Evidence map›Paper›PMID 33909151›Full record

ArticleHernia : the journal of hernias and abdominal wall surgery2022

Trends and outcomes of open, laparoscopic, and robotic inguinal hernia repair in the veterans affairs system.

T J Holleran, M A Napolitano, A D Sparks, J E Duncan, M Garrett, F J Brody

Abstract read
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In one paragraph

Article in Hernia : the journal of hernias and abdominal wall surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 5 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 5 syntheses or guidelines pooled it, 26 citations in OpenAlex.

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  10. Senhance versus da Vinci robotic inguinal hernia repair: a multi-center propensity-weighted study.Hernia : the journal of hernias and abdominal wall surgery · 2025
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  18. Open, laparoscopic, and hernia repair: more options, more questions-author's reply.Hernia : the journal of hernias and abdominal wall surgery · 2022
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  19. Open, laparoscopic, and robotic inguinal hernia repair: more options, more questions.Hernia : the journal of hernias and abdominal wall surgery · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

T J HolleranDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
M A NapolitanoDepartment of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA.
A D SparksDepartment of Surgery, George Washington University Hospital, Washington, DC, USA.
J E DuncanDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
M GarrettDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA.
F J BrodyDepartment of Surgery, Veterans Affairs Medical Center, 50 Irving St. NW, Washington, DC, 20422, USA. Fredrick.brody@va.gov.
George Washington University Hospital · USMedStar Georgetown University Hospital · USVeterans Health Administration · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRobotic inguinal hernia repair (RHR) is an evolving technique but is comparatively expensive and has yet to show superior outcomes versus open (OHR) or laparoscopic (LHR) approaches. The utilization and clinical outcomes of RHR have not been reported within the veterans affairs (VA) system. This study analyzes trends in utilization and 30-day post-operative outcomes between OHR, LHR, and RHR in veterans.

methodsThis is a retrospective review of patients that underwent inguinal herniorrhaphy using the Veterans Affairs Quality Improvement Program database. Multivariable analysis of outcomes was performed adjusting for pre-operative confounding covariates between OHR, LHR, and RHR. Trends in utilization, complication rates, and operative times were also reported.

resultsFrom 2008-2019, 124,978 cases of inguinal herniorrhaphy were identified: 100,880 (80.7%) OHR, 18,035 (14.4%) LHR, and 6063 (4.9%) RHR. Compared to LHR, RHR was associated with 4.94 times higher odds of complications, 100 min longer mean operative time, and 1.5 days longer median length of stay (LOS). Compared to OHR, RHR was associated with 5.92 times higher odds of complications, 57 min longer mean operative time, and 1.1 days longer median LOS. Utilization of RHR and LHR significantly increased over time. RHR complication rates decreased over time (2008: 20.8% to 2019: 3.2%) along with mean operative times (2008: 4.9 h to 2019: 2.8 h; p < 0.05).

conclusionWhile this study demonstrated inferior outcomes after RHR, the temporal trends are encouraging. This may be due to increased surgeon experience with robotics. Further prospective data will elucidate the role of RHR as this technique increases.

Indexed as

Hernia, InguinalLaparoscopyRobotic Surgical ProceduresVeteransHerniorrhaphyHumansOperative TimeRetrospective StudiesDatabaseInguinal herniaOutcomesRobotic surgery

Identifiers

PMID33909151
OpenAlexW3157638409

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.