Stapler-assisted endoscopic mini- or less-open sublay technique: How do I do it?

Background: This study evaluates the clinical efficacy of the endoscopic mini- or less-open sublay (EMILOS) technique with stapler-assisted fascial closure for ventral hernia repair.

Materials and methods: Twelve patients underwent EMILOS with stapler-assisted fascial closure between July 2022 and August 2024 with a mean follow-up of 12.4 months.

Results: The cohort (7 females and 5 males; mean age: 58.9 ± 16.3 years and body mass index: 27.8 ± 3.5 kg/m²) underwent repair for various ventral hernias (mean defect: 4.9 cm × 5.2 cm). The mean operative time was 95 min. Complications included seroma (17%), surgical site infection (8%) and small bowel obstruction requiring reoperation (8%). The hernia recurrence rate was 8%. Patients reporting excellent quality of life increased from 17% preoperatively to 50% postoperatively.

Conclusions: EMILOS with stapler-assisted closure offers a safe, efficient approach with favourable short-term outcomes, particularly for obese patients and medium-sized hernias. The technique combines enhanced visualisation with efficient fascial closure, yielding an 8% recurrence rate that compares favourably with alternatives. Larger studies with extended follow-up are needed to establish long-term efficacy.