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01-04-2021 | Incisional Hernia | How-I-Do-It

Totally endoscopic sublay (TES) repair for lateral abdominal wall hernias: technique and first results

Authors: B. Li, C. Qin, J. Yu, D. Gong, X. Nie, G. Li, R. Bittner

Published in: Hernia | Issue 2/2021

Abstract

Background

The optimal surgical treatment for lateral hernias of the abdominal wall remains unclear. The presented prospective study assesses for the first time in detail the clinical value of a totally endoscopic sublay (TES) technique for the repair of these hernias.

Methods

Twenty-four consecutive patients with a lateral abdominal wall hernia underwent TES repair. This technique is naturally combined with a transversus abdominis release maneuver to create a sufficient retromuscular/preperitoneal space that can accommodate, if necessary, a giant prosthetic mesh.

Results

The operations were successful in all but one patient who required open conversion because of dense intestinal adhesion. The mean defect width was 6.7 ± 3.9 cm. The mean defect area was 78.0 ± 102.4 cm² (range 4–500 cm²). The mean mesh size used was 330.2 ± 165.4 cm² (range 108–900 cm²). The mean operative time was 170.2 ± 73.8 min (range, 60–360 min). The mean visual analog scale score for pain at rest on the first day was 2.5 (range 1–4). The average postoperative stay was 3.4 days (range 2–7 days). No serious complications (Dindo–Clavien Grade 2–4) were seen within a mean follow-up period of 13.3 months.

Conclusions

A totally endoscopic technique (TES) for the treatment of lateral hernias is described. The technique revealed to be reliable, safe and cost-effective. The first results are promising, but larger studies with longer follow-up periods are recommended to determine the real clinical value.

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Title: Totally endoscopic sublay (TES) repair for lateral abdominal wall hernias: technique and first results
Authors: B. Li
C. Qin
J. Yu
D. Gong
X. Nie
G. Li
R. Bittner
Publication date: 01-04-2021
Publisher: Springer Paris
Keyword: Incisional Hernia
Published in: Hernia / Issue 2/2021
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-021-02374-z

At a glance: The STEP trials

Springer Medicine

Totally endoscopic sublay (TES) repair for lateral abdominal wall hernias: technique and first results

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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