Aim
The Rives-Stoppa (RS) procedure is a gold standard in the treatment of midline abdominal wall hernias. Comparability of pain control and outcomes to the less invasive enhanced-view totally extraperitoneal prosthetic (eTEP) repair remain unclear.
Material & Methods
Single centre surgical cohort including 30 RS repairs (January 2019 – November 2021), and 30 consecutive eTEP procedures (September 2021 – August 2022) for midline abdominal wall hernia(s) with rectus abdominis diastasis. Postoperative pain and outcomes were compared.
Results
Presence and median duration of patient-controlled analgesia (PCA) were respectively 90% and 3 nights with RS, versus 30% and 0 nights with eTEP. Median switch to only oral analgesics occurred at postoperative day (POD) 3 after RS and at POD 2 after eTEP. Postoperative analgesics and opioid prescription at discharge were comparable between groups. Median length of hospital stay was 6 nights after RS versus 3 nights after eTEP. Median duration of surgery was 110.5 and 164.5 minutes for RS and eTEP respectively. After RS, 30 patients had a postoperative drain compared to 3 patients after eTEP. Conversion was needed in 3 eTEP procedures. Postoperative complications were comparable. No early recurrences were observed. Minimal residual diastasis was observed at postoperative consultation in 11 patients after eTEP.
Conclusions
eTEP is a feasible minimally invasive alternative to RS for the treatment of midline abdominal wall hernias with rectus abdominis diastasis and is associated with a shorter length of hospital stay, less postoperative pain and a comparable risk of short-term complications.
Registration number: NCT05446675 (ClinicalTrials.gov).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.