V-012 MADRID-PCS. STEP BY STEP E-TEP APPROACH

Abstract

Abstract Aim To show the steps involved in the Madrid Modification of posterior component separation (PCS) by e-TEP approach. Material and Methods We present a case of a patient with a lateral incisional hernia (L3W1) associated with primary umbilical hernia and ipsilateral groin hernia. The repair that allows treatment of all defects and wide prosthetic coverage with wall reinforcement is PCS, performed in this case according to the Madrid modification. Due to the presence of risk factors for surgical site occurrences such as obesity, we decided to perform a totally extraperitoneal minimally invasive approach (e-TEP) and the step-by-step procedure is shown. Conclusions Minimally invasive surgery has become the standard approach in many abdominal wall pathologies. Since the description of the e-TEP technique in 2017, its growth and development has been exponential, progressively expanding for large defects and other locations; being especially indicated versus open surgery for patients with risk factors for surgical site events. Likewise, the technique of PCS described in 2012 by Novitsky has been extended in recent years and is now the gold standard in the treatment of complex abdominal wall hernias. From the Madrid group, modifications to this technique have been proposed. We present a video that combines this modification with minimally invasive surgery, visualizing the steps of this technique using the e-TEP approach.