A comparison of robotic enhanced-view totally extraperitoneal approach versus trans-abdominal retro-muscular approach for midline ventral hernias.
Hernia repair
Midline ventral hernia
Minimally invasive
Rives Stoppa
Robotic surgery
TARM
eTEP
Journal
Hernia : the journal of hernias and abdominal wall surgery
ISSN: 1248-9204
Titre abrégé: Hernia
Pays: France
ID NLM: 9715168
Informations de publication
Date de publication:
26 Apr 2024
26 Apr 2024
Historique:
received:
04
09
2023
accepted:
07
04
2024
medline:
26
4
2024
pubmed:
26
4
2024
entrez:
26
4
2024
Statut:
aheadofprint
Résumé
The evolution of midline ventral hernia repair has progressed from the open Rives-Stoppa technique to minimally invasive robotic approaches, notably the trans-abdominal retromuscular (TARM) and enhanced-view Totally Extraperitoneal (eTEP) methods. This study compares these two robotic techniques in repairing medium-sized midline ventral hernias. A retrospective comparative study of electronic medical records from 2015 to 2021 was conducted on patients undergoing robotic TARM or eTEP at NYU Langone Hospital-Long Island. Data on demographics, comorbid conditions, surgical history, intraoperative details, hernia characteristics, and postoperative outcomes were analyzed. Both eTEP and TARM groups exhibited comparable outcomes regarding operative duration, hernia defect size, and overall complications. However, notable differences were observed in patients' BMI, implanted mesh area, mesh composition, and fixation techniques across the groups. The TARM group required a longer hospital stay (median: 1 day) in contrast to the eTEP group (median: 0 days). Additionally, eTEP patients indicated reduced postoperative pain scores (median: 2) compared to TARM (median: 3), with both differences being statistically significant (p < 0.001). The robotic eTEP approach is associated with lower post-operative pain scores, decreased hospital length of stay, and larger areas of mesh implantation as compared to the TARM approach. Other variables are largely comparable between the two techniques. Level III.
Sections du résumé
BACKGROUND
BACKGROUND
The evolution of midline ventral hernia repair has progressed from the open Rives-Stoppa technique to minimally invasive robotic approaches, notably the trans-abdominal retromuscular (TARM) and enhanced-view Totally Extraperitoneal (eTEP) methods. This study compares these two robotic techniques in repairing medium-sized midline ventral hernias.
METHODS
METHODS
A retrospective comparative study of electronic medical records from 2015 to 2021 was conducted on patients undergoing robotic TARM or eTEP at NYU Langone Hospital-Long Island. Data on demographics, comorbid conditions, surgical history, intraoperative details, hernia characteristics, and postoperative outcomes were analyzed.
RESULTS
RESULTS
Both eTEP and TARM groups exhibited comparable outcomes regarding operative duration, hernia defect size, and overall complications. However, notable differences were observed in patients' BMI, implanted mesh area, mesh composition, and fixation techniques across the groups. The TARM group required a longer hospital stay (median: 1 day) in contrast to the eTEP group (median: 0 days). Additionally, eTEP patients indicated reduced postoperative pain scores (median: 2) compared to TARM (median: 3), with both differences being statistically significant (p < 0.001).
CONCLUSION
CONCLUSIONS
The robotic eTEP approach is associated with lower post-operative pain scores, decreased hospital length of stay, and larger areas of mesh implantation as compared to the TARM approach. Other variables are largely comparable between the two techniques.
LEVEL OF EVIDENCE
METHODS
Level III.
Identifiants
pubmed: 38668808
doi: 10.1007/s10029-024-03042-8
pii: 10.1007/s10029-024-03042-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Ventral Hernia Working Group, Breuing K, Butler CE, Ferzoco S, Franz M, Hultman CS, Kilbridge JF, Rosen M, Silverman RP, Vargo D (2010) Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 148(3):544–558. https://doi.org/10.1016/j.surg.2010.01.008
doi: 10.1016/j.surg.2010.01.008
Masurkar AA (2020) Laparoscopic Trans-Abdominal Retromuscular (TARM) Repair for ventral hernia: a novel, low-cost technique for sublay and posterior component separation. World J Surg 44(4):1081–1085. https://doi.org/10.1007/s00268-019-05298-z
doi: 10.1007/s00268-019-05298-z
pubmed: 31773221
Santos DA, Limmer AR, Gibson HM, Ledet CR (2021) The current state of robotic retromuscular repairs-a qualitative review of the literature. Surg Endosc 35(1):456–466. https://doi.org/10.1007/s00464-020-07957-y
doi: 10.1007/s00464-020-07957-y
pubmed: 32926251
Belyansky I, Reza Zahiri H, Sanford Z, Weltz AS, Park A (2018) Early operative outcomes of endoscopic (eTEP access) robotic-assisted retromuscular abdominal wall hernia repair. Hernia: J Hernias Abdom Wall Surg 22(5):837–847. https://doi.org/10.1007/s10029-018-1795-z
doi: 10.1007/s10029-018-1795-z
Baig SJ, Priya P (2019) Extended totally extraperitoneal repair (eTEP) for ventral hernias: short-term results from a single centre. J Minim Access Surg 15(3):198–203. https://doi.org/10.4103/jmas.JMAS_29_18
doi: 10.4103/jmas.JMAS_29_18
pubmed: 29794361
pmcid: 6561058
Carbonell A (2018) The 9th annual abdominal wall reconstruction summit, Montana, USA
Haskins IN, Horne CM, Krpata DM, Prabhu AS, Tastaldi L, Perez AJ, Rosenblatt S, Poulose BK, Rosen MJ (2018) A call for standardization of wound events reporting following ventral hernia repair. Hernia: J Hernias Abdom Wall Surg 22(5):729–736. https://doi.org/10.1007/s10029-018-1748-6
doi: 10.1007/s10029-018-1748-6
Addo A, Lu R, Broda A, George P, Zahiri HR, Belyansky I (2021) Hybrid versus open retromuscular abdominal wall repair: early outcomes. Surg Endosc 35(10):5593–5598. https://doi.org/10.1007/s00464-020-08060-y
doi: 10.1007/s00464-020-08060-y
pubmed: 33034775
Zaman J, Teixeira L, Patel PB, Ridler G, Ata A, Singh TP (2023) From transabdominal to totally extra-peritoneal robotic ventral hernia repair: observations and outcomes. Hernia: J Hernias Abdom Wall Surg 27(3):635–643. https://doi.org/10.1007/s10029-023-02767-2
Rege SA, Churiwala JJ, A Kaderi AS, Kshirsagar KF, Dalvi AN (2021) Comparison of efficacy and safety of the enhanced-view totally extraperitoneal (eTEP) and transabdominal (TARM) minimal access techniques for retromuscular placement of prosthesis in the treatment of irreducible midline ventral hernia. J Minim Access Surg 17(4):519–524. https://doi.org/10.4103/jmas.JMAS_145_20
Andreuccetti J, Sartori A, Lauro E, Crepaz L, Sanna S, Pignata G, Bracale U, Di Leo A (2021) Extended totally extraperitoneal Rives-Stoppa (eTEP-RS) technique for ventral hernia: initial experience of The Wall Hernia Group and a surgical technique update. Updat Surg 73(5):1955–1961. https://doi.org/10.1007/s13304-021-01067-7
doi: 10.1007/s13304-021-01067-7
Kudsi OY, Chang K, Bou-Ayash N, Gokcal F (2020) Transabdominal (TA) versus totally extraperitoneal (TEP) robotic retromuscular ventral hernia repair: a propensity score matching analysis. Surg Endosc 34(8):3550–3559. https://doi.org/10.1007/s00464-020-07574-9
doi: 10.1007/s00464-020-07574-9
pubmed: 32500458
Yang GP (2017) Laparoscopy in emergency hernia repair. Annals Laparosc Endosc Surg 2(6):23.
Halpern DK, Liu H, Amodu LI, Weinman K, Akerman M, Petrone P (2023) Long term outcomes of robotic-assisted abdominal wall reconstruction: a single surgeon experience. Hernia: J Hernias Abdom Wall Surg 27(3):645–656. https://doi.org/10.1007/s10029-023-02774-3
doi: 10.1007/s10029-023-02774-3