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Published in: Surgical Endoscopy 6/2024

18-04-2024 | Diastasis Recti

Early results of eTEP access surgery with preperitoneal repair of primary midline ventral hernias and diastasis recti. A 33 patient case series of “PeTEP”

Authors: Héctor Alí Valenzuela Alpuche, Francisco Regin Torres, Juan Pablo Saucedo González

Published in: Surgical Endoscopy | Issue 6/2024

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Abstract

Background

This article aims to share the initial experience of the preperitoneal eTEP approach and its potential benefits in a selected group of patients. The eTEP Rives-Stoppa is a proven minimally invasive surgical technique for the treatment of ventral midline and off-midline hernias that has shown to be a solid, durable, and reproducible repair. The preperitoneal eTEP repair is a surgical technique that brings together the extraperitoneal access surgery with a preperitoneal repair for primary midline hernias avoiding posterior rectus sheath division and preservation of the retrorectus space while being able to treat simultaneous diastasis recti.

Methods

The analysis included 33 patients operated with the preperitoneal eTEP approach from September 2022 to September 2023 in patients with primary small to medium (< 4 cm) midline hernias, single or multiple defects with or without diastasis recti. Age, gender, hernia characteristics, operative time, and surgical site occurrences will be discussed, as well as fine details and landmarks in the operative technique.

Results

33 consecutive patients were operated, 19 female (57.5%) and 14 males (42.5%) between 32 and 63 years of age, the most common comorbidity found was obesity (BMI > 30). In 70% of the cases, operative time was 90 min ± 25 min. The average hospital stay was one day, while 12 went home the same day, and so far, no reoccurrences have been reported.

Conclusions

We believe the preperitoneal eTEP approach for small to medium primary midline hernias is an effective and solid repair that combines excellent features of proven surgical techniques and eliminates the need for posterior rectus sheath division while saving the retrorectus space, among other benefits that will be discussed. The reproducibility of the technique remains to be proven.
Literature
5.
go back to reference Strâmbu V, Radu P, Brătucu M, Garofil D, Iorga C, Iorga R, Popa F (2013) Rives technique, a gold standard for incisional hernias-our experience. Chirurgia (Bucur) 1:46–50 Strâmbu V, Radu P, Brătucu M, Garofil D, Iorga C, Iorga R, Popa F (2013) Rives technique, a gold standard for incisional hernias-our experience. Chirurgia (Bucur) 1:46–50
7.
go back to reference Nikolian VC, Coleman NL, Podolsky D, Novitsky YW (2020) Robotic-assisted transabdominal preperitoneal ventral hernia repair. Surg Technol Int 28(36):95–97 Nikolian VC, Coleman NL, Podolsky D, Novitsky YW (2020) Robotic-assisted transabdominal preperitoneal ventral hernia repair. Surg Technol Int 28(36):95–97
10.
go back to reference Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RK, Simons MP, Smietański M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13(4):407–14. https://doi.org/10.1007/s10029-009-0518-xCrossRefPubMedPubMedCentral Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RK, Simons MP, Smietański M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13(4):407–14. https://​doi.​org/​10.​1007/​s10029-009-0518-xCrossRefPubMedPubMedCentral
19.
go back to reference Parker SG, Wood CPJ, Butterworth JW, Boulton RW, Plumb AAO, Mallett S, Halligan S, Windsor ACJ (2018) A systematic methodological review of reported perioperative variables, postoperative outcomes and hernia recurrence from randomised controlled trials of elective ventral hernia repair: clear definitions and standardised datasets are needed. Hernia 22(2):215–226. https://doi.org/10.1007/s10029-017-1718-4CrossRefPubMed Parker SG, Wood CPJ, Butterworth JW, Boulton RW, Plumb AAO, Mallett S, Halligan S, Windsor ACJ (2018) A systematic methodological review of reported perioperative variables, postoperative outcomes and hernia recurrence from randomised controlled trials of elective ventral hernia repair: clear definitions and standardised datasets are needed. Hernia 22(2):215–226. https://​doi.​org/​10.​1007/​s10029-017-1718-4CrossRefPubMed
21.
go back to reference Radu VG (2019) Retromuscular approach in ventral hernia repair—endoscopic Rives-Stoppa procedure. Chirurgia (Bucur) 114(1):109–114CrossRefPubMed Radu VG (2019) Retromuscular approach in ventral hernia repair—endoscopic Rives-Stoppa procedure. Chirurgia (Bucur) 114(1):109–114CrossRefPubMed
24.
go back to reference Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz UA, de Beaux A, Ferzli G, Fortelny R, Hoffmann H, Iskander M, Ji Z, Jorgensen LN, Khullar R, Kirchhoff P, Köckerling F, Kukleta J, LeBlanc K, Li J, Lomanto D, Mayer F, Meytes V, Misra M, Morales-Conde S, Niebuhr H, Radvinsky D, Ramshaw B, Ranev D, Reinpold W, Sharma A, Schrittwieser R, Stechemesser B, Sutedja B, Tang J, Warren J, Weyhe D, Wiegering A, Woeste G, Yao Q (2019) Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))-part A. Surg Endosc 33(10):3069–3139. https://doi.org/10.1007/s00464-019-06907-7CrossRefPubMedPubMedCentral Bittner R, Bain K, Bansal VK, Berrevoet F, Bingener-Casey J, Chen D, Chen J, Chowbey P, Dietz UA, de Beaux A, Ferzli G, Fortelny R, Hoffmann H, Iskander M, Ji Z, Jorgensen LN, Khullar R, Kirchhoff P, Köckerling F, Kukleta J, LeBlanc K, Li J, Lomanto D, Mayer F, Meytes V, Misra M, Morales-Conde S, Niebuhr H, Radvinsky D, Ramshaw B, Ranev D, Reinpold W, Sharma A, Schrittwieser R, Stechemesser B, Sutedja B, Tang J, Warren J, Weyhe D, Wiegering A, Woeste G, Yao Q (2019) Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))-part A. Surg Endosc 33(10):3069–3139. https://​doi.​org/​10.​1007/​s00464-019-06907-7CrossRefPubMedPubMedCentral
Metadata
Title
Early results of eTEP access surgery with preperitoneal repair of primary midline ventral hernias and diastasis recti. A 33 patient case series of “PeTEP”
Authors
Héctor Alí Valenzuela Alpuche
Francisco Regin Torres
Juan Pablo Saucedo González
Publication date
18-04-2024
Publisher
Springer US
Keyword
Diastasis Recti
Published in
Surgical Endoscopy / Issue 6/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-024-10832-9

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