184 THE EFFECT OF MENTAL HEALTH DISORDERS ON POST-OPERATIVE OUTCOMES AFTER BARIATRIC SURGERY

Introduction.Robot-assisted, enhanced-view totally extraperitoneal (eTEP) ventral hernia repair is a novel technique that is gaining popularity in minimally invasive surgery.However, early adaptation may be inhibited by the complexity of operating in a completely retroperitoneal environment when a more traditional, trans-abdominal pre-peritoneal (TAPP) approach exists.This study seeks to compare early peri-operative outcomes of these two approaches to abdominal wall reconstruction.Methods.Retrospective chart review of patients undergoing robotic-assisted eTEP and TAPP ventral hernia repair by an individual surgeon from 2012 to 2019 was performed.Patient demographics, intra-operative details, and thirty-day postoperative outcomes were collected from the electronic medical record.Statistical analysis was performed using STATA (Statcorp, Version 15.0).Chi-Squared test, Fisher's test, and two sample t-tests with equal variances were used for comparison of continuous nonparametric variables.Results.158 patients underwent robotic ventral hernia repair; 108 underwent TAPP and 50 had an eTEP repair.There were no statistically significant differences in patient demographics or co-morbidities between the two cohorts.Mean patient age was 53 years, 62% were female, and average BMI was 33 kg/m2.Patients with eTEP had larger hernia defects (215.1 cm2 vs. 70.1 cm2, p<0.05) and a larger mesh used (426.8cm2 vs. 137.9cm2 p<0.05).Operative time was essentially equivalent at 158.3±90.6 minutes for eTEP and 155.8±65.2minutes for TAPP (p=0.80) with no difference in intraoperative complications or conversion to open.Hospital length of stay was shorter in the eTEP cohort, 1.3 days vs. 2.2days (p<0.05).At 30 days, there were no differences in post-operative complications, emergency room visits, or hospital readmissions.Conclusion.Robotic ventral hernia repair utilizing the eTEP approach is safe in the 30-day peri-operative time frame, and can be performed efficiently despite increased complexity and size of the abdominal wall defect.In addition, a decreased length of stay in the eTEP cohort indicates that patients may experience less pain and a more superior outcome, which needs to be studied further.