Shlomi Rayman1, Mnouskin Yuori1, Rachmuth Jacob1, Katz Ephraim2, Adileh Mohammad2, Segev Lior2, Hazzan David2. 1. Department of General Surgery, Assuta Ashdod Public Hospital, Ashdod, Israel. Affiliated with the Faculty of Health and Science, Ben-Gurion University, Beer-Sheba, Israel. 2. Minimally Invasive and Robotic Surgery, Sheba Medical Center, Tel-Hashomer, Israel. Affiliated with The Sackler Faculty of Medicine, Tel Aviv University, Israel.
Abstract
BACKGROUND AND OBJECTIVES: Spigelian hernias (SH) are a rare variant of abdominal wall defects that require prompt surgical intervention. With the advancement of abdominal wall surgery capabilities, there are several possible approaches of repairing SH. The aim of the study was to present our experience in performing laparoscopic or robotic transabdominal preperitoneal (TAPP) repairs of SH and discuss the advantages of TAPP in such hernias. METHODS: Retrospective review of a prospectively maintained database of SH TAPP repairs between February 1, 2015 and February 29, 2020. Data included clinical details, size and location of fascial defect, presence of concomitant hernias, surgery duration, length of stay (LOS), mesh type, mesh size, and fixation method. Follow up visits at 1 month postoperative and telephone survey for pain assessment and subsequent hernia-related treatment. RESULTS: During the study period 16 patients underwent TAPP SH repairs, 13 laparoscopically and 3 robotic. Seven (44%) patients had a concomitant inguinal hernia with 1 patient having bilateral inguinal defects. Mean surgery duration and mean LOS were 78 (range 41 - 120) minutes & 1.6 (range 1 - 3) days, respectively. Immediate postoperative complications included 2 seromas and 1 port-site hematoma. Mean telephone survey follow up was 17 months (range 3 - 49). Mean visual analogue scale scores were significantly lower at follow-up compared to discharge (1.9 vs 0.5, P = 0.0015). CONCLUSION: Advantages of TAPP SH repair include low postoperative chronic pain, potential low wound complications, intra-abdominal visualization of hernia contents, and repairing of concomitant inguinal hernias simultaneously.
BACKGROUND AND OBJECTIVES: Spigelian hernias (SH) are a rare variant of abdominal wall defects that require prompt surgical intervention. With the advancement of abdominal wall surgery capabilities, there are several possible approaches of repairing SH. The aim of the study was to present our experience in performing laparoscopic or robotic transabdominal preperitoneal (TAPP) repairs of SH and discuss the advantages of TAPP in such hernias. METHODS: Retrospective review of a prospectively maintained database of SH TAPP repairs between February 1, 2015 and February 29, 2020. Data included clinical details, size and location of fascial defect, presence of concomitant hernias, surgery duration, length of stay (LOS), mesh type, mesh size, and fixation method. Follow up visits at 1 month postoperative and telephone survey for pain assessment and subsequent hernia-related treatment. RESULTS: During the study period 16 patients underwent TAPP SH repairs, 13 laparoscopically and 3 robotic. Seven (44%) patients had a concomitant inguinal hernia with 1 patient having bilateral inguinal defects. Mean surgery duration and mean LOS were 78 (range 41 - 120) minutes & 1.6 (range 1 - 3) days, respectively. Immediate postoperative complications included 2 seromas and 1 port-site hematoma. Mean telephone survey follow up was 17 months (range 3 - 49). Mean visual analogue scale scores were significantly lower at follow-up compared to discharge (1.9 vs 0.5, P = 0.0015). CONCLUSION: Advantages of TAPP SH repair include low postoperative chronic pain, potential low wound complications, intra-abdominal visualization of hernia contents, and repairing of concomitant inguinal hernias simultaneously.
Authors: Pierre A Clavien; Jeffrey Barkun; Michelle L de Oliveira; Jean Nicolas Vauthey; Daniel Dindo; Richard D Schulick; Eduardo de Santibañes; Juan Pekolj; Ksenija Slankamenac; Claudio Bassi; Rolf Graf; René Vonlanthen; Robert Padbury; John L Cameron; Masatoshi Makuuchi Journal: Ann Surg Date: 2009-08 Impact factor: 12.969
Authors: R Bittner; J Bingener-Casey; U Dietz; M Fabian; G S Ferzli; R H Fortelny; F Köckerling; J Kukleta; K Leblanc; D Lomanto; M C Misra; V K Bansal; S Morales-Conde; B Ramshaw; W Reinpold; S Rim; M Rohr; R Schrittwieser; Th Simon; M Smietanski; B Stechemesser; M Timoney; P Chowbey Journal: Surg Endosc Date: 2013-10-11 Impact factor: 4.584
Authors: Arianna Birindelli; Massimo Sartelli; Salomone Di Saverio; Federico Coccolini; Luca Ansaloni; Gabrielle H van Ramshorst; Giampiero Campanelli; Vladimir Khokha; Ernest E Moore; Andrew Peitzman; George Velmahos; Frederick Alan Moore; Ari Leppaniemi; Clay Cothren Burlew; Walter L Biffl; Kaoru Koike; Yoram Kluger; Gustavo P Fraga; Carlos A Ordonez; Matteo Novello; Ferdinando Agresta; Boris Sakakushev; Igor Gerych; Imtiaz Wani; Michael D Kelly; Carlos Augusto Gomes; Mario Paulo Faro; Antonio Tarasconi; Zaza Demetrashvili; Jae Gil Lee; Nereo Vettoretto; Gianluca Guercioni; Roberto Persiani; Cristian Tranà; Yunfeng Cui; Kenneth Y Y Kok; Wagih M Ghnnam; Ashraf El-Sayed Abbas; Norio Sato; Sanjay Marwah; Muthukumaran Rangarajan; Offir Ben-Ishay; Abdul Rashid K Adesunkanmi; Helmut Alfredo Segovia Lohse; Jakub Kenig; Stefano Mandalà; Raul Coimbra; Aneel Bhangu; Nigel Suggett; Antonio Biondi; Nazario Portolani; Gianluca Baiocchi; Andrew W Kirkpatrick; Rodolfo Scibé; Michael Sugrue; Osvaldo Chiara; Fausto Catena Journal: World J Emerg Surg Date: 2017-08-07 Impact factor: 5.469