A novel laparoscopic approach: (e-TEP) technique in ventral abdominal hernia-our experience

Abstract

Background: Enhanced view totally extra peritoneal (eTEP) repair is the novel method for inguinal hernia management. Igor Belyansky extended the principle of eTEP to ventral and incisional hernia. The eTEP technique is based on the principle that the extra peritoneal space can be created from almost anywhere in the anterior abdominal wall. The classical Totally Extra peritoneal (TEP) technique is considered closest to an ideal hernia repair, but this technique has several drawbacks such as restricted port placement, limited space for dissection and mesh placement, a low tolerance of accidental pneumoperitoneum, and difficulty in teaching and learning the technique. We present our experience with eTEP technique, which overcomes several of these drawbacks.Methods: We conducted a short term 6 months retrospective analysis of 24 patients in our hospital who underwent eTEP procedure for umbilical hernia and inguinal hernia, with a minimum of 3 months follow-up. Their data were analyzed for operative details, intra‑operative and post‑operative complications.Results: Judging from our short term results, for 24 patients we have not come across any post-operative complications like seroma, SSI, recurrence, with a minimum of 3 months follow-up.Conclusion: Our evaluation of eTEP technique in umbilical and inguinal hernias has found the approach not only novel one but also very feasible and highly effective. This technique provides flexible port set-up optimal for laparoscopic closure of defects, along with placement of wide mesh in the retro-muscular space with no transfascial fixation while restoring abdominal wall dynamics. We suggest that the eTEP technique is the most ideal option for ventral abdominal hernia repair and can be adapted in hospitals with advanced laparoscopic setup.