In the treatment of ventral incisional hernias, a mesh repair in the retromuscular plane is considered as the gold standard. To allow for adequate medialization of the fascial borders and a complete closure of the defect in case of large incisional hernias, component separation techniques are increasingly being used. When compared to anterior component separation, posterior component separation by transversus abdominis release (TAR) seems to decrease postoperative wound problems. While laparoscopic techniques pose significant difficulties to perform TAR minimally invasively (mainly due to ergonomic and technical reasons), these limitations seem to be overcome by robotic platforms. Initial retrospective patient series report on significantly shorter postoperative hospital stay and fewer complications after robotic transversus abdominis release (rTAR), when compared to open transversus abdominis release (oTAR). High-quality prospective evidence on rTAR is currently lacking.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
100
Incisional hernia repair for the treatment of wide ventral incisional hernias.
Length of postoperative hospital stay
Length of postoperative hospital stay
Time frame: hours from the end of surgery (last skin suture) until discharge, assessed up to 20 days
Skin-to-skin operative time
Skin-to-skin operative time from first incision until last skin suture
Time frame: Per-operative (minutes)
Conversion rate
Conversion rate from the robotic-assisted approach to the open approach
Time frame: Per-operative
Surgical site related complications
Surgical site infection - surgical site occurrence - surgical site occurrence requiring procedural interventions
Time frame: 30 days
Readmission rate
Readmission rate
Time frame: 30 Days and 3 months postoperative
Post-anesthetic discharge scoring system
Minimum score is 0, maximum score is 12. The higher the score, the better the outcome.
Time frame: From the end of surgery (last skin suture) until discharge, assessed up to 20 days
Postoperative visual analogue scale pain score
Minimum score is 0, maximum score is 10. The higher the score, the worse the outcome.
Time frame: From the end of surgery (last skin suture) until discharge, assessed up to 20 days
EuraHS Quality of Life Scoring
Minimum score is 0, maximum score is 90. The higher the score, the worse the outcome.
Time frame: Preoperatively, 30 days, 3 months, 12 months, 24 months, 60 months
Body Image Scale
Minimum score is 0, maximum score is 10. A higher score means a higher level of body image disturbance (worse outcome).
Time frame: Preoperatively, 30 days, 3 months, 12 months, 24 months, 60 months
Hernia recurrence
Hernia recurrence
Time frame: 30 days, 3 Months, 12 months, 24 months, 60 months
Reoperation for hernia recurrence or abdominal surgery not for hernia recurrence
Reoperation for hernia recurrence or abdominal surgery not for hernia recurrence
Time frame: 30 days, 3 Months, 12 months, 24 months, 60 months
Postoperative complications
Postoperative complications classified acoording to the Clavien-Dindo Classification
Time frame: 30 days
Reoperation rate
Reoperation rate
Time frame: 30 days
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