P-006 LAPAROSCOPIC ETEP APPROACH TO VENTRAL HERNIAS: INITIAL EXPERIENCE AND SHORT-TERM RESULTS

Abstract

Abstract Aim Ventral hernias are a pathology with a high incidence within general surgery.Repair techniques have been evolving,and the minimally invasive approach to this type of pathology is currently on the rise due to the advantages offered by the minimally invasive surgery (laparoscopic or robotic):less postoperative pain, SSI,seromas,length of stay (LOS) and faster return to routine daily activities.We present our initial series of patients with ventral hernias treated by laparoscopic eTEP approach. Material & Methods Retrospective-study where we analyzed our database of patients with ventral hernias (primary and secondary)undergoing abdominal wall surgery using laparoscopic-eTEP-approach. Results 15 patients underwent laparoscopic-eTEP-surgery (men:73.3%, age:64(RIQ:41–74years)). LOS:1.73±0.7days. Pathological history: diabetes mellitus (26.7%), arterial hypertension (46.7%), dyslipidemia (66.7%),smoking (20%), alcohol-consumption(13.3%), cardiovascular disease (13.3%). ASA-Classification: I (26.7%), II(53.3%), III(20%). BMI:29.82±4.78kg/m2. Overweight: 14(93.3%) and obesity: 6(40%). Primary hernias:4(26.7%) and incisional-hernias:11(73.3%). Location:midline (100%), supraumbilical:60%, umbilical:93.3% and infraumbilical:26.7%.Hernia-width(EHS classification): W1:13.3% and W2:86.7%, transverse hernia-diameter: 6.2±2.1cm, hernia length-size:7.2±4.4cm. Diastasis:10(66.7%), diastasis-width:5.7±1.38cm. Associated with inguinal hernia:5(33.3%). Type of laparoscopic surgical technique performed: Rives-Stoppa: 10(66.7%), unilateral-TAR: 3(20%), bilateral-TAR: 2(13.3%). #trocars: 4(RIQ:4–5). Preoperative botulinum-toxin: 6(40%). Posterior-sheath-closure: 14(93.3%). Mesh fixation-type:Glutack 5(33.3%), Tisseel 6(40%), non-fixation 4(26.7%). Mesh type: Low density wide-pore polypropylene 6(40%), PVDF-Mesh 8(53.3%), PVDF-IPOM-mesh 1(6.7%). Mesh size: width 20(RIQ:18–25cm) and length 30(RIQ:26–30cm).Drainage:3(20%).Surgical time:240(RIQ:180–300min). Global and serious complications (CD≥III):1(6.7%) and Re-IQ due to incarcerated hernia due to posterior-sheath-dehiscence:1(6.7%).No intraoperative-complications.Clinical-seroma:0% and ultrasound-seroma:66.7% that resolved completely spontaneously during the first-second postoperative-months.No hematomas or surgical-wound-infection.Until the current follow-up no-recurrence. Conclusions The laparoscopic-eTEP-approach of ventral-hernias has a low rate of global-complications,despite being our first cases performed.It also has low rates of postoperative pain and shorter-LOS.We can conclude that in our Hospital the laparoscopic-eTEP-approach is a safe, efficient and effective technique.