O Y Kudsi1, F Gokcal2. 1. Good Samaritan Medical Center, Tufts University School of Medicine, One Pearl Street, Brockton, MA, 02301, USA. omar.kudsi@tufts.edu. 2. Good Samaritan Medical Center, Tufts University School of Medicine, One Pearl Street, Brockton, MA, 02301, USA.
Abstract
BACKGROUND: The enhanced (or extended) view total extraperitoneal (TEP) access that was initially described for laparoscopic inguinal hernia repair has been applied to first laparoscopic and now robotic retromuscular ventral hernia repair (RRVHR). However, a 'dynamic' port setup that is based on the area of interest is preferred by most surgeons. In this study, we present our center's early operative outcomes after utilizing a lateral approach TEP-access RRVHR with and without transversus abdominis release (TAR). METHOD: An evaluation of a prospectively maintained database of hernia patients was conducted identifying patients who underwent a lateral approach TEP-access RRVHR between February 2013 and April 2019. The lateral approach TEP-access RRVHR was described. Patient demographics, intraoperative and postoperative variables were reviewed. Preoperative and postoperative results were presented according to recommended classification systems by European Hernia Society. RESULTS: Fifty-two patients who underwent a lateral approach TEP-access RRVHR were included in this study. A lateral dock setup was utilized for all patient who had a midline defect, as well as a lateral defect. The mean console time was 121.6 min., skin-to-skin time was 138.5 min. There was no intraoperative complication or conversion. The mean hospital length of stay was 0.71 day. During the mean 6.5 months follow-up period, no hernia recurrence arose. CONCLUSION: The lateral approach TEP-access RRVHR with and without TAR is a reproducible technique. Feasibility of this approach needs to be demonstrated by other surgeons familiar with retromuscular hernia repair in addition to long-term follow up.
BACKGROUND: The enhanced (or extended) view total extraperitoneal (TEP) access that was initially described for laparoscopic inguinal hernia repair has been applied to first laparoscopic and now robotic retromuscular ventral hernia repair (RRVHR). However, a 'dynamic' port setup that is based on the area of interest is preferred by most surgeons. In this study, we present our center's early operative outcomes after utilizing a lateral approach TEP-access RRVHR with and without transversus abdominis release (TAR). METHOD: An evaluation of a prospectively maintained database of herniapatients was conducted identifying patients who underwent a lateral approach TEP-access RRVHR between February 2013 and April 2019. The lateral approach TEP-access RRVHR was described. Patient demographics, intraoperative and postoperative variables were reviewed. Preoperative and postoperative results were presented according to recommended classification systems by European Hernia Society. RESULTS: Fifty-two patients who underwent a lateral approach TEP-access RRVHR were included in this study. A lateral dock setup was utilized for all patient who had a midline defect, as well as a lateral defect. The mean console time was 121.6 min., skin-to-skin time was 138.5 min. There was no intraoperative complication or conversion. The mean hospital length of stay was 0.71 day. During the mean 6.5 months follow-up period, no hernia recurrence arose. CONCLUSION: The lateral approach TEP-access RRVHR with and without TAR is a reproducible technique. Feasibility of this approach needs to be demonstrated by other surgeons familiar with retromuscular hernia repair in addition to long-term follow up.
Authors: Igor Belyansky; Jorge Daes; Victor Gheorghe Radu; Ramana Balasubramanian; H Reza Zahiri; Adam S Weltz; Udai S Sibia; Adrian Park; Yuri Novitsky Journal: Surg Endosc Date: 2017-09-15 Impact factor: 4.584
Authors: F E Muysoms; S A Antoniou; K Bury; G Campanelli; J Conze; D Cuccurullo; A C de Beaux; E B Deerenberg; B East; R H Fortelny; J-F Gillion; N A Henriksen; L Israelsson; A Jairam; A Jänes; J Jeekel; M López-Cano; M Miserez; S Morales-Conde; D L Sanders; M P Simons; M Śmietański; L Venclauskas; F Berrevoet Journal: Hernia Date: 2015-01-25 Impact factor: 4.739
Authors: F E Muysoms; M Miserez; F Berrevoet; G Campanelli; G G Champault; E Chelala; U A Dietz; H H Eker; I El Nakadi; P Hauters; M Hidalgo Pascual; A Hoeferlin; U Klinge; A Montgomery; R K J Simmermacher; M P Simons; M Smietański; C Sommeling; T Tollens; T Vierendeels; A Kingsnorth Journal: Hernia Date: 2009-06-03 Impact factor: 4.739