Robotic versus open mesh-enforced retrorectus ventral hernia repair: a multi-center comparative study
In brief
Robotic hernia repair had revisions in 4.8%, versus 13.7% with open surgery
In this prospective multicenter cohort of 230 patients, 30-day revision was 4.8% after robotic repair versus 13.7% after open repair, and hospital stay was one day shorter; one-year recurrence was 0% versus 7.1%. Robotic operations took longer and caused slightly more pain at two days, while pain was lower at six weeks; randomized trials must confirm whether these differences reflect the surgical approach.
- Journal
- Journal of robotic surgery (Q1)
- Published
- 27 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Johannes Baur, Marie-Therese Böttcher, Anna Rümmele-Vogt, Michael Meir, Regina Pistorius, Jörg Filser, et al.
- PMID
- 42801423
- DOI
- 10.1007/s11701-026-03987-1
Why clinicians should know about it
- Picked for Surgery (paper of the day, 29 September 2026): Robotic vs open mesh‑enforced retrorectus ventral hernia repair comparative study
Abstract
Mesh-enforced open ventral hernia repair (OVHR) is associated with increased surgical site occurrences and prolonged hospital stay. Robotic-assisted ventral hernia repair (RVHR) may offer benefits compared to OVHR, but comparative literature is scarce. This multicenter prospective cohort study used data from the international CROSSFIRE (MultiCentre InteRnational PrOSpective DatabaSe For Ventral HernIa REpair) register. Patients undergoing OVHR or RVHR for ventral hernias with 3-15 cm transverse diameter between December 2023 and March 2026 were analyzed. The primary outcome was surgical revision after 30 days. Secondary outcomes included postoperative pain after 2 days and 6 weeks, operative time, length of stay (LOS), readmissions and follow-up at 1 year. Two hundred thirty patients were included and analyzed, of which 77 (41% female, BMI 28.4 kg/m2, 90.7% incisional hernias, median hernia diameter 4 cm) underwent OVHR, and 153 (33.7% female, BMI 29.4 kg/m2, 91.7% incisional hernias, median hernia diameter 5 cm) underwent RVHR. Surgical revisions were more frequent after OVHR compared to RVHR (13.7% vs. 4.8%; p = 0.027). Median LOS was longer after OVHR (4 days vs. 3days; p < 0.001). Median operation time was shorter in OVHR (100 min vs. 210 min; p < 0.001). The pain after two days was lower after OVHR (VAS 2 vs. 3; p = 0.002); however, it was higher after 6 weeks (2 vs. 1 VAS; p = 0.008). After one year, the clinical recurrence rate was higher after OVHR 7.1% vs. 0.0%; p = 0.010). RVHR was associated with fewer surgical revisions after 30 days, a shorter LOS, less pain after 6 weeks and improved outcomes after one year. Randomized controlled trials are needed to confirm these findings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.