Robotic versus open ventral hernia repair (ROVHR): a randomized controlled trial protocol
Abstract
Robotic retromuscular hernia repair has proven to be feasible and safe but lacks randomized data to demonstrate significant clinical benefit. The majority of current comparative studies published have been case series, retrospective studies, systematic reviews, or large registry data, all of which have significant limitations and bias (Bittner et al. in Surg Endosc 32:727–734. https://doi.org/10.1007/s00464-017-5729-0, 2018; Bracale et al in Hernia 25:1471–1480. https://doi.org/10.1007/s10029-021-02487-5, 2021; Carbonell in Ann Surg 267:210–217. https://doi.org/10.1097/SLA.0000000000002244, 2018; (Warren et al. in Surg Endosc. https://doi.org/10.1007/s00464-024-11202-1, 2024; Dewulf et al in BJS Open 6:zrac057. https://doi.org/10.1093/bjsopen/zrac057, 2022; Maskal and Beffa in Surg Clin N Am 103:977–991. https://doi.org/10.1016/j.suc.2023.04.007, 2023). It was only recently that the first randomized trial was conducted by Warren et al. comparing open and robotic retromuscular hernia repairs with synthetic mesh (Warren et al. in Surg Endosc. https://doi.org/10.1007/s00464-024-11202-1, 2024). The data currently available has yielded inconsistent outcomes leaving significant knowledge gaps for clinical decision making. Reduced length of stay for robotic retromuscular repairs has been a consistently proven outcome, however, and therefore, we hypothesized that robotic retromuscular hernia repairs would be superior to open retromuscular hernia repair by reducing length of stay in…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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