Robotic ventral hernia repair (rVHR) has been rapidly adopted globally, driven by the promise of superior articulation and reduced wound morbidity compared with laparoscopic ventral hernia repair (lVHR). However, the magnitude of the operative time penalty remains a subject of intense debate. This meta-analysis aimed to pool real-world evidence comparing the clinical outcomes and operational efficiencies of the two platforms.

We conducted a systematic search of PubMed, Embase, and Google Scholar, focusing on contemporary comparative studies that evaluated elective rVHR versus lVHR. Continuous outcomes were expressed as mean differences (MD) and binary events as risk ratios (RR) with 95% confidence intervals (CI). Five comparative studies (45,787 patients) were reviewed, and four studies (552 patients) contributed data for the quantitative meta-analysis of operative time and SSOs.

Regarding operative efficiency, rVHR was associated with a statistically significant time penalty (Pooled MD: 47.78 min longer; 95% CI: [12.68, 82.88]; P = 0.0076), although with high clinical heterogeneity (I² = 95.9%). Conversely, pooling of binary surgical site occurrences (SSOs) revealed no statistically significant difference in postoperative wound complication rates (Pooled RR: 0.61; 95% CI: [0.22, 1.68]; P = 0.3376; I² = 42.2%).