Abstract BACKGROUND: The role of prophylactic drains in retromuscular ventral hernia repair remains controversial. Although drains have traditionally been used to prevent seroma or hematoma formation, evidence regarding their necessity in minimally invasive robotic extended totally extraperitoneal (eTEP) Rives–Stoppa (RS) repairs is limited. This study evaluates the need for prophylactic drain placement following robotic-assisted eTEP RS hernia repair. METHODS: A retrospective review of 53 patients who underwent robotic-assisted eTEP RS hernia repair at a single high-volume hernia center between July 2021 and December 2022 was conducted. No prophylactic drains were placed. Postoperative evaluation included 30-day follow-up visits, and computed tomography (CT) scans were obtained 30–60 days postoperatively, which were reviewed for retromuscular fluid (RMF) accumulation and classified by severity. RESULTS: Of the 53 patients, 41 (77%) underwent postoperative CT scanning. Among these, 27 (66%) had no RMF, 9 (22%) had minimal RMF, 4 (10%) had moderate RMF, and 1 (2%) had large RMF. All fluid collections resolved spontaneously within approximately 5.5 months without intervention. No cases of infection, seroma-related morbidity, or recurrence were identified during the follow-up. CONCLUSION: Prophylactic drain placement may not be necessary in robotic-assisted eTEP RS hernia repair. Most patients in this series demonstrated no or minimal postoperative fluid accumulation, and all observed collections resolved without intervention. These findings support omitting routine drain use in robotic eTEP RS repairs.
Muca et al. (Fri,) studied this question.