I Belyansky1, H Reza Zahiri2, Z Sanford2, A S Weltz2, A Park2,3. 1. Department of Surgery, Anne Arundel Medical Center, 2000 Medical Parkway, Suite 100, Annapolis, MD, 21401, USA. ibelyansky@aahs.org. 2. Department of Surgery, Anne Arundel Medical Center, 2000 Medical Parkway, Suite 100, Annapolis, MD, 21401, USA. 3. Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
BACKGROUND: The enhanced-view totally extraperitoneal (eTEP) hernia repair technique was first described for laparoscopic inguinal hernia repair and later applied to laparoscopic ventral and incisional hernia repair. We present our center's early operative outcomes utilizing principles of this technique during robotic ventral and incisional hernia repair for implementation of the robotic eTEP Rives-Stoppa (eRS) and eTEP transversus abdominis release (eTAR) techniques. METHODS: A review of a prospectively maintained database of hernia patients was conducted identifying 37 patients who underwent robotic eTEP for ventral, incisional, flank or parastomal hernia repair between March and October 2017. All patients underwent retrorectus dissection with selective utilization of transversus abdominis release (TAR) as indicated. RESULTS: 37 patients including 13 male and 24 female with mean age, body mass index, and ASA score of 54, 35.5, and 2.4, respectively, underwent a mean operation room time of 198 min. Mean length of stay was 0.7 days. There were no intraoperative complications. Two patients developed subcutaneous seromas requiring interventional radiology drainage. One patient was readmitted at 30 days for PO intolerance that was managed expectantly. Mean postoperative follow-up visit occurred at 36 days with no sign of early hernia recurrences. CONCLUSION: The enhanced-view totally extraperitoneal approach is both safe and feasible in robotic-assisted repair of ventral and incisional hernias. Although long-term outcomes and patient selection criteria require further study, we believe this technique will become an important tool in the armamentarium of minimally invasive hernia surgeons.
BACKGROUND: The enhanced-view totally extraperitoneal (eTEP) hernia repair technique was first described for laparoscopic inguinal hernia repair and later applied to laparoscopic ventral and incisional hernia repair. We present our center's early operative outcomes utilizing principles of this technique during robotic ventral and incisional hernia repair for implementation of the robotic eTEP Rives-Stoppa (eRS) and eTEP transversus abdominis release (eTAR) techniques. METHODS: A review of a prospectively maintained database of herniapatients was conducted identifying 37 patients who underwent robotic eTEP for ventral, incisional, flank or parastomal hernia repair between March and October 2017. All patients underwent retrorectus dissection with selective utilization of transversus abdominis release (TAR) as indicated. RESULTS: 37 patients including 13 male and 24 female with mean age, body mass index, and ASA score of 54, 35.5, and 2.4, respectively, underwent a mean operation room time of 198 min. Mean length of stay was 0.7 days. There were no intraoperative complications. Two patients developed subcutaneous seromas requiring interventional radiology drainage. One patient was readmitted at 30 days for PO intolerance that was managed expectantly. Mean postoperative follow-up visit occurred at 36 days with no sign of early hernia recurrences. CONCLUSION: The enhanced-view totally extraperitoneal approach is both safe and feasible in robotic-assisted repair of ventral and incisional hernias. Although long-term outcomes and patient selection criteria require further study, we believe this technique will become an important tool in the armamentarium of minimally invasive hernia surgeons.
Authors: Paul A Harris; Robert Taylor; Robert Thielke; Jonathon Payne; Nathaniel Gonzalez; Jose G Conde Journal: J Biomed Inform Date: 2008-09-30 Impact factor: 6.317
Authors: Amir Szold; Roberto Bergamaschi; Ivo Broeders; Jenny Dankelman; Antonello Forgione; Thomas Langø; Andreas Melzer; Yoav Mintz; Salvador Morales-Conde; Michael Rhodes; Richard Satava; Chung-Ngai Tang; Ramon Vilallonga Journal: Surg Endosc Date: 2014-11-08 Impact factor: 4.584
Authors: Igor Belyansky; Adam S Weltz; Udai S Sibia; Justin J Turcotte; Haley Taylor; H Reza Zahiri; T Robert Turner; Adrian Park Journal: Surg Endosc Date: 2017-09-15 Impact factor: 4.584
Authors: Alfredo M Carbonell; Jeremy A Warren; Ajita S Prabhu; Conrad D Ballecer; Randy J Janczyk; Javier Herrera; Li-Ching Huang; Sharon Phillips; Michael J Rosen; Benjamin K Poulose Journal: Ann Surg Date: 2018-02 Impact factor: 12.969
Authors: Jacopo Andreuccetti; Alberto Sartori; Enrico Lauro; Lorenzo Crepaz; Silvia Sanna; Giusto Pignata; Umberto Bracale; Alberto Di Leo Journal: Updates Surg Date: 2021-04-30