OC-050 FULL ENDOSCOPIC RETROMUSCULAR ACCESS (ETEP) ASSOCIATED WITH TRANSVERSUS ABDOMINIS RELEASE (TAR) IN INCISIONAL HERNIA AFTER LIVER TRANSPLANTATION. CASE-CONTROL STUDY

Abstract

Abstract eTEP is a new technique that minimizes the possibility of intraperitoneal lesions or adhesions formation. Methods From January 2018 to January 2023, patients with symptomatic right subcostal incisional hernia after liver transplantation were underwent to eTEP - TAR. The results were compared to those operated on using IPOM + from 2016 to 2018 in a prospectively maintained database. Variables: type of scar -Defect length/width-mesh area-surgical time- complications-conversion rate-Length of stay- Pain at 1°-7°-30–90 days- recurrence rate. Results 21 patients were included in eTEP and 14 in IPOM groups. No differences were seen in preoperative measurements/type of scar. defect length 6,3+/- 1 cm width 4,2+/- 0,3 cm in eTEP and 8,7+/-1,5 and 5,1+/-0,7 cm respectively in IPOM. Surgical time was longer in eTEP with significant differences (115+/- 16 vs 65+/- 7,1 minutes). Seromav11% in eTEP and 13% in IPOM. Length of stay 1,2 +/- 0,7 and 2,1+/-0,6 days in eTEP and IPOM groups respectively with significant improvement in favor of eTEP. Operative time was higher in eTEP (106,8 +/- 20,5 minutes) than IPOM+ group (61,4 +/- 18 minutes) with significant differences. Postoperative pain in eTEP showed significantly less pain on 1st, 7th and 30th than IPOM+. No differences when 90th day pain was compared. follow-up 20,9 +/- 6,5 months in eTEP group and 38,3 +/- 4,8 months in IPOM+ group. No recurrences were identified. Conclusions eTEP-TAR for incisional hernia after liver transplantation is an optimal approach due the benefits of the extraperitoneal approach.. Postoperative pain and surgical stay are improved.