Impact of COVID-19 on clinical outcomes of robotic retromuscular ventral hernia repair

Background The COVID-19 pandemic disrupted the healthcare sector and forced hospitals to limit the number of elective procedures with the goal of reducing overcrowding of wards and thus viral transmission. Recent trends for ventral hernia repair have shifted towards retromuscular techniques, which normally require a longer length of stay. Therefore, the aim of this study is to investigate the impact of the COVID-19 pandemic on clinical outcomes of robotic retromuscular ventral hernia repair (rRVHR). Methods Patients who underwent rRVHR up to 600 days before and after March 10, 2020, were included in this retrospective study and assigned to the pre- or post-COVID group depending on the date of their procedure. Pre-, intra-, and postoperative variables including patients' demographics, hernia characteristics, complications, and hernia recurrence were compared between both groups. Results 153 (46% female) and 141 (51% female) patients were assigned to the pre- and post-COVID groups respectively. Median age was statistically different between both groups [pre-COVID: 57 (48-68) vs. post-COVID 55 (42-64) years, p = 0.045]. Median hospital length of stay (LOS) was 0 day (0-1) in both groups, and same day discharge were 61% pre-pandemic and 70% post-pandemic (p = 0.09). Mean postoperative follow-up was 39.2 (4.1-93.6) months. In total, 26 pre-COVID patients had postoperative complications, out of which 7 were pulmonary complications, whereas 23 complications were recorded in the post-COVID group, with only 3 pulmonary complications (p = 0.88). Rate of surgical-site events was comparable between both groups, and no recurrences were recorded. Conclusion This is the first study to describe the impact of the COVID-19 on rRVHR. Hospital LOS was comparable between both groups. Rates of medical and hernia specific complications were not altered by the pandemic.