Robotic extended total extraperitoneal transversus abdominus release for traumatic flank and abdominal intercostal hernias.

IF 2.6 2区 医学 Q1 SURGERY
Hernia Pub Date : 2025-01-23 DOI:10.1007/s10029-024-03192-9
Antonela Muca, Kimberly Aung, Mikholae Hutchinson, Ashley Beale, Randy Janczyk, Anthony Iacco
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引用次数: 0

Abstract

Purpose: Traumatic abdominal intercostal/flank hernias present a perplexing challenge for surgeons seeking to repair them. There has been a paucity of studies describing robotic repairs of such hernias. We aim to evaluate the effectiveness of the Robotic-assisted Extended Total Extraperitoneal/Transversus Abdominus Release (rETEP/TAR) method in repairing traumatic abdominal intercostal and flank hernias.

Methods: Patients with traumatic abdominal intercostal hernias at a high-volume hernia center between 2019 and 2022 were identified and retrospective data including patient demographics, perioperative parameters, postoperative complications and up to a three-year follow-up were collected for those undergoing rETEP/TAR. Robotic ETEP access was gained through the retro-rectus space ipsilateral to the hernia, using a transversus abdominis release performed laterally to the level of the posterior axillary line. Dissection was completed from the pelvis to the central tendon as necessary.

Results: A total of 8 patients were analyzed. All patients suffered traumatic or Valsalvainduced hernias. The average age was 54 +/-15yrs. The mean defect size was 11x17cm. Heavyweight uncoated polypropylene mesh was placed in the retromuscular space and secured with transfascial suture. Mean mesh size was 34x30cm and mean operative time was 216 +/- 69 minutes. The median length of stay was 1 day. All patients reported improvement in pain without any evidence of recurrence at postoperative follow-up.

Conclusion: This study demonstrates that the Robotic-assisted ETEP/TAR technique is an effective way of repairing abdominal intercostal and flank hernias.

机器人扩展全腹膜外腹横松解术治疗创伤性侧腹和腹部肋间疝。
目的:外伤性腹肋间/腹疝是外科医生寻求修复它们的一个令人困惑的挑战。关于机器人修复这类疝气的研究很少。我们的目的是评估机器人辅助的扩展全腹膜外/腹横释放(rETEP/TAR)方法在修复外伤性腹肋间疝和腹侧疝中的有效性。方法:对2019年至2022年在一家大容量疝中心接受创伤性腹肋间疝治疗的患者进行研究,并收集回顾性数据,包括患者人口统计学、围手术期参数、术后并发症和长达三年的随访。机器人通过疝侧的后直肌间隙进入ETEP,在腋窝后线水平侧行腹侧松解术。必要时完成从骨盆到中央肌腱的剥离。结果:共分析8例患者。所有患者均为外伤性或瓣膜诱发疝。平均年龄为54±15岁。平均缺陷尺寸为11x17cm。将重量级无涂层聚丙烯网置入肌后间隙,经筋膜缝合固定。平均补片尺寸34x30cm,平均手术时间216±69分钟。中位住院时间为1天。术后随访时,所有患者均报告疼痛改善,无复发迹象。结论:机器人辅助ETEP/TAR技术是修复腹肋间疝和腹侧疝的有效方法。
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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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