Initial experience of totally extraperitoneal (eTEP) repair for ventral hernias

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OBJECTIVE

To analyze the short-term results of the standardized eTEP-RS/TAR technique for hernioplasty of ventral and incisional hernias.

MATERIALS AND METHODS

A retrospective single-center study was carried out based on L.G. Sokolov North-Western Regional Scientific and Clinical Center. The study included 58 patients with ventral hernias (primary or postoperative) who underwent endoscopic eTEP surgery.

RESULTS

Hernioplasty eTEP-RS was performed in 39 patients, eTEP-RS TAR in 12 patients and — eTEP-RS uni-TAR — in 7 patients. The average duration of operations was 156±63.6 minutes. The average area of the defect and the mesh implant was 51.0±63.5 and 468±212 cm². There was no fixation of the mesh implant in none of the cases of hernioplasty. The average score on the visual analog scale of pain on the 1st postoperative day was 2.71±1.39 points, which is regarded as moderate pain. Retromuscular hematoma occurred in one patient (1.7%), that required repeated surgical treatment. The formation of seromas was detected in 4 patients (6.8%) mainly after eTEP-RS TAR and eTEP-RS uni-TAR.

CONCLUSION

ETEP-RS/TAR technologies are a relatively safe approach for hernia repair of ventral hernias. Advantages of the technique include no need of fixation of the implant, low postoperative pain. The disadvantages are related to the technical limitations of the method, long learning curve and the long duration of the operations. Further research is needed to more accurately determine the place of eTEP technology in hernia practice.

Keywords:

eTEP

ventral and incisional hernia

abdominal wall repair

retromuscular mesh placement

TAR

Authors:

Kopteev N.R.

Sokolov North-Western Regional Scientific and Clinical Center;
St. Petersburg State University

ORCID: 0000-0003-4276-6007

Akhmetov A.D.

Saint-Petersburg State University;
Sokolov North-Western District Scientific and Clinical Center

ORCID: 0000-0002-7973-9371

Lodygin A.V.

Sokolov North-Western Regional Scientific and Clinical Center;
St. Petersburg State University

ORCID: 0000-0002-5535-6915

Kashchenko V.A.

Sokolov North-Western District Scientific Clinical Center;
St. Petersburg State University

ORCID: 0000-0002-4958-5850

Received:

08.09.2021

Accepted:

24.10.2021

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