Anterior abdominal wall hernia repair with e-TEP technique: A single-center experience with short term results

Introduction: Ventral hernia repair is one of the most common surgical procedures performed by surgeons. Extended-view totally extraperitoneal (e-TEP) hernia repair is an emerging surgical technique that can be applied in the surgical treatment of ventral hernias. We present our experience of an e-TEP technique with the corresponding short-term results.

Materials and Methods: Between June 2019 and February 2020, 18 patients with ventral hernia were operated on by the same surgeon using the e-TEP technique and were reviewed retrospectively. Patients diagnosed with diastasis recti defect ≥2 cm with concomitant umbilical hernia were included in the study.

Results: A total of 18 cases underwent eTEP until February 2020. Out of 18 patients, 10 (55.5%) were male while eight (44.5%) were female. The mean age was 46.4 years (29–68), mean body mass index (BMI) was 25.7 kg/m2 (18.7–30.8 kg/m2), average hospitalization time was 1.78 days (1–3 days), average ASA score was 1.7 (1–2), mean operation time was 145 minute (100–298 min.), and mean mesh area used was 266 cm2. Cyanoacrylate glue (Liquiband®Fix8™) was used to fix the mesh to the peritoneum in 14 patients, while no fixation method was used in 4 patients. None of the cases underwent open surgery. No recurrence was detected during the follow-up, with a maximum of 12 months and a minimum of 4 months (mean 8.3 months).

Conclusion: e-TEP is a safe and feasible emerging surgical technique for primary or incisional ventral hernia repairs. This new approach that has all the advantages of laparoscopic surgery allows flexible port insertion and the closure of defects by allowing large size mesh placement in the retromuscular area. Placing the meshes in the extraperitoneal area may also prevent the development of mesh-related complications from its contact with intraperitoneal organs.