Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Hernia
Published in: Hernia 3/2021

01-06-2021 | Incisional Hernia | Original Article

Robotic assisted eTEP ventral hernia repair: Brazilian early experience

Authors: A. L. G. Morrell, A. C. Morrell, L. T. Cavazzola, G. S. S. Pereira, J. M. Mendes, R. Z. Abdalla, R. B. Garcia, T. N. Costa, A. C. Morrell-Junior, F. Malcher

Published in: Hernia | Issue 3/2021

Login to get access

Abstract

Purpose

The enhanced view totally extraperitoneal (eTEP) concept first applied to inguinal hernias has become an important tool in the armamentarium of ventral hernia repair. The purpose of this report is to date the first brazilian robotic-assisted eTEP ventral hernia repair case series.

Methods

A review of a prospectively maintained database was conducted in patients who underwent robotic-assisted enhanced view totally extraperitoneal (eTEP) for ventral hernia repair between June 2018 and January 2020. Patients demographics, preoperative hernia characteristics, intraoperative variables and postoperative outcomes were evaluated.

Results

Our review identified 74 patients submitted to the procedure. Thirty-one patients (41.8%) presented primary ventral hernias (PVHs) and 43 patients (58.2%) presented incisional hernias (IHs). Female patients were predominant in both groups PVHs and IHs with 17 (22.9%) and 22 (29.7%) respectively, with a total of 39 patients (52.7%). Mean BMI was 29.1 kg/m2 (range 21.3–48.0 kg/m2) with higher mean BMI rates of 30.3 kg/m2 in the IHs group (range 22–48 years). A lateral dock setup was utilized in 55 cases (74.4%), having the inferior and superior dock setup in 18 (24.3%) and 1 (1.3%) cases respectively. Mean console time was 148.3 (range 75–277 min) and 192.6 min (range 66–301 min) in the PVHs and IHs groups respectively. There were no intraoperative complications or conversions. Average length of stay was 1.5 days. Four patients were readmitted within 30 days of surgery. There were no reoperation or cases of intraparietal herniation in this cohort. No hernia recurrence was verified during the mean 230.7 days of follow up in both groups.

Conclusion

We present the first brazilian series to-date of the robotic assisted eTEP approach for ventral hernia repairs. Although long term outcomes require further analysis, its feasibility and reproducibility in experienced surgeons hands are evident, with safe and acceptable early postoperative outcomes.
Literature
1.
Burger JW, Luijendijk RW, Hop WC et al (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240(4):578–583CrossRef
2.
LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3(1):39–41PubMed
3.
Sauerland S, Walgenbach M, Habermalz B, et al. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011 ;16;(3):CD007781
4.
Daes J (2012) The enhanced view-totally extraperitoneal technique for repair of inguinal hernia. Surg Endosc 26(4):1187–1189CrossRef
5.
Belyansky I, Reza Zahiri H, Sanford Z et al (2018) Early operative outcomes of endoscopic (eTEP access) robotic-assisted retromuscular abdominal wall hernia repair. Hernia 22(5):837–847CrossRef
6.
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213CrossRef
7.
Muysoms FE, Miserez M, Berrevoet F et al (2009) Classification of primary and incisional abdominal wall hernias. Hernia 13(4):407–414CrossRef
8.
Kingsnorth AN (2013) General introduction and history of hernia surgery. In: Kingsnorth A, LeBlanc K (eds) Management of abdominal hernias. Springer, LondonCrossRef
9.
Chelala E, Gaede F, Douillez V et al (2003) The suturing concept for laparoscopic mesh fixation in ventral and incisional hernias: preliminary results. Hernia 7(4):191–196CrossRef
10.
Yang GPC (2017) From intraperitoneal onlay mesh repair to preperitoneal onlay mesh repair. Asian J Endosc Surg 10(2):119–127CrossRef
11.
Claus CM, Malcher F, Cavazzola LT et al (2018) Subcutaneous onlay laparoscopic approach (SCOLA) for ventral hernia and rectus abdominis diastasis repair: technical description and initial results. Arq Bras Cir Dig 31(4):e1399CrossRef
12.
Claus CMP, Oliveira FMM, Furtado ML et al (2019) Guidelines of the Brazilian Hernia Society (BHS) for the management of inguinocrural hernias in adults. Rev Col Bras Cir 46(4):e20192226CrossRef
13.
Simons MP, Aufenacker T, Bay-Nielsen M et al (2009) European Hernia Society guidelines on the treatment of inguinal hernia in adult patients. Hernia 13(4):343–403 (European)CrossRef
14.
Schwarz J, Reinpold W, Bittner R et al (2017) Endoscopic mini/less open sublay technique (EMILOS)—a new technique for ventral hernia repair. Langenbecks Arch Surg 402(1):173–180CrossRef
15.
Lee GI, Lee MR, Green I et al (2017) Surgeons’ physical discomfort and symptoms during robotic surgery: a comprehensive ergonomic survey study. Surg Endosc 31(4):1697–1706CrossRef
16.
Warren JA, Cobb WS, Ewing JA et al (2017) Standard laparoscopic versus robotic retromuscular ventral hernia repair. Surg Endosc 31(1):324–332CrossRef
17.
Kudsi OY, Gokcal F (2019) Lateral approach totally extraperitoneal (TEP) robotic retromuscular ventral hernia repair. Hernia 27:1–2
18.
Stabilini C, Cavallaro G, Dolce P et al (2019) Pooled data analysis of primary ventral (PVH) and incisional hernia (IH) repair is no more acceptable: results of a systematic review and metanalysis of current literature. Hernia 23(5):831–845CrossRef
Metadata
Title
Robotic assisted eTEP ventral hernia repair: Brazilian early experience
Authors
A. L. G. Morrell
A. C. Morrell
L. T. Cavazzola
G. S. S. Pereira
J. M. Mendes
R. Z. Abdalla
R. B. Garcia
T. N. Costa
A. C. Morrell-Junior
F. Malcher
Publication date
01-06-2021
Publisher
Springer Paris
Published in
Hernia / Issue 3/2021
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-020-02233-3

Other articles of this Issue 3/2021

Hernia 3/2021 Go to the issue

Original Article

Is there an advantage to laparoscopy over open repair of primary umbilical hernias in obese patients? An analysis of the Americas Hernia Society Quality Collaborative (AHSQC)

Editorial

Endolaparoscopic retromuscular repair of smaller midline ventral hernias—too much for too little?

Original Article

Prophylactic mesh augmentation using permanent synthetic mesh: outcomes of keyhole and Stapled Ostomy Reinforcement with Retromuscular Mesh techniques

Comment

Comparing apples and oranges will not guide treatment the right way in umbilical hernia repair: use either level-1 evidence or guidelines

Original Article

Non-coated versus coated mesh for retrorectus ventral hernia repair: a propensity score-matched analysis of the Americas Hernia Society Quality Collaborative (AHSQC)

Original Article

Learning curve in robotic transabdominal preperitoneal (rTAPP) ventral hernia repair: a cumulative sum (CUSUM) analysis