The carolinas crossover, a preperitoneal crossover for enhanced-view totally extraperitoneal (eTEP) ventral hernia repair (VHR): a novel technique.

IF 2.6 2区 医学 Q1 SURGERY
Hernia Pub Date : 2024-10-01 Epub Date: 2024-07-29 DOI:10.1007/s10029-024-03117-6
Jana M Sacco, Monica Polcz, Sullivan A Ayuso, Kiara Brown, Gregory T Scarola, B Todd Heniford
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Abstract

Purpose: To present a novel technique of preperitoneal cross-over for eTEP VHR.

Methods: Patients who underwent robotic eTEP with mesh utilizing a preperitoneal cross over technique were identified using a single-institution hernia database. This novel technique involves minimally invasive access to the retro-rectus space on one side with midline cross over into the preperitoneal space on the contralateral side. Baseline demographics of the patients were obtained, and intra-operative and post-operative outcomes were reported.

Results: Nine VHR patients underwent robotic eTEP with mesh using a preperitoneal crossover technique. Five patients were male, mean age was 53 ± 18.4 years, and mean BMI was 32.5 ± 4.2 kg/m2. Two patients were diabetic and 2 were previous smokers. Two of the hernias were recurrent. The average hernia defect was 96.9 ± 45.5 cm2 and the average mesh size was 593.3 ± 168.2 cm2. Four patients underwent a unilateral TAR, while five patients did not require any component separation. All cases were CDC Class 1 wounds. All patients met discharge criteria on post-operative day 1. There was one post-operative wound occurrence which was a seroma. There were no infectious complications and no hernia recurrences. The average follow up was 1.4 ± 1.2 months.

Conclusions: Preperitoneal cross-over during eTEP ventral hernia technique is a safe technique that allows placement of a large extra-peritoneal mesh. Early patient outcomes are favorable. Larger sample size and follow-up are needed to truly assess postoperative outcomes.

Abstract Image

卡洛纳斯交叉术,一种用于腹膜外全视角(eTEP)腹股沟疝修补术(VHR)的腹膜前交叉术:一种新型技术。
目的:介绍一种用于 eTEP VHR 的新型腹膜前交叉技术:利用单个机构的疝气数据库确定了使用腹膜前交叉技术进行带网片机器人 eTEP 的患者。这种新颖的技术包括微创进入一侧直肠后间隙,中线交叉进入对侧腹膜前间隙。研究人员了解了患者的基本情况,并报告了术中和术后结果:9名VHR患者采用腹膜前交叉技术接受了带网片的机器人eTEP手术。五名患者为男性,平均年龄为(53±18.4)岁,平均体重指数为(32.5±4.2)千克/平方米。两名患者患有糖尿病,两名患者曾经吸烟。其中两个疝气是复发性的。疝气缺损面积平均为 96.9 ± 45.5 平方厘米,网片大小平均为 593.3 ± 168.2 平方厘米。四名患者接受了单侧 TAR,五名患者无需进行任何组件分离。所有病例均为 CDC 1 级伤口。所有患者均在术后第 1 天达到出院标准。术后有一处伤口出现血清肿。没有感染性并发症,也没有疝气复发。平均随访时间为(1.4 ± 1.2)个月:结论:eTEP腹股沟疝技术中的腹膜前交叉术是一种安全的技术,可以放置大型腹膜外网片。患者的早期疗效良好。要真正评估术后效果,还需要更大的样本量和随访。
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来源期刊
Hernia
Hernia SURGERY-
CiteScore
4.90
自引率
26.10%
发文量
171
审稿时长
4-8 weeks
期刊介绍: Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery. Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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