Enhanced view-totally extraperitoneal technique for repair of lower abdomen hernias

Abstract

Objective Investigating a novel minimally invasive approach (Enhanced-view Totally Extraperitoneal technique, e-TEP) to repair lower abdomen hernias. The procedure will be described in details and the safety and efficacy evaluated. Methods During October 2017 and August 2018, forty-four consecutive cases of lower abdomen hernias were repaired using the e-TEP procedure. Surgical indications of this series were complex inguinal hernias including the recurrent cases, incarcerated cases, large inguinoscrotal hernias, groin hernia patients with a short umbilical-pubic tubercle distance or who have a previous lower abdomen surgery history, as well as lower abdomen hernias such as suprapubic hernia and incisional hernia. Results All operations were successful without open conversion. The mean operative time was 65 minutes (35 to 125 minutes). Postoperative pain was mild and the mean visual analogue pain scale (VAS) was 2.0 on first postoperative day. The average postoperative stay in hospital was 1.6 days (1 to 3 days). Three cases experienced postoperative scrotal seroma but without adverse effect on the final outcome. Neither hernia recurrences nor long lasting postoperative pain were noted during the follow-up period of 3 to 13 months. Conclusions The e-TEP procedure is safe, feasible and minimally invasive for lower abdomen hernias. It expands the indications of TEP procedure which make it a good technical alternative for the treatment of lower abdomen hernias. Key words: Hernia, inguinal; Totally extraperitoneal technique; Enhanced view; Endoscopic hernia repair