (2023) Right colectomy with intra-corporeal anastomosis: a European multicenter propensity score matching retrospective study of robotic versus laparoscopic procedures. World J Surg 47(8):2039–2051. https://doi.org/10.1007/s00268-023-07031-3
doi: 10.1007/s00268-023-07031-3
Dohrn N, Klein MF, Gogenur I (2021) Robotic versus laparoscopic right colectomy for colon cancer: a nationwide cohort study. Int J Colorectal Dis 36:2147–2158
doi: 10.1007/s00384-021-03966-y
pubmed: 34076746
Miller PE, Dao H, Paluvoi N et al (2016) Comparison of 30-day postoperative outcomes after laparoscopic vs robotic colectomy. J Am Coll Surg 223:369–373
doi: 10.1016/j.jamcollsurg.2016.03.041
pubmed: 27109780
Clarke EM, Rahme J, Larach T et al (2022) Robotic versus laparoscopic right hemicolectomy: a retrospective cohort study of the binational colorectal cancer database. J Robot Surg 16:927–933
doi: 10.1007/s11701-021-01319-z
pubmed: 34709537
Schwenk W, Haase O, Neudecker J, Müller JM (2005) Short-term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev 20(3):CD003145
Bosanquet D, Ansell J, Abdelrahman T et al (2015) Systematic review and meta-regression of factors affecting midline incisional hernia rates: analysis of 14618 patients. PLoS ONE 10:e0138745
doi: 10.1371/journal.pone.0138745
pubmed: 26389785
pmcid: 4577082
Lee L, Abou-Khalil M, Liberman S et al (2017) Incidence of incisional hernia in the specimen extraction site for laparoscopic colorectal surgery: systematic review and meta-analysis. Surg Endosc 31(12):5083–5093. https://doi.org/10.1007/s00464-017-5573-2
doi: 10.1007/s00464-017-5573-2
pubmed: 28444496
Kennedy RH, Francis EA, Wharton R et al (2014) Multicenter randomized controlled trial of conventional versus laparoscopic surgery for colorectal cancer within an enhanced recovery programme: EnROL. J Clin Oncol 32:1804–1811
doi: 10.1200/JCO.2013.54.3694
pubmed: 24799480
Weber PA, Merola S, Wasielewski A, Ballantyne GH (2002) Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 45(12):1689–1696. https://doi.org/10.1007/s10350-004-7261-2
doi: 10.1007/s10350-004-7261-2
pubmed: 12473897
Tschann P, Szeverinski P, Weigl MP et al (2022) Short- and long-term outcome of laparoscopic- versus robotic-assisted right colectomy: a systematic review and meta-analysis. J Clin Med 11(9):2387. https://doi.org/10.3390/jcm11092387
doi: 10.3390/jcm11092387
pubmed: 35566512
pmcid: 9103048
Park JS, Choi GS, Park SY et al (2012) Randomized clinical trial of robot-assisted versus standard laparoscopic right colectomy. Br J Surg 99(9):1219–1226. https://doi.org/10.1002/bjs.8841
doi: 10.1002/bjs.8841
pubmed: 22864881
MERCY Study Collaborating Group (2022) Predictors of surgical outcomes of minimally invasive right colectomy: the MERCY study. Int J Colorectal Dis 37(4):907–918. https://doi.org/10.1007/s00384-022-04095-w
doi: 10.1007/s00384-022-04095-w
Gómez Ruiz M, Espin-Basany E, Spinelli A et al (2023) Early outcomes from the minimally invasive right colectomy anastomosis study (MIRCAST). Br J Surg 110(9):1153–1160. https://doi.org/10.1093/bjs/znad077
doi: 10.1093/bjs/znad077
pubmed: 37289913
pmcid: 10416692
Gómez Ruiz M, et al. The impact of anastomosis method, surgical approach and postoperative complications on long-term quality of life after minimally invasive right colectomy: preliminary analysis of MIRCAST study. OR02. ESCP, Thessaloniki, 2024.
da Costa DW, van Dekken H, Witte BI et al (2015) Lymph node yield in colon cancer: individuals can make the difference. Dig Surg 32(4):269–274. https://doi.org/10.1159/000381863
doi: 10.1159/000381863
pubmed: 26113047
Damani T, James L, Fisher JC, Shah PC (2021) Incidence of acute postoperative robotic port-site hernias: results from a high-volume multispecialty center. J Robot Surg 15(3):457–463. https://doi.org/10.1007/s11701-020-01128-w
doi: 10.1007/s11701-020-01128-w
pubmed: 32710254
Deerenberg EB, Henriksen NA, Antoniou GA et al (2022) Updated guideline for closure of abdominal wall incisions from the European and American Hernia Societies. Br J Surg 109(12):1239–1250. https://doi.org/10.1093/bjs/znac302
doi: 10.1093/bjs/znac302
pubmed: 36026550
pmcid: 10364727