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  • Title: Totally endoscopic sublay (TES) repair for lateral abdominal wall hernias: technique and first results.
    Author: Li B, Qin C, Yu J, Gong D, Nie X, Li G, Bittner R.
    Journal: Hernia; 2021 Apr; 25(2):523-533. PubMed ID: 33599899.
    Abstract:
    BACKGROUND: The optimal surgical treatment for lateral hernias of the abdominal wall remains unclear. The presented prospective study assesses for the first time in detail the clinical value of a totally endoscopic sublay (TES) technique for the repair of these hernias. METHODS: Twenty-four consecutive patients with a lateral abdominal wall hernia underwent TES repair. This technique is naturally combined with a transversus abdominis release maneuver to create a sufficient retromuscular/preperitoneal space that can accommodate, if necessary, a giant prosthetic mesh. RESULTS: The operations were successful in all but one patient who required open conversion because of dense intestinal adhesion. The mean defect width was 6.7 ± 3.9 cm. The mean defect area was 78.0 ± 102.4 cm2 (range 4-500 cm2). The mean mesh size used was 330.2 ± 165.4 cm2 (range 108-900 cm2). The mean operative time was 170.2 ± 73.8 min (range, 60-360 min). The mean visual analog scale score for pain at rest on the first day was 2.5 (range 1-4). The average postoperative stay was 3.4 days (range 2-7 days). No serious complications (Dindo-Clavien Grade 2-4) were seen within a mean follow-up period of 13.3 months. CONCLUSIONS: A totally endoscopic technique (TES) for the treatment of lateral hernias is described. The technique revealed to be reliable, safe and cost-effective. The first results are promising, but larger studies with longer follow-up periods are recommended to determine the real clinical value.
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