Robotic, laparoscopic or open ventral hernia repair: long-term outcomes broadly match

Design

Nationwide survey- and register-based cohort using the Abdominal Hernia-Q questionnaire

Population

9,552 adults (79% response) after elective mesh repair of primary ventral hernias under 10 cm

Primary outcome

Long-term patient-reported pain, function, scar and recurrence

Effect

Scar dissatisfaction robotic 4.2% / laparoscopic 5.7% vs open 10.2%; recurrence laparoscopic 11.4% vs open 9.2%

A nationwide survey-and-register study asked how elective primary ventral hernia repair compares across robotic, laparoscopic and open approaches on what patients actually report years later, using a validated hernia questionnaire. Of 12,040 eligible patients, 9,552 (79%) responded.

Severe chronic pain, foreign-body sensation and physical-impact scores did not differ by approach. Scar dissatisfaction was lower after minimally invasive repair than open, while patient-reported recurrence was slightly higher after laparoscopic than open. The differences are small and the design observational, so this informs rather than dictates approach selection.

The usable point is for consent: for a small primary ventral hernia, the long-term patient experience is broadly similar whichever route is chosen, so the decision can rest on the surgeon's expertise, the specific hernia, and what the patient values — appearance versus a lower reported recurrence.

• Severe chronic pain, foreign-body sensation and physical-impact scores did not differ across robotic, laparoscopic and open repair.
• Scar dissatisfaction was lower after minimally invasive repair (robotic 4.2% vs open 10.2%; laparoscopic 5.7% vs open 10.2%).
• Patient-reported recurrence was slightly higher after laparoscopic than open repair (11.4% vs 9.2%).
• Let approach selection rest on surgeon expertise, the hernia, and patient priorities rather than an assumed outcome gap.

Why it matters

It reframes the robotic-versus-open debate around patient-valued trade-offs rather than a presumed hard-outcome advantage.

Don't overread it

This was a register-and-survey study, not a randomised comparison — unmeasured differences in who received each approach could explain part of the small gaps.

The statistics, in plain English

These are patient-reported percentages, not trial endpoints. The scar-dissatisfaction gap (about 5–6 percentage points) is statistically clear given the large sample, but small in absolute terms; the slightly higher laparoscopic recurrence (2.2 points) is likewise modest.

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