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Laparoendoscopic stapled rives stoppa sublay technique for extraperitoneal ventral hernia repair

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Summary

Background

Laparoscopic and robotic extraperitoneal ventral hernia repair techniques have developed with the goal of combining the benefits of traditional open sublay repair with those of minimally invasive surgery. We describe the use of a laparoendoscopic extraperitoneal sublay repair employing a linear stapler for plication and division of the linea alba with subsequent mesh augmentation.

Methods

Between January 2016 and February 2017, 21 patients with midline ventral and incisional hernias underwent repair using a laparoendoscopic extraperitoneal stapled sublay mesh repair. Six of the cases included simultaneous laparoscopic bilateral posterior component separation with division of the posterior lamella of the internal oblique muscle. Three of these had additional myofascial release of the transversus abdominis muscle to facilitate midline approximation. Intraoperative and perioperative complications, recurrence, pain, and narcotic usage were measured.

Results

Defect width ranged from 3 to 9 cm. No significant intraoperative complications or conversions to open surgery occurred. Patients were discharged at 0.9 days on average. Early postoperative complications included hernia site seroma in two patients. There were no early postoperative infections of recurrences. One patient underwent local exploration at 6 months to remove a palpable suprafascial retained hernia sac. Compared with traditional laparoscopic intraperitoneal onlay mesh repair, less acute pain was reported.

Conclusion

Laparoendoscopic extraperitoneal stapled sublay is a safe and effective method for small to medium-sized ventral and incisional hernias and adds another option to achieve minimally invasive extraperitoneal ventral hernia repair.

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Author information

Authors and Affiliations

  1. General Surgery, Kaiser Permanente, East Bay, CA, USA

    David K. Nguyen

  2. Lichtenstein Amid Hernia Clinic, David Geffen School of Medicine at UCLA, 1304 15th Street, Suite 102, 90404, Santa Monica, CA, USA

    David C. Chen MD

Authors
  1. David K. Nguyen
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  2. David C. Chen MD
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Corresponding author

Correspondence to David C. Chen MD.

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Conflict of interest

D.K. Nguyen and D.C. Chen declare that they have no competing interests.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Nguyen, D.K., Chen, D.C. Laparoendoscopic stapled rives stoppa sublay technique for extraperitoneal ventral hernia repair. Eur Surg 49, 175–179 (2017). https://doi.org/10.1007/s10353-017-0483-z

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  • DOI: https://doi.org/10.1007/s10353-017-0483-z

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