V-013 ETEP - STEP BY STEP

Abstract

Abstract Minimally invasive approaches are increasingly being used for the correction of abdominal wall hernias. Although laparoscopy presents as a greater technical challenge compared to classical techniques, once the learning curve is overcome, the advantages are multiple: less postoperative pain, shorter hospital stay, faster return to daily/professional activities and lower rate of surgical site infection. The authors present the case of a 55yo women with a history of type 2 diabetes mellitus and peripheral venous insufficiency. No history of previous surgeries. The patient was referred to an appointment in the Ambulatory Surgery Centre for evaluation of a primary midline hernia. Symptoms were worsening in the last 6 months. No previous episodes of complications. Preoperative evaluation included an abdominopelvic computed tomography, which revealed a hernia sac containing only fatty tissue (no intestinal loops present) and a 19 mm hernial neck with a supra-umbilical median location. No other abdominal wall defects were evident. The patient was proposed for a laparoscopic approach - extended totally extraperitoneal (eTEP) in ambulatory setting. The surgery and post-operative period (9 months) to date went without intercurrences. The present video aims to demonstrate the main steps of the surgical technique applied in a tertiary centre with years of experience in laparoscopic abdominal wall surgery. With this paper the authors pretend to demonstrate that laparoscopy may become the gold-standard in abdominal wall hernia correction as soon as the know-how and respective learning curve are aquired. Until then, these cases should continue to be referred to specialized tertiary centres.