OC-099 ROBOTICALLY-ASSISTED ENHANCED-VIEW TOTALLY EXTRAPERITONEAL (R-ETEP) TECHNIQUE FOR ENDOSCOPIC RETROMUSCULAR HERNIA REPAIR. A RETROSPECTIVE ANALYSIS OF OUR FIRST 99 CASES

Abstract

Abstract Introduction The availability of robotics has marked the beginning of a new era in hernia surgery. Due to its tiltable instruments the robot grants a dexterity which is not comparable to any conventional minimally invasive approach. In 2019 we have established r-eTEP-repair in our hospital. The objective of this analysis is to share our experience of the first ninety-nine cases. Materials and Methods A retrospective analysis was carried out of all patients who underwent a r-eTEP repair in our hospital from September 2019 to January 2023 using gathered data out of our hospital information system (ORBIS Dedalus). Results Within the study period, we operated on a total of 99 patients. In 27 patients an extraperitoneal transversus abdominis release (eTAR) was performed. Complete closure of the hernia defect was possible in all cases and an uncoated synthetic mesh was placed in the retromuscular plane. In 3 cases a partial open hybrid procedure with robotic transversus abdominis release was performed. The median defect size was 25cm2 (2,25–375 cm2). The median mesh size was 540 cm2 (260–1350 cm2). The postoperative complication rate was 6.06%. There was one intraoperative complication and no abdominal reoperations. Median length of hospital stay was 3 days (2–10). Conclusion eTEP is a safe and minimally invasive procedure for a retromuscular mesh placement. In combination with a transversus abdominis release, even complex findings can comfortably be treated endoscopically.