The Evolving Applications of Laparoscopic Intracorporeal Rectus Aponeuroplasty (LIRA) in Ventral Hernia Repair-A Systematic Review.

Autor:	Balthazar da Silveira CA; Bahiana School of Medicine and Public Health, Salvador, BA, Brazil., Rasador ACD; Bahiana School of Medicine and Public Health, Salvador, BA, Brazil., Marcolin P; Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States., Kasakewitch JPG; Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States., Lima DL; Department of Surgery, Montefiore Medical Enter, Bronx, NY, United States., Morales-Conde S; Department of General and Digestive Surgery, University Hospital Virgen Macarena, Seville, Spain., Malcher F; Division of General Surgery, NYU Langone Health, New York, NY, United States.
Jazyk:	angličtina
Zdroj:	Journal of abdominal wall surgery : JAWS [J Abdom Wall Surg] 2024 Oct 23; Vol. 3, pp. 13497. Date of Electronic Publication: 2024 Oct 23 (Print Publication: 2024).
DOI:	10.3389/jaws.2024.13497
Abstrakt:	Purpose: Laparoscopic intracorporeal rectus aponeuroplasty (LIRA), emerged as a method that combines benefits from minimally invasive and abdominal wall reconstruction with defect closure, restoring the midline without tension by folding the posterior aponeurosis of both abdominal rectus muscles and using intraperitoneal mesh repair. We aimed to perform a systematic review of the existing evidence on LIRA results and potential applications. Source: A thorough search of Cochrane Central, Scopus, SciELO, LILACS, and PubMed/MEDLINE, focusing on studies that explored LIRA's possible applications and results was performed. Key outcomes evaluated included recurrence, seroma, hematoma, surgical site infection (SSI), and length of hospital stay. We included both analytic data and descriptive studies. Principal Findings: Out of 128 screened studies, three met the inclusion criteria and comprised 113 patients, of which 69 (61.1%) were operated using LIRA. Three studies comprised two case series of conventional and robotic LIRA repair, and one comparative study of LIRA versus intraperitoneal underlay mesh repair (IPUM plus). No surgical site infections were reported. Seroma rates ranged between 11.1% and 50%, while no bleeding or hematoma was noted. There were no patients presenting recurrence in a median follow-up ranging from 12 to 15 months, despite the comparative study reporting a 4.4% rate of bulging without clinical recurrence. The mean length of hospital stay ranged from 12 to 36 h. LIRA presented no differences in postoperative complications compared to the IPUM plus technique. Conclusion: LIRA is linked to low recurrence and postoperative complications. It is a novel approach with potential applications in various types of primary and incisional ventral hernias. Competing Interests: FM discloses consulting fees from BD, Intuitive, Integra, DeepBlue, Allergan and Medtronic, outside the submitted study. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Balthazar da Silveira, Rasador, Marcolin, Kasakewitch, Lima, Morales-Conde and Malcher.)
Databáze:	MEDLINE
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