E-TEP IN VENTRAL AND INCISIONAL HERNIA REPAIR – OUR EXPERIENCES

Authors

DOI:

https://doi.org/10.55791/2831-0098.1.1.99

Keywords:

ventral hernia, endoscopic retromuscular approach, laparoscopic ventral hernia repair

Abstract

Background: Rives-Stoppa repair has become the standard for repairing ventral and incisional hernias. The endoscopic retromuscular approach has the same benefits and offers the advantages of minimal invasive surgery. Method: The technique is based on the retromuscular approach to the linea semilunaris (longitudinal technique) or the linea semicircularis (transverse technique). The incision is made on the anterior rectus sheath, and the trocar is placed below the muscle. A retromuscular space is created and the neck of the hernia sac can be reached. Upon release of the hernia, the sheath of the opposite rectus muscle opens up entirely up to the semilunar line, allowing
the creation of enough space for placing the mesh. The mesh can be fixed using transcutaneous sutures, glue or be non-fixed. It is not always necessary to close the defect.
Results: Between 2003 and 2017 we performed 108 operations. We had 35 umbilical, 17 epigastric, one Spigelian and 55 incisional hernias. There were no intraoperative complications with ventral hernias, and one bowel injury in the incisional hernia group. There were five conversions and four recurrences. All of them were caused by a small mesh, after insufficient dissection. There were no infections.
Conclusion: Unlike LVRH, e-TEP will probably achieve the results and benefits of the retromuscular open technique.

References

Georgiev-Hristov T, Celdran A, Comment to: A systematic review of the surgical treatment of large incisional hernia. Hernia 2015;19:89-101.

Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair (Review). The Cochrane Collaboration. 2011.

Nowitsky JW, Porter JR, Rucho ZC, Getz SB, Pratt BL, Kercher KW, et al. Open preperitoneal retrofascial mesh repair for multiply recurrent ventral incisional hernias. J Am Coll Surg. 2006; 203:283-9.

Miserez M, Penninckx F. Endoscopic totally preperitoneal ventral hernia repair. Surg Endosc. 2002;16:1207-13.

Grevious MA, Cohen M, Shah SR, Rodriguez P. Structural and functional anatomy of the abdominal wall. Clinics in plastic surgery.2006; 33:169-79

Novitsky YW. Posterior component separation via transversus abdominis muscle release: the TAR procedure. In Nowitsky YW (editor), Hernia Surgery. Current Principles. Switzerland: Springer International Publishing; 2016. P. 117-136.

Stoppa R. The treatment of complicated groin and incisional hernias. World J Surg. 1989; 13:545-554.

Jenkins ED, Yom V, Melman L, Brunt LM, Eagon CJ, Frisella MM, Matthews BD. Prospective evaluation of adhesion characteristics to intraperitoneal mesh and adhesiolysisrelated copli cations during laparoscopic re-exploration after prior ventral hernia repair. Surg. Endosc. 2010; 24:3002-3007.

Passot G, Villeneuve L, Sabbagh C, Renard Y, Regimbeau JM, Verheage P, et al. Definition of giant ventral hernias: Development of standardization through a practice survey. Int J Surg. 2016; 28:136-40.

Karem CH, Rosen MJ. Endoscopic versus open component separation in complex abdominal wall reconstruction. Am J Surg. 2010;199:3.

Fox M, Cannon RM, Egger M, Spate K, Kehdy FJ. Laparoscopic component separation reduces postoperative wound complications but does not alter recurrence rates in complex hernia repairs. Am J Surg. 2013;206:869-74.

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Published

16.03.2022

How to Cite

E-TEP IN VENTRAL AND INCISIONAL HERNIA REPAIR – OUR EXPERIENCES. (2022). South-East European Endo-Surgery Journal, 1(1), 24-29. https://doi.org/10.55791/2831-0098.1.1.99