2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Ta00,The use of robotic-assisted groin hernia repair is increasing rapidly across the US, but evidence regarding its comparative effectiveness to more established laparoscopic or open approaches is limited. To compare the incidence of long-term operative hernia recurrence between robotic-assisted, laparoscopic, and open groin hernia repairs. This retrospective cohort study analyzed groin hernia repairs among Medicare beneficiaries aged 65 years and older from January 2010 to December 2021, with 5-year follow-up, using a population-based analysis of US inpatient and outpatient administrative claims. Data were analyzed between August 2024 and April 2025. Surgical approach: robotic-assisted, laparoscopic, or open groin hernia repair. The main outcome was operative recurrence up to 5 years after initial groin hernia repair. Cox proportional hazards modeling was used to estimate the risk-adjusted cumulative incidence of operative recurrence up to 5 years after the initial procedure, controlling for patient demographics, comorbidities, hernia type (inguinal or femoral), and procedure type (unilateral or bilateral). A total of 199 163 Medicare beneficiaries (mean [SD] age, 72.6 [9.3] years; 29 307 female patients [14.7%]) were included in the study. From January 2010 to December 2021, the proportion of robotic-assisted procedures increased 8.6-fold, from 0.3% to 2.6%. The proportion of open procedures decreased 0.6-fold (84.4% to 51.9%), while laparoscopic procedures increased 3.0-fold (15.3% to 45.5%). Patients undergoing robotic-assisted hernia repair had the highest 5-year risk-adjusted cumulative incidence of operative recurrence (3.78%; 95% CI, 3.76%-3.79%), followed by open (3.37%; 95% CI, 3.36%-3.37%) and laparoscopic (3.21%; 95% CI, 3.21%-3.22%) approaches. Compared to open repairs, the laparoscopic approach was associated with a lower risk of operative recurrence (hazard ratio [HR], 0.75; 95% CI, 0.66-0.86), while there was no difference in risk of operative recurrence between the open and robotic cohorts (HR, 1.29; 95% CI, 0.48-2.10). In this cohort study among Medicare beneficiaries, robotic-assisted groin hernia repair was associated with a higher long-term cumulative incidence of operative recurrence compared to open and laparoscopic approaches. With low operative recurrence rates across all surgical techniques, these findings suggest that alternative measures of clinical value may be necessary to assess the benefits of minimally invasive approaches, particularly as robotic-assisted repair continues to expand.31:Ted3, Importance The use of robotic-assisted groin hernia repair is increasing rapidly across the US, but evidence regarding its comparative effectiveness to more established laparoscopic or open approaches is limited. Objective To compare the incidence of long-term operative hernia recurrence between robotic-assisted, laparoscopic, and open groin hernia repairs. Design, Setting, and Participants This retrospective cohort study analyzed groin hernia repairs among Medicare beneficiaries aged 65 years and older from January 2010 to December 2021, with 5-year follow-up, using a population-based analysis of US inpatient and outpatient administrative claims. Data were analyzed between August 2024 and April 2025. Exposure Surgical approach: robotic-assisted, laparoscopic, or open groin hernia repair. Main Outcomes and Measures The main outcome was operative recurrence up to 5 years after initial groin hernia repair. Cox proportional hazards modeling was used to estimate the risk-adjusted cumulative incidence of operative recurrence up to 5 years after the initial procedure, controlling for patient demographics, comorbidities, hernia type (inguinal or femoral), and procedure type (unilateral or bilateral). Results A total of 199 163 Medicare beneficiaries (mean [SD] age, 72.6 [9.3] years; 29 307 female patients [14.7%]) were included in the study. From January 2010 to December 2021, the proportion of robotic-assisted procedures increased 8.6-fold, from 0.3% to 2.6%. The proportion of open procedures decreased 0.6-fold (84.4% to 51.9%), while laparoscopic procedures increased 3.0-fold (15.3% to 45.5%). Patients undergoing robotic-assisted hernia repair had the highest 5-year risk-adjusted cumulative incidence of operative recurrence (3.78%; 95% CI, 3.76%-3.79%), followed by open (3.37%; 95% CI, 3.36%-3.37%) and laparoscopic (3.21%; 95% CI, 3.21%-3.22%) approaches. Compared to open repairs, the laparoscopic approach was associated with a lower risk of operative recurrence (hazard ratio [HR], 0.75; 95% CI, 0.66-0.86), while there was no difference in risk of operative recurrence between the open and robotic cohorts (HR, 1.29; 95% CI, 0.48-2.10). Conclusions and Relevance In this cohort study among Medicare beneficiaries, robotic-assisted groin hernia repair was associated with a higher long-term cumulative incidence of operative recurrence compared to open and laparoscopic approaches. With low operative recurrence rates across all surgical techniques, these findings suggest that alternative measures of clinical value may be necessary to assess the benefits of minimally invasive approaches, particularly as robotic-assisted repair continues to expand. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Robotic-Assisted Surgery: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Robotic-Assisted Surgery (modality). Clinician-written summaries and actionable practice insights. 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Hernia","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"modality","value":"Open Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"modality","value":"Robotic-Assisted Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"sample_size","value":"n=199,163","value_numeric":199163},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"warning","value":"Operative recurrence (requiring reoperation) likely underestimates true clinical recurrence, which includes non-operative cases.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"warning","value":"The robotic vs. open hazard ratio (HR 1.29; 95% CI 0.48–2.10) crosses 1.0 and is not statistically significant, so the higher recurrence rate for robotic repair should be interpreted cautiously — the wide CI reflects the small proportion of robotic cases.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1126","tag_type":"warning","value":"The study population is exclusively Medicare beneficiaries aged ≥65; generalizability to younger or privately insured populations is limited.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study compared 5-year operative hernia recurrence rates among Medicare beneficiaries (≥65 years) undergoing robotic-assisted, laparoscopic, or open groin hernia repair using US administrative claims data from January 2010 to December 2021 (n=199,163).","key_result":"Laparoscopic repair had the lowest 5-year risk-adjusted cumulative recurrence (3.21%), followed by open (3.37%) and robotic-assisted (3.78%). Compared to open, laparoscopic repair reduced recurrence risk (HR 0.75; 95% CI 0.66–0.86), while robotic-assisted showed no statistically significant difference from open (HR 1.29; 95% CI 0.48–2.10). Robotic use grew 8.6-fold (0.3% → 2.6%) from 2010 to 2021.","limitations":"- Administrative claims data cannot capture all clinical nuances (e.g., surgeon experience, hernia complexity, or non-operative recurrences).\n- Study is limited to Medicare beneficiaries aged ≥65, so findings may not generalize to younger patients.\n- Robotic-assisted cases represented a very small proportion of procedures, which may explain the wide confidence interval and statistical non-significance for the robotic vs. open comparison.","practice_takeaway":"Laparoscopic groin hernia repair remains associated with the lowest operative recurrence risk in older adults. Given the rapid growth of robotic-assisted repair and its numerically higher recurrence rate (though not statistically superior to open), surgeons should weigh cost and clinical value carefully before defaulting to robotic approaches for groin hernias."}}],"initialOffset":2,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"modality","value":"Robotic-Assisted Surgery"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Modalities","href":"/hub/tag/modality"},{"name":"Robotic-Assisted Surgery"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"modality","hub_tag_value":"Robotic-Assisted Surgery"}}}]]

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