Frederick Olivier1, Mohamed Abasbassi2, Joachim Geers2. 1. Department of General and Abdominal Surgery, AZ Damiaan, Gouwelozestraat 100, 8400, Ostend, Belgium. folivier@azdamiaan.be. 2. Department of General and Abdominal Surgery, AZ Damiaan, Gouwelozestraat 100, 8400, Ostend, Belgium.
Abstract
PURPOSE: Robotic retromuscular abdominal wall repair (RAWR) for ventral hernias can be performed transabdominal or extraperitoneal by using an enhanced view totally extraperitoneal repair (eTEP). For defects in the meso- or epigastric region, an inverted approach can be used, starting the development of the totally extraperitoneal plane in the suprapubic region and progressing in a caudal-to-cranial direction (inverted TEP, iTEP). The aim of the study is to present the surgical technique and to report the short-term outcomes. METHODS: A retrospective analysis of a prospectively maintained database was performed, including patients who underwent a robotic RAWR using the iTEP approach between December 2019 and January 2022. The surgical technique was described, and patients' characteristics and intra- and postoperative parameters were studied and compared to the TARUP technique (robotic transabdominal retromuscular umbilical prosthetic hernia repair). RESULTS: Thirty-four patients were treated with an iTEP approach, and 14 patients underwent a TARUP procedure. The median length of stay was 1 day (range 1-3), and there were no intraoperative complications in both groups. One patient (3%) required reoperation after an iTEP approach for a small bowel internal herniation due to a rupture of the posterior rectus sheath. There were no recurrences or mortality with a median follow-up of 15 months (range 3-29) in the iTEP group, compared to 35 months (range 29-37) in the TARUP group. CONCLUSION: For defects in the upper abdominal region, a robotic RAWR with an iTEP approach appears to be safe and feasible. Long-term follow-up is needed to evaluate the late recurrence rate.
PURPOSE: Robotic retromuscular abdominal wall repair (RAWR) for ventral hernias can be performed transabdominal or extraperitoneal by using an enhanced view totally extraperitoneal repair (eTEP). For defects in the meso- or epigastric region, an inverted approach can be used, starting the development of the totally extraperitoneal plane in the suprapubic region and progressing in a caudal-to-cranial direction (inverted TEP, iTEP). The aim of the study is to present the surgical technique and to report the short-term outcomes. METHODS: A retrospective analysis of a prospectively maintained database was performed, including patients who underwent a robotic RAWR using the iTEP approach between December 2019 and January 2022. The surgical technique was described, and patients' characteristics and intra- and postoperative parameters were studied and compared to the TARUP technique (robotic transabdominal retromuscular umbilical prosthetic hernia repair). RESULTS: Thirty-four patients were treated with an iTEP approach, and 14 patients underwent a TARUP procedure. The median length of stay was 1 day (range 1-3), and there were no intraoperative complications in both groups. One patient (3%) required reoperation after an iTEP approach for a small bowel internal herniation due to a rupture of the posterior rectus sheath. There were no recurrences or mortality with a median follow-up of 15 months (range 3-29) in the iTEP group, compared to 35 months (range 29-37) in the TARUP group. CONCLUSION: For defects in the upper abdominal region, a robotic RAWR with an iTEP approach appears to be safe and feasible. Long-term follow-up is needed to evaluate the late recurrence rate.
Authors: R Bittner; K Bain; V K Bansal; F Berrevoet; J Bingener-Casey; D Chen; J Chen; P Chowbey; U A Dietz; A de Beaux; G Ferzli; R Fortelny; H Hoffmann; M Iskander; Z Ji; L N Jorgensen; R Khullar; P Kirchhoff; F Köckerling; J Kukleta; K LeBlanc; J Li; D Lomanto; F Mayer; V Meytes; M Misra; S Morales-Conde; H Niebuhr; D Radvinsky; B Ramshaw; D Ranev; W Reinpold; A Sharma; R Schrittwieser; B Stechemesser; B Sutedja; J Tang; J Warren; D Weyhe; A Wiegering; G Woeste; Q Yao Journal: Surg Endosc Date: 2019-06-27 Impact factor: 4.584
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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: 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; 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: 2014-02 Impact factor: 4.584
Authors: R Bittner; K Bain; V K Bansal; F Berrevoet; J Bingener-Casey; D Chen; J Chen; P Chowbey; U A Dietz; A de Beaux; G Ferzli; R Fortelny; H Hoffmann; M Iskander; Z Ji; L N Jorgensen; R Khullar; P Kirchhoff; F Köckerling; J Kukleta; K LeBlanc; J Li; D Lomanto; F Mayer; V Meytes; M Misra; S Morales-Conde; H Niebuhr; D Radvinsky; B Ramshaw; D Ranev; W Reinpold; A Sharma; R Schrittwieser; B Stechemesser; B Sutedja; J Tang; J Warren; D Weyhe; A Wiegering; G Woeste; Q Yao Journal: Surg Endosc Date: 2019-07-10 Impact factor: 4.584