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. 2019 Jul-Sep;15(3):198-203.
doi: 10.4103/jmas.JMAS_29_18.

Extended totally extraperitoneal repair (eTEP) for ventral hernias: Short-term results from a single centre

Sarfaraz Jalil Baig  1 , Pallawi Priya  1
Affiliations

Extended totally extraperitoneal repair (eTEP) for ventral hernias: Short-term results from a single centre

Sarfaraz Jalil Baig et al. J Minim Access Surg. 2019 Jul-Sep.

Abstract

Introduction: There has been a surge of innovative procedures in the field of abdominal wall hernias. Works of pioneers such as Dr. Yuri Novitsky, Dr. Jorge Daes and Dr. Igor Belyansky have started a new era in the field of hernia surgery. Conventional and popular surgeries for ventral hernias are open onlay mesh hernioplasty, open retromuscular mesh hernioplasty (Rives-Stoppa procedure) and laparoscopic intraperitoneal mesh hernioplasty. Evidence seems to suggest that retromuscular mesh hernioplasty has advantages over other procedures regarding recurrence and surgical site occurrences. An alternative strategy has been developed for this setting where a mesh is placed in retromuscular space by minimal access technique of the extended Totally Extraperitoneal approach (eTEP).

Methods: We have retrospectively analysed the data of 21 patients who underwent an eTEP procedure with a minimum follow-up of 2 months. Their data were analysed for operative details, intra-operative and post-operative complications.

Results: For a total of 21 patients, we have recorded a total of two surgical site occurrences (1 seroma and 1 linea alba dehiscence) and one recurrence. One patient had chronic pain. There was no surgical site infection.

Conclusion: Judging from our short-term results, we suggest that the eTEP technique can be adapted in centres with advanced laparoscopic skills with the careful patient selection.

Keywords: Rives-Stoppa; Sublay mesh hernioplasty; eTEP TAR; eTEP-RS; extended totally extraperitoneal Rives-Stoppa repair; extended totally extraperitoneal repair e-TEP; totally extraperitoneal repair; transversus abdominis release; ventral hernia.

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Conflict of interest statement

None

Figures

Figure 1
Figure 1
Port positions. (a) for umbilical and infraumbilical hernia; (b) for supraumbilical hernia
Figure 2
Figure 2
(a) Creation of retro-rectus space. Note the neurovascular bundles - black arrow, Linea Semilunaris - yellow arrow, posterior rectus sheath - blue arrow (b) intraperitoneal dissection and taking down hernia contents (c) crossing the midline. Note the falciform pad of fat
Figure 3
Figure 3
(a) Closure of linea alba. Rectus abdominis are marked with white arrows (b) closure of posterior rectus sheath
Figure 4
Figure 4
Transversus abdominis release. TA fibres are marked with black arrow
Figure 5
Figure 5
Mesh placement. Pubic bone is marked with an arrow
See this image and copyright information in PMC

References

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