Patient perceptions of acute pain and activity disruption following inguinal hernia repair: a propensity-matched comparison of robotic-assisted, laparoscopic, and open approaches

J Robot Surg. 2018 Dec;12(4):625-632. doi: 10.1007/s11701-018-0790-9. Epub 2018 Feb 16.

Abstract

Few publications describe the potential benefit of robotic-assisted inguinal hernia repair on acute postoperative groin pain (APGP). This study compared patients' perceptions of APGP, activity limitation, and overall satisfaction after robotic-assisted- (R), laparoscopic (L), or open (O) inguinal hernia repair (IHR). Random samples of patients from two web-based research panels and surgical practices were screened for patients who underwent IHR between October 28, 2015 and November 1, 2016. Qualified patients were surveyed to assess perceived APGP at 1 week postoperatively, activity disruption, and overall satisfaction. Three cohorts based on operative approach were compared after propensity matching. Propensity scoring resulted in 83 R-IHR matched to 83 L-IHR respondents, while 85 R-IHR matched with 85 O-IHR respondents. R-IHR respondents recalled less APGP compared to respondents who had O-IHR (4.1 ± 0.3 vs 5.6 ± 0.3, p < 0.01) but similar APGP compared to L-IHR (4.0 ± 0.3 vs 4.4 ± 0.3, p = 0.37). Respondents recalled less activity disruption 1 week postoperatively after R-IHR versus O-IHR (6.1 ± 0.3 vs. 7.3 ± 0.2, p < 0.01) but similar levels of activity disruption after R-IHR and L-IHR (6.0 ± 0.3 vs. 6.6 ± 0.27, p = 0.32). At the time of the survey, respondents perceived less physical activity disruption after R-IHR compared to O-IHR (1.4 ± 0.2 vs. 2.8 ± 0.4, p < 0.01) but similar between R-IHR and L-IHR (1.3 ± 0.2 vs 1.2 ± 0.2, p = 0.94). Most respondents felt satisfied with their outcome regardless of operative approach. Patient perceptions of pain and activity disruption differ by approach, suggesting a potential advantage of a minimally invasive technique over open for IHR. Further studies are warranted to determine long-term outcomes regarding pain and quality of life after IHR.

Keywords: Groin hernia; Groin pain; Inguinal hernia; Inguinal hernia repair; Laparoscopic inguinal hernia repair; Postoperative groin pain; Robotic; Robotic assisted; Robotic-assisted inguinal hernia repair.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Aged
  • Exercise
  • Female
  • Groin
  • Hernia, Inguinal / surgery*
  • Herniorrhaphy / adverse effects*
  • Herniorrhaphy / methods
  • Humans
  • Laparoscopy / adverse effects*
  • Male
  • Middle Aged
  • Pain, Postoperative / psychology*
  • Patient Satisfaction*
  • Perception*
  • Propensity Score
  • Robotic Surgical Procedures / adverse effects*