Summary
Introduction
Primary ventral and incisional hernia repair is a routine operation in general surgery. The most widely used techniques, however, have some disadvantages and risks. In order to minimize complications and postoperative pain, we developed the endoscopically assisted mini and less open sublay (MILOS) operation.
Methods
The surgical steps of this novel technique are described here. The operation is performed via a small incision transhernially with light-armed laparoscopic instruments either under direct visualization or endoscopic view. After creating an extraperitoneal space of at least 8 cm and CO2 insufflation, total extraperitoneal preperitoneal mesh repair (TEP) of ventral and incisional hernias can be performed.
Results
The results and complication rates of 715 MILOS operations for incisional hernias are presented. The data of all MILOS operations were prospectively documented in the German hernia database “Herniamed.”
Conclusion
The MILOS technique facilitates minimally invasive transhernial repair of primary ventral and incisional hernias using large retromuscular/preperitoneal meshes; the technique is associated with a very low morbidity rate and with less chronic pain.
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W. Reinpold, M. Schröder, A. Schröder, C. Berger, J. Nehls, W. Stoltenberg, and F. Köckerling declare that they have no competing interests.
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Reinpold, W., Schröder, M., Schröder, A. et al. Minimally invasive sublay mesh repair of incisional and primary abdominal wall hernias using the MILOS technique. Eur Surg 49, 59–64 (2017). https://doi.org/10.1007/s10353-017-0475-z
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DOI: https://doi.org/10.1007/s10353-017-0475-z