Comparison of Hybrid Versus Synthetic Mesh in Robotic Rives-Stoppa Ventral Hernia Repair

Abstract

Background and Objectives: To estimate the average treatment effect on the treated (ATT) and to assess the clinical outcomes in two different types of mesh in robotic Rives-Stoppa (rRS) ventral hernia repair (VHR). Methods: A retrospective analysis of a robotic VHR database between February 1, 2013 and May 31, 2022. Patients who underwent a rRS VHR were included in this study and separated into two groups depending on the mesh used: Synecor™ Preperitoneal Biomaterial (Synecor™ Pre) and Bard™ Soft. Through propensity score and inverse-proba-bility-treatment-weighting, the ATT was estimated for two scenarios; the first with the treated target having used the Synecor™ Pre, the second having used the Bard™ Soft mesh. Adjusted linear regression models, including linger-ing imbalanced variables, were used for both the primary outcome of the Comprehensive Complication Index (CCI®), and the secondary outcome of the hospital cost. Results: A total of 186 patients who underwent rRS were separated into the two groups (Synecor™ Pre mesh, n = 85; Bard™ Soft mesh, n = 101). Adjusted linear regression models for the CCI showed no statistical difference between both groups (p > 0.05), whereas ATT on hospital cost was significantly higher (p < 0.001) in the Synecor™ Pre group in both scenarios [(95% confidence interval) = 3882 (2352, 5413) and 5185 (8213, 2157), respectively]. Conclusion: Both mesh materials provided excellent outcomes with no difference in complications or recurrence rates. However, hospital cost was found to be higher in the hybrid mesh group. Long-term follow-up is needed to fully assess the performance of both mesh types in rRS.