Nationwide Readmissions Analysis of Minimally Invasive Versus Open Ventral Hernia Repair: A Retrospective Population-Based Study

Introduction Minimally invasive ventral hernia repair (MISVHR) has been performed for almost 30 years; recently, there has been an accelerated adoption of the robotic platform leading to renewed comparisons to open ventral hernia repair (OVHR). The present study evaluates patterns and outcomes of re...

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Bibliographic Details
Published in:The American surgeon 2022-03, Vol.88 (3), p.463-470
Main Authors: Ayuso, Sullivan A., Katzen, Michael M., Aladegbami, Bola G., Nayak, Raageswari B., Augenstein, Vedra A., Heniford, B Todd, Colavita, Paul D.
Format: Article
Language:English
Subjects:
Abdomen
Comorbidity
Complications
Databases, Factual - statistics & numerical data
Elective Surgical Procedures - economics
Elective Surgical Procedures - methods
Elective Surgical Procedures - statistics & numerical data
Female
Hernia
Hernia, Ventral - surgery
Hernias
Herniorrhaphy - economics
Herniorrhaphy - methods
Herniorrhaphy - statistics & numerical data
Hospital Charges
Hospitalization
Hospitals
Humans
Laparoscopy
Laparoscopy - economics
Laparoscopy - statistics & numerical data
Laparotomy
Length of stay
Length of Stay - economics
Length of Stay - statistics & numerical data
Logistic Models
Male
Middle Aged
Mortality
Patient Readmission - economics
Patient Readmission - statistics & numerical data
Patients
Population studies
Population-based studies
Postoperative infection
Retrospective Studies
Robotic Surgical Procedures - economics
Robotic Surgical Procedures - statistics & numerical data
Robotics
Sepsis
Statistical analysis
Statistical methods
Subgroups
Surgeons
Surgical outcomes
Surgical site infections
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Summary:Introduction Minimally invasive ventral hernia repair (MISVHR) has been performed for almost 30 years; recently, there has been an accelerated adoption of the robotic platform leading to renewed comparisons to open ventral hernia repair (OVHR). The present study evaluates patterns and outcomes of readmissions for MISVHR and OVHR patients. Methods The Nationwide Readmissions Database (NRD) was queried for patients undergoing OVHR and MISVHR from 2016 to 2018. Demographic characteristics, complications, and 90-day readmissions were determined. A subgroup analysis was performed to compare robotic ventral hernia repair (RVHR) vs laparoscopic hernia repair (LVHR). Standard statistical methods and logistic regression were used. Results Over the 3-year period, there were 25 795 MISVHR and 180 635 OVHR admissions. Minimally invasive ventral hernia repair was associated with a lower rate of 90-day readmission (11.3% vs 17.3%, P < .01), length of stay (LOS) (4.0 vs 7.9 days, P < .01), and hospital charges ($68,240 ± 75 680 vs $87,701 ± 73 165, P < .01), which remained true when elective and non-elective repairs were evaluated independently. Postoperative infection was the most common reason for readmission but was less common in the MISVHR group (8.4% vs 16.8%, P < .01). Robotic ventral hernia repair increased over the 3-year period and was associated with decreased LOS (3.7 vs 4.1 days, P < .01) and comparable readmissions (11.3% vs 11.2%, P = .74) to LVHR, but was nearly $20,000 more expensive. In logistic regression, OVHR, non-elective operation, urban-teaching hospital, increased LOS, comorbidities, and payer type were predictive of readmission. Conclusions Open ventral hernia repair was associated with increased LOS and increased readmissions compared to MISVHR. Robotic ventral hernia repair had comparable readmissions and decreased LOS to LVHR, but it was more expensive.
ISSN:0003-1348
1555-9823
DOI:10.1177/00031348211050835