This study evaluates the long-term recurrence rates of ventral hernia repairs using robotic-assisted, laparoscopic, and open approaches. Using Medicare claims data from 2010 to 2020, the researchers analyzed 161,415 patients who underwent elective inpatient ventral hernia repairs. The primary outcome was operative hernia recurrence up to 10 years post-surgery. The results showed that robotic-assisted repairs had a higher cumulative incidence of operative recurrence (13.43%) compared to laparoscopic (12.33%) and open (12.74%) repairs. After adjusting for various factors, the adjusted hazard ratios (HRs) for reoperation were 0.78 (95% CI, 0.62-0.94) for laparoscopic repairs and 0.81 (95% CI, 0.64-0.97) for open repairs compared to robotic-assisted repairs. These findings suggest that robotic-assisted ventral hernia repairs have inferior long-term outcomes compared to established open and laparoscopic approaches, raising questions about the clinical rationale for their widespread adoption. The study also highlights the need for better training and credentialing standards for surgeons performing robotic-assisted procedures.This study evaluates the long-term recurrence rates of ventral hernia repairs using robotic-assisted, laparoscopic, and open approaches. Using Medicare claims data from 2010 to 2020, the researchers analyzed 161,415 patients who underwent elective inpatient ventral hernia repairs. The primary outcome was operative hernia recurrence up to 10 years post-surgery. The results showed that robotic-assisted repairs had a higher cumulative incidence of operative recurrence (13.43%) compared to laparoscopic (12.33%) and open (12.74%) repairs. After adjusting for various factors, the adjusted hazard ratios (HRs) for reoperation were 0.78 (95% CI, 0.62-0.94) for laparoscopic repairs and 0.81 (95% CI, 0.64-0.97) for open repairs compared to robotic-assisted repairs. These findings suggest that robotic-assisted ventral hernia repairs have inferior long-term outcomes compared to established open and laparoscopic approaches, raising questions about the clinical rationale for their widespread adoption. The study also highlights the need for better training and credentialing standards for surgeons performing robotic-assisted procedures.