Ventral Hernia Repair: A Journey from Laparoscopic to Robotic Surgery: Is Cost Efficiency Guaranteed?

Abstract

<b>Background/Objectives</b>: Ventral hernia repair has evolved with the introduction of minimally invasive techniques like l-IPOM and rTA-RM. While robotic surgery offers advantages in precision and ergonomics, its higher costs pose questions regarding its cost-effectiveness compared to laparoscopic approaches. <b>Methods</b>: A retrospective analysis of patients with primary or incisional ventral hernias undergoing either l-IPOM or rTA-RM between February 2022 and October 2023 was conducted. Data on demographics, surgical outcomes, hospital costs, disposable supplies, and robotic system expenses were collected. A one-to-one propensity score matching (PSM) was used to ensure comparability between the groups. <b>Results</b>: After matching, 30 patients were included in each group. The rTA-RM group had longer operative times (93.2 vs. 74.4 min, <i>p</i> = 0.004) but shorter hospital stays (1 day vs. 2 days, <i>p</i> = 0.003) and lower postoperative pain scores (median VAS score 3 vs. 5, <i>p</i> = 0.004). Total costs were comparable between rTA-RM and l-IPOM (EUR 6862 vs. EUR 6575, <i>p</i> = 0.32), with robotic surgery incurring higher capital costs but lower disposable supply costs (EUR 1057 vs. EUR 2006, <i>p</i> < 0.01). <b>Conclusions</b>: Despite the higher per-case cost associated with robotic systems, overall costs for rTA-RM were similar to those for l-IPOM, suggesting that robotic surgery may be cost-competitive due to lower disposable supply expenses and shorter hospital stays. Further research is needed to assess long-term outcomes and broader economic impacts.