Robotic Ventral Hernia Repair: Promise, Performance, and Current Evidence

Abstract

Purpose of Review Robotic ventral hernia repair (RVHR) has rapidly evolved over the past decade, offering an additional minimally invasive platform for complex abdominal wall reconstruction. This review aims to reflect on the current status of RVHR, focusing on contemporary evidence regarding techniques, clinical outcomes, patient-reported measures, and cost.Recent Findings Randomized controlled trials, including the PROVE-IT trial and multicenter blinded studies, demonstrate comparable short- and mid-term outcomes between robotic and laparoscopic ventral hernia repair. Meta-analyses and systematic reviews published between 2024 and 2025 confirm similar recurrence and complication rates across approaches, with robotic repair associated with longer operative times but lower conversion rates and increased rates of fascial closure. Emerging long-term data suggests that recurrence is more closely related to surgical technique and patient factors than operative platform. In addition, studies have highlighted a measurable learning curve and persistent concerns regarding increased costs.Summary RVHR is a safe and effective approach that expands the technical capabilities of minimally invasive hernia surgery, particularly for complex reconstructions. While it offers clear ergonomic and reconstructive advantages, current evidence does not demonstrate consistent superiority in clinical outcomes compared to laparoscopic repair. Future efforts should focus on long-term durability, cost optimization, and standardization of advanced techniques.