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Purpose <p>Reduction in postoperative pain with adoption of the robotic platform has been shown in other surgical specialties, but this has not been demonstrated in hernia surgery. We compared postoperative opioid use after open and robotic-assisted abdominal wall reconstruction (AWR).</p> Methods <p>A retrospective cohort analysis of all patients with ventral hernias between 4 to 28 cm who underwent open or robotic AWR from January 2020 to May 2024 was completed. Patient characteristics, surgery information, postoperative opioid use, and pain scores were reviewed.</p> Results <p>114 patients underwent open and 63 underwent robotic AWR. There was no difference in sex distribution, BMI, and hernia diameter. The robot group was younger (60.1 +/-12.7 vs. 65.0 +/- 12.7, <i>P</i> = 0.02), with a lower ASA class (<i>P</i> = 0.04). Median total inpatient opioid use (in mg oral morphine equivalent) was higher for open repairs (65.7 (15.0-159.0) vs. 15.0 (0-60.0), <i>P</i> &lt; 0.001). Multivariable logistic regression analysis indicates robotic surgical approach as a protective factor against high total (OR = 0.10 (0.03, 0.31), <i>P</i> &lt; 0.001) and high daily (OR = 0.32 (0.11, 0.87), <i>P</i> = 0.03) opioid use. Subgroup analysis of posterior component separation cases demonstrates the robotic approach is a protective factor against high total (OR = 0.11 (0.02, 0.44), <i>P</i> = 0.004) but not high daily (OR = 0.45 (0.13, 1.50), <i>P</i> = 0.20) opioid use. There was no significant difference in pain scores, short-term major complications, or hernia recurrence.</p> Conclusion <p>Open AWR patients had higher total inpatient postoperative opioid exposure. Future studies should further explore the potential of the robotic approach at minimizing postoperative opioid exposure. </p>

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Association of robotic surgical approach with decreased inpatient opioid exposure after abdominal wall reconstruction: a retrospective cohort study

  • 期刊论文

  • 发表日期：

    2026年3月16日

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  • Shuling Yang,
  • Yuwei Yang,
  • Rochelle Guan,
  • Yolanda Zhang,
  • Chieh Jack Chiu,
  • Adam T. Meneghetti,
  • Rachel Q. Liu Hennessey

摘要

Purpose

Reduction in postoperative pain with adoption of the robotic platform has been shown in other surgical specialties, but this has not been demonstrated in hernia surgery. We compared postoperative opioid use after open and robotic-assisted abdominal wall reconstruction (AWR).

Methods

A retrospective cohort analysis of all patients with ventral hernias between 4 to 28 cm who underwent open or robotic AWR from January 2020 to May 2024 was completed. Patient characteristics, surgery information, postoperative opioid use, and pain scores were reviewed.

Results

114 patients underwent open and 63 underwent robotic AWR. There was no difference in sex distribution, BMI, and hernia diameter. The robot group was younger (60.1 +/-12.7 vs. 65.0 +/- 12.7, P = 0.02), with a lower ASA class (P = 0.04). Median total inpatient opioid use (in mg oral morphine equivalent) was higher for open repairs (65.7 (15.0-159.0) vs. 15.0 (0-60.0), P < 0.001). Multivariable logistic regression analysis indicates robotic surgical approach as a protective factor against high total (OR = 0.10 (0.03, 0.31), P < 0.001) and high daily (OR = 0.32 (0.11, 0.87), P = 0.03) opioid use. Subgroup analysis of posterior component separation cases demonstrates the robotic approach is a protective factor against high total (OR = 0.11 (0.02, 0.44), P = 0.004) but not high daily (OR = 0.45 (0.13, 1.50), P = 0.20) opioid use. There was no significant difference in pain scores, short-term major complications, or hernia recurrence.

Conclusion

Open AWR patients had higher total inpatient postoperative opioid exposure. Future studies should further explore the potential of the robotic approach at minimizing postoperative opioid exposure.