Laparoscopic versus robotic inguinal hernia repair: 1- and 2-year outcomes from the RIVAL trial. Surg Endosc 2023 Jan;37(1):723-728
Date
05/17/2022Pubmed ID
35578051DOI
10.1007/s00464-022-09320-9Scopus ID
2-s2.0-85130115725 (requires institutional sign-in at Scopus site) 16 CitationsAbstract
INTRODUCTION: Robotic inguinal hernia repair is growing in popularity among general surgeons despite little high-quality evidence supporting short- or long-term advantages over traditional laparoscopic inguinal hernia repair. The original RIVAL trial showed increased operative time, cost, and surgeon frustration for the robotic approach without advantages over laparoscopy. Here we report the 1- and 2-year outcomes of the trial.
METHODS: This is a multi-center, patient-blinded, randomized clinical study conducted at six sites from 2016 to 2019, comparing laparoscopic versus robotic transabdominal preperitoneal (TAPP) inguinal hernia repair with follow-up at 1 and 2 years. Outcomes include pain (visual analog scale), neuropathic pain (Leeds assessment of neuropathic symptoms and signs pain scale), wound morbidity, composite hernia recurrence (patient-reported and clinical exam), health-related quality of life (36-item short-form health survey), and physical activity (physical activity assessment tool).
RESULTS: Early trial participation included 102 patients; 83 (81%) completed 1-year follow-up (45 laparoscopic vs. 38 robotic) and 77 (75%) completed 2-year follow-up (43 laparoscopic vs. 34 robotic). At 1 and 2 years, pain was similar for both groups. No patients in either treatment arm experienced neuropathic pain. Health-related quality of life and physical activity were similar for both groups at 1 and 2 years. No long-term wound morbidity was seen for either repair type. At 2 years, there was no difference in hernia recurrence (1 laparoscopic vs. 1 robotic; P = 1.0).
CONCLUSIONS: Laparoscopic and robotic inguinal hernia repairs have similar long-term outcomes when performed by surgeons with experience in minimally invasive inguinal hernia repairs.
Author List
Miller BT, Prabhu AS, Petro CC, Beffa LRA, Carbonell AM, Hope W, Warren J, Higgins RM, Jacob B, Blatnik J, Krpata DM, Tu C, Costanzo A, Rosen MJAuthor
Rana Higgins MD Associate Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Hernia, InguinalHerniorrhaphy
Humans
Laparoscopy
Neuralgia
Quality of Life
Robotic Surgical Procedures
Surgical Mesh