Transabdominal Preperitoneal (TAPP) for the Treatment of Spigelian hernias.
Abdomen
/ surgery
Adult
Aged
Hernia, Abdominal
/ surgery
Herniorrhaphy
/ methods
Humans
Laparoscopy
/ methods
Length of Stay
Male
Middle Aged
Operative Time
Pain, Postoperative
/ etiology
Peritoneum
/ surgery
Postoperative Complications
/ etiology
Postoperative Period
Prospective Studies
Retrospective Studies
Treatment Outcome
Abdominal Wall
Spigelian Hernia
TAPP
rTAPP
Journal
JSLS : Journal of the Society of Laparoendoscopic Surgeons
ISSN: 1938-3797
Titre abrégé: JSLS
Pays: United States
ID NLM: 100884618
Informations de publication
Date de publication:
Historique:
entrez:
12
7
2021
pubmed:
13
7
2021
medline:
24
7
2021
Statut:
ppublish
Résumé
Spigelian hernias (SH) are a rare variant of abdominal wall defects that require prompt surgical intervention. With the advancement of abdominal wall surgery capabilities, there are several possible approaches of repairing SH. The aim of the study was to present our experience in performing laparoscopic or robotic transabdominal preperitoneal (TAPP) repairs of SH and discuss the advantages of TAPP in such hernias. Retrospective review of a prospectively maintained database of SH TAPP repairs between February 1, 2015 and February 29, 2020. Data included clinical details, size and location of fascial defect, presence of concomitant hernias, surgery duration, length of stay (LOS), mesh type, mesh size, and fixation method. Follow up visits at 1 month postoperative and telephone survey for pain assessment and subsequent hernia-related treatment. During the study period 16 patients underwent TAPP SH repairs, 13 laparoscopically and 3 robotic. Seven (44%) patients had a concomitant inguinal hernia with 1 patient having bilateral inguinal defects. Mean surgery duration and mean LOS were 78 (range 41 - 120) minutes & 1.6 (range 1 - 3) days, respectively. Immediate postoperative complications included 2 seromas and 1 port-site hematoma. Mean telephone survey follow up was 17 months (range 3 - 49). Mean visual analogue scale scores were significantly lower at follow-up compared to discharge (1.9 vs 0.5, P = 0.0015). Advantages of TAPP SH repair include low postoperative chronic pain, potential low wound complications, intra-abdominal visualization of hernia contents, and repairing of concomitant inguinal hernias simultaneously.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
Spigelian hernias (SH) are a rare variant of abdominal wall defects that require prompt surgical intervention. With the advancement of abdominal wall surgery capabilities, there are several possible approaches of repairing SH. The aim of the study was to present our experience in performing laparoscopic or robotic transabdominal preperitoneal (TAPP) repairs of SH and discuss the advantages of TAPP in such hernias.
METHODS
METHODS
Retrospective review of a prospectively maintained database of SH TAPP repairs between February 1, 2015 and February 29, 2020. Data included clinical details, size and location of fascial defect, presence of concomitant hernias, surgery duration, length of stay (LOS), mesh type, mesh size, and fixation method. Follow up visits at 1 month postoperative and telephone survey for pain assessment and subsequent hernia-related treatment.
RESULTS
RESULTS
During the study period 16 patients underwent TAPP SH repairs, 13 laparoscopically and 3 robotic. Seven (44%) patients had a concomitant inguinal hernia with 1 patient having bilateral inguinal defects. Mean surgery duration and mean LOS were 78 (range 41 - 120) minutes & 1.6 (range 1 - 3) days, respectively. Immediate postoperative complications included 2 seromas and 1 port-site hematoma. Mean telephone survey follow up was 17 months (range 3 - 49). Mean visual analogue scale scores were significantly lower at follow-up compared to discharge (1.9 vs 0.5, P = 0.0015).
CONCLUSION
CONCLUSIONS
Advantages of TAPP SH repair include low postoperative chronic pain, potential low wound complications, intra-abdominal visualization of hernia contents, and repairing of concomitant inguinal hernias simultaneously.
Identifiants
pubmed: 34248327
doi: 10.4293/JSLS.2021.00024
pii: JSLS.2021.00024
pmc: PMC8241280
pii:
doi:
Types de publication
Case Reports
Evaluation Study
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2021 by SLS, Society of Laparoscopic & Robotic Surgeons.
Déclaration de conflit d'intérêts
Conflict of interests: Hazzan David has an honorarium for speaking engagements from Dover LTD and an educational grant from Medtronic. All other authors have nothing to disclose.
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