Minimally Invasive Approach Utilizing Linear Stapler for Midline Incisional Hernia: Stapler Repair Technique

IF 3.3 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Gastroenterological Surgery Pub Date : 2025-04-21 DOI:10.1002/ags3.70026

Sho Ueda, Takuya Saito, Kohei Yasui, Kentaro Shinohara, Yasuyuki Fukami, Kenitiro Kaneko, Tsuyoshi Sano

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Abstract

Aim

We successfully established the stapler repair technique (SRT), a straightforward laparoscopic Rives-Stoppa approach utilizing a linear stapler. This study retrospectively evaluated its short-term outcomes to determine its safety and efficacy.

Methods

The surgical outcomes of 87 patients who underwent laparoscopic median incisional hernia repair at our hospital were reviewed between August 2017 and May 2024. Patients were treated with intraperitoneal onlay mesh (IPOM), laparoscopic trans-abdominal retromuscular (TARM), or SRT.

Results

Among these patients, 37 were treated with IPOM, 16 with TARM, and 34 with SRT, with no significant differences in patient characteristics. The median surgical time (range) was 96 min (50–211) for IPOM, 256 min (196–300) for TARM, and 112 min (60–289) for SRT, respectively. The median mesh areas (ranges) were 210 cm² (80–500) for IPOM, 500 cm² (270–780) for TARM, and 379 cm² (176–864) for SRT, respectively. The SRT group had significantly shorter operative times (p < 0.001) and smaller mesh areas (p = 0.005) than the TARM group. Compared to the IPOM group, there was no significant difference in operative time in the SRT group (p = 0.444), but the mesh area was significantly larger (p < 0.001). The SRT group had no significant intraoperative complications or conversions to open surgery.

Conclusion

SRT offers a comparable operative time to IPOM and a significantly shorter time than TARM. Additionally, SRT can be performed extraperitoneally with no significant intraoperative complications or conversion to open surgery. These findings suggest that SRT is a safe and effective minimally invasive approach in median laparoscopic incisional hernia repair.

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应用线性吻合器微创治疗中线切口疝：吻合器修复技术

目的：我们成功地建立了吻合器修复技术（SRT），这是一种直接使用线性吻合器的腹腔镜rivers - stoppa方法。本研究回顾性评估了其短期疗效，以确定其安全性和有效性。方法回顾性分析2017年8月至2024年5月我院行腹腔镜正中切口疝修补术的87例患者的手术效果。患者接受腹腔内补片（IPOM）、腹腔镜下经腹肌后（TARM）或SRT治疗。结果IPOM组37例，TARM组16例，SRT组34例，患者特征无显著性差异。IPOM的中位手术时间（范围）分别为96分钟（50-211），TARM为256分钟（196-300），SRT为112分钟（60-289）。IPOM的中位网格面积（范围）为210 cm2 (80-500)， TARM为500 cm2 (270-780)， SRT为379 cm2（176-864）。SRT组手术时间明显短于TARM组（p < 0.001），补片面积明显小于TARM组（p = 0.005）。与IPOM组相比，SRT组手术时间差异无统计学意义（p = 0.444），但补片面积明显大于IPOM组（p < 0.001）。SRT组无明显术中并发症或转为开放手术。结论SRT的手术时间与IPOM相当，明显短于TARM。此外，SRT可以在腹膜外进行，没有明显的术中并发症或转换为开放手术。提示SRT是一种安全有效的微创腹腔镜切口疝修补方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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