Table 1. Cohort Characteristics by Operative Approach.
| Characteristic | Operative approach, No. (%) | P valuea | |||
|---|---|---|---|---|---|
| All | Robotic-assisted | Laparoscopic | Open | ||
| Total | 161 415 (100) | 12 693 (7.8) | 32 542 (20.2) | 116 180 (72.0) | NA |
| Age, mean (SD), y | 69.0 (10.8) | 69.9 (8.9) | 68.5 (11.1) | 69.0 (10.9) | <.001 |
| Sex | |||||
| Female | 93 823 (58.1) | 5810 (45.8) | 19 992 (61.4) | 68 021 (58.5) | <.001 |
| Male | 67 592 (41.9) | 6883 (54.2) | 12 550 (38.6) | 48 159 (41.5) | |
| Race and ethnicity | |||||
| Asian | 871 (0.5) | 89 (0.7) | 152 (0.5) | 630 (0.5) | .009 |
| Black | 13 885 (8.6) | 1048 (8.3) | 2707 (8.3) | 10 130 (8.7) | .03 |
| Hispanic | 3155 (2.0) | 227 (1.8) | 593 (1.8) | 2335 (2.0) | .04 |
| White | 139 179 (86.2) | 10 911 (86.0) | 28 285 (86.9) | 99 983 (86.1) | <.001 |
| Comorbiditiesb | |||||
| Hypertension | 108 223 (67.0) | 8640 (68.1) | 22 072 (67.8) | 77 511 (66.7) | <.001 |
| Obesity | 37 920 (23.5) | 3281 (25.8) | 7606 (23.4) | 27 033 (23.3) | <.001 |
| Chronic pulmonary disease | 37 840 (23.4) | 2683 (21.1) | 8014 (24.6) | 27 143 (23.4) | <.001 |
| Diabetes without chronic complications | 36 631 (22.7) | 2415 (19.0) | 8077 (24.8) | 26 139 (22.5) | <.001 |
| Hypothyroidism | 24 991 (15.5) | 1861 (14.7) | 5215 (16.0) | 17 915 (15.4) | .001 |
| Fluid and electrolyte disorders | 24 274 (15.0) | 1565 (12.3) | 3571 (11.0) | 19 138 (16.5) | <.001 |
| Depression | 19 516 (12.1) | 1400 (11.0) | 4270 (13.1) | 13 846 (11.9) | <.001 |
| Kidney failure | 18 712 (11.6) | 1405 (11.1) | 3304 (10.2) | 14 003 (12.1) | <.001 |
| Deficiency anemias | 18 339 (11.4) | 1211 (9.5) | 2915 (9.0) | 14 213 (12.2) | <.001 |
| Congestive heart failure | 12 655 (7.8) | 920 (7.2) | 2372 (7.3) | 9363 (8.1) | <.001 |
| Diabetes with chronic complications | 9786 (6.1) | 1076 (8.5) | 1695 (5.2) | 7015 (6.0) | <.001 |
| Peripheral vascular disease | 8300 (5.1) | 511 (4.0) | 1577 (4.8) | 6212 (5.3) | <.001 |
| Other neurological disorders | 7777 (4.8) | 492 (3.9) | 1523 (4.7) | 5762 (5.0) | <.001 |
| Valvular disease | 7487 (4.6) | 556 (4.4) | 1522 (4.7) | 5409 (4.7) | .35 |
| Liver disease | 7163 (4.4) | 428 (3.4) | 1563 (4.8) | 5172 (4.5) | <.001 |
| Weight loss | 5155 (3.2) | 263 (2.1) | 535 (1.6) | 4357 (3.8) | <.001 |
| Rheumatoid arthritis or collagen vascular disease | 5104 (3.2) | 354 (2.8) | 1017 (3.1) | 3733 (3.2) | .03 |
| Psychoses | 4578 (2.8) | 262 (2.1) | 907 (2.8) | 3409 (2.9) | <.001 |
| Coagulopathy | 4313 (2.7) | 299 (2.4) | 629 (1.9) | 3385 (2.9) | <.001 |
| Metastatic cancer | 4296 (2.7) | 300 (2.4) | 344 (1.1) | 3652 (3.1) | <.001 |
| Solid tumor without metastasis | 3366 (2.1) | 267 (2.1) | 470 (1.4) | 2629 (2.3) | <.001 |
| Hernia type | |||||
| Ventral or incisional | 131 021 (81.2) | 7674 (60.5) | 28 426 (87.4) | 94 921 (81.7) | <.001 |
| Umbilical | 30 394 (18.8) | 5019 (39.5) | 4116 (12.6) | 21 259 (18.3) | <.001 |
| Hernia technique | |||||
| Mesh usec | 109 907 (68.1) | 12 693 (100) | 32 542 (100) | 64 672 (55.7) | <.001 |
| Myofascial flap | 20 625 (12.8) | 818 (6.4) | 597 (1.8) | 19 210 (16.5) | <.001 |
| Year of surgery | |||||
| 2010 | 20 184 (12.5) | 415 (3.3) | 4799 (14.7) | 14 970 (12.9) | <.001 |
| 2011 | 19 465 (12.1) | 516 (4.1) | 4535 (13.9) | 14 414 (12.4) | |
| 2012 | 18 153 (11.2) | 574 (4.5) | 4259 (13.1) | 13 320 (11.5) | |
| 2013 | 16 706 (10.3) | 626 (4.9) | 3848 (11.8) | 12 232 (10.5) | |
| 2014 | 15 145 (9.4) | 791 (6.2) | 3275 (10.1) | 11 079 (9.5) | |
| 2015 | 14 247 (8.8) | 1032 (8.1) | 2806 (8.6) | 10 409 (9.0) | |
| 2016 | 13 888 (8.6) | 1453 (11.4) | 2574 (7.9) | 9861 (8.5) | |
| 2017 | 13 247 (8.2) | 1763 (13.9) | 2197 (6.8) | 9287 (8.0) | |
| 2018 | 11 618 (7.2) | 1826 (14.4) | 1781 (5.5) | 8011 (6.9) | |
| 2019 | 10 817 (6.7) | 1960 (15.4) | 1522 (4.7) | 7335 (6.3) | |
| 2020 | 7945 (4.9) | 1737 (13.7) | 946 (2.9) | 5262 (4.5) | |
Abbreviation: NA, not applicable.
a
P values shown are for analysis of variance, Kruskal-Wallis, or Pearson χ2 tests depending on variable type.
b
Comorbidities with a sample prevalence of at least 2% reported.
c
Mesh use includes any open procedure with a separate billing claim for mesh placement or any minimally invasive procedure (robotic, laparoscopic), as mesh placement is included in the billing claim for these case.