OC-042 LAPAROSCOPIC ETEP APPROACH TO VENTRAL HERNIAS: SHORT-TERM OUTCOMES

Autor: J Trujillo Díaz, J R Gómez López, P Concejo Cutoli, C Martinez Moreno, J Atienza Herrero, J C Martín Del Olmo
Rok vydání: 2023
Předmět:
Zdroj: British Journal of Surgery. 110
ISSN: 1365-2168
0007-1323
DOI: 10.1093/bjs/znad080.049
Popis: Aim Ventral hernias are a pathology with a high incidence within general surgery.Repair techniques have been evolving, and the minimally invasive approach to this type of pathology is currently on the rise due to the advantages of the MIS. Material & Methods We analyzed our database of patients with ventral hernias undergoing laparoscopic-eTEP approach,August-2021 to December-2022. We present our short-term outcomes. Results A total of 31 patients(men:54.8%,age:64(RIQ:43–73years)). LOS:1.48±0.62days. Pathological history:diabetes mellitus(19.4%),arterial hypertension(45.2%),dyslipidemia(51.6%), smoking(25.8%), alcohol consumption(13.3%), cardiovascular disease(12.9%). ASA Classification:I(32.3%), II(45.2%), III(22.6%). BMI:30.6±4.68kg/m2. Overweight:11(35.5%) and obesity:17(54.8%). Primary hernias:4(26.7%) and incisional hernias:19(61.3%).Location:midline(100%), supraumbilical:58.1%,umbilical:87.1% and infraumbilical:25.8%.Hernia width (EHS classification): W1:12.9%, W2:80.6% and W3:6.5%, transverse hernia diameter: 5.5±2.1cm, hernia length size:6.1±4.4cm. Associated with diastasis:24(77.4%),diastasis width:4.9±1.7cm. Associated with inguinal hernia:6(19.4%). Type of laparoscopic surgical technique performed:Rives-Stoppa: 24(77.4%), unilateral TAR:5(16.1%), bilateral TAR:2(6.5%).Number of trocars used by procedure:4(RIQ:4–5). Preoperative botulinum toxin:7(22.6%). Posterior sheath closure:23(74.2%). Mesh fixation type:Glutack 5(16.1%), Tisseel 19(61.3%), no fixation 7(22.6%). Mesh type used: Low density wide-pore polypropylene 11(35.5%),PVDF-Mesh 18(58.1%), PVDF-IPOM mesh 2(6.5%). Mesh size: width 18(RIQ:16–22cm) and length 28(RIQ:25–30cm). Drainage: 3(9.7%). Surgical time:200(RIQ:180–300min). Global and serious complications (CD≥III): 4(12.9%) and 1(3.2%), Re-IQ due to incarcerated hernia due to posterior sheath dehiscence: 1 (3.2%). No intraoperative complications. Clinical seroma:3(9.7%).No cases of hematoma or surgical wound infection.No recurrence. Conclusions The laparoscopic eTEP approach of ventral hernias has a low rate of global complications,despite being our first cases performed. It also has low rates of postoperative pain and shorter LOS.We can conclude that in our Hospital the laparoscopic eTEP approach is a safe, efficient and effective technique.
Databáze: OpenAIRE
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