P-103 LAPAROSCOPIC MANAGEMENT OF VENTRAL HERNIAS: TRANSPERITONEAL APPROACH FOR POSTERIOR COMPONENT SEPARATION WITH THE AIM OF ABDOMINAL WALL RECONSTRUCTION AND EXTRAPERITONEAL MESH REINFORCEMENT

Abstract

Abstract Aim The Stoppa-Rives sublay and the transversus abdominis release (TAR) technique are well established in open hernia surgery. The principles are currently being translated into minimally invasive surgery with different concepts. In this study, we investigate initial results of laparoscopic sublay and TAR surgery (LASTAR). Patients and methodology Over a 20-month period, 23 consecutive patients with ventral incisional hernias underwent surgery. LASTAR surgery was performed conventionally laparoscopically, transperitoneally with adhesiolysis from the anterior abdominal wall, development of the sublay space and TAR, and midline reconstruction and extraperitoneal mesh reinforcement. Perioperative outcomes were evaluated by unadjusted analyses as part of an initial site assessment in comparison to the Herniamed registry. Results Hernias were median in 19 cases, of which 70% (M2-M4) and 60% were W3, respectively. Median patient age was 68 and median BMI was 31. Median operative time was 313 minutes, and hospital length of stay was 4 days. Morbidity was 26% (Dindo Clavien (DC) 1: n=4 and DC 2 + 3a: n=2). Register comparison (LASTAR: n=23 vs. all others: n=63634) showed that comparable defects were treated with component separation but not in minimal invasive technique. The time required for surgery is significantly greatest compared to all other procedures. However, the length of stay is significantly shorter than with component separation Conclusion With the presented surgical technique, a first series of patients with ventral incisional hernias was treated using conventional minimally invasive techniques (LASTAR). The significance of the method should be supplemented by follow-up data.