Introduction of Robotic Abdominal Wall Reconstruction Into a UK-Abdominal Wall Reconstruction Practice: Early Outcomes and Economic Analysis

摘要

Introduction There is strong evidence that robotic abdominal wall reconstruction (AWR) reduces length of stay and postoperative complications. Despite this, it remains significantly limited in publicly funded healthcare systems due to reported costs and limited access to robotic surgical platforms. Methods Cases were reviewed from a prospectively maintained database of AWR patients in a single unit undergoing Robotic Rives-Stoppa repair or open Rives-Stoppa repair. A prospectively maintained database was accessed and analysed. Data analysed included demographics, comorbidities, hernia characteristics, operative times and surgical outcomes. Cost analysis was performed based on length of stay, critical care bed days, and cost of consumables. Results Data were collected from 28 robotic Rives-Stoppa repairs and 18 open Rives-Stoppa repairs. There was no difference in operative time between the two groups (199 min vs. 186 min, p = 0.147). The anaesthetic time was shorter in the robotic group (36 min vs. 56 min, p = <0.001), and the length of stay was longer in the open group (2 days vs. 7 days, p = <0.001). There were five critical care unit bed days in the open group, vs. 0 in the robotic group ( p = <0.001). Complications were not significantly different (10.7% vs. 22.0%, p = 0.407), and there were no cases of postoperative mortality. Cost analysis showed an average saving of £1,807.58 per case. Conclusion Our series demonstrates that robotic Rives-Stoppa AWR can be delivered in a safe manner with financial savings and equivalent operative time compared with open surgery.