OC-117 LIRA (LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY) TECHNIQUE FOR MIDLINE VENTRAL AND INCISIONAL HERNIAS: PRELIMINARY ANALYSIS OF A PROSPECTIVE SERIES

Abstract

Abstract Objective To analyze the safety and efficacy of the LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) technique by evaluating postoperative pain, complications (seroma, infection, etc.), bulging, and recurrence rate. Methods Prospective analysis of patients who underwent elective laparoscopic repair of midline ventral and incisional hernias with defects 4 to 8 cm wide (W2, EHS classification). Endpoints: Recurrence rate (primary endpoint). Secondary objectives: acute pain, postoperative seroma, infection, chronic pain, bulging and patient satisfaction. Results From 2020 to 2021, LIRA repair was performed in 12 patients (mean age 51-y, mean BMI: 33.5 kg/m2). Mean defect width: 5.9 cm. Rectus diastasis>5cm. was present in 6 patients. No intraoperative complications were observed. Tension-free closure was achieved in all patients. Mean operative time: 79 minutes. Postop clinical seroma: 4/12 patients (No intervention needed). Postoperative pain (VAS): 4 at 24h, 0.6 at one month, and 0 in those patients who have completed one year of follow-up. No clinical or radiological recurrences, nor trocar hernias have been observed. The degree of patient satisfaction is 9/10. No one complained of bulging. Conclusions Despite being a technically demanding procedure, the LIRA technique allowed a tension-free midline reconstruction of patients suffering from hernia defects smaller than 8 cm without relevant complications. Although the follow-up time is short, no recurrences or trocar hernias have been observed to date. Therefore, LIRA should be considered a safe and efficient therapeutic alternative in patients with ventral and incisional hernias type W2.