A comparative prospective study of short-term outcomes of extended view totally extraperitoneal (e-TEP) repair versus laparoscopic intraperitoneal on lay mesh (IPOM) plus repair for ventral hernia

Kumar, Niraj; Palanisamy, N.; Parthasarathi, Ramakrishnan; Sabnis, S.; Nayak, Sunil; Palanivelu, Chinnusamy

doi:10.1007/s00464-020-07990-x

Cited by 38 publications

(53 citation statements)

References 14 publications

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“…In a study, they recorded mean operating time was 176.48 min which ranged from 138 to 310 min in eTEP. 9 Karim et al,11 reported mean operative time for TAPP was 64.27 min, Kumar et al, 12 reported operative time was significantly higher for e-TEP. Hospital stay after surgery in Group TEP (1.7±0.7) was higher as compared with Group eTEP (1.1±0.3) and difference among group was significant, which was in contrast to Rekhi et al, 13 reported hospital stay and time to return to usual activity no statistical difference present between TEP and TAPP while pain score was in TEP more than TAPP.…”

Section: Discussionmentioning

confidence: 99%

A prospective randomized study of eTEP and TEP repair for inguinal hernia in terms of ease of operability, complication and recurrences

Singh

Kala

et al. 2022

Asian J Med Sci

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Background: Inguinal hernia is one of the diseases that has haunted humanity from its very beginning to the modern times. Groin hernias are the most common conditions referred to surgeons all over the world and over five lakh hernia repairs are performed annually. The lifetime risk for men is 27.0% and for women is 3.0%. Approximately 75.0% of all abdominal wall hernias occur in the groin. Inguinal hernias are more common on the right than on the left and are seven times more likely in males than in females. Aims and Objectives: Aim and objective of the study is to compare extended total extra peritoneal (e-TEP) and total extra peritoneal (TEP) repair in terms of complications and recurrence. To evaluate ease of operability of e-TEP and TEP for inguinal hernia repair. Materials and Methods: Patients with inguinal hernia who were hospitalized to the Department of General Surgery at GSVM Medical College, Kanpur, and who were over the age of 18 years of both sexes were studied from December 2019 to October 2021 after signing a consent form. The research procedure followed was in accordance with the approved ethical standards of GSVM Medical College, Kanpur, UP, India Ethics Committee (Human). Data were analyzed and evaluated using Statistical Package for Social Sciences, version 23 (SPSS Inc., Chicago, IL). Results for continuous variables are shown as mean ± standard deviation, whereas results for categorical variables are shown as number (percentage). For comparison of nominal data, Chi-square (χ2) test was used. The level P<0.05 was considered as the cut-off value of significance. Results: Majority of the patients of Group TEP (25 patients) had complications as Conversion to trans abdominal pre-peritoneal (TAPP) 4 (16.0%) and proceed surgery without veress needle decompression 2 (8.0%). In Group eTEP (25 patients) majority of patients had complications as proceed surgery without veress needle decompression 8 (32%) followed by Seroma 2 (8.0%). No recurrences seen in either groups. Mean operative time of eTEP was less as compared to TEP. Conclusion: With TEP, complications such as SSI, hematoma, and conversion to TAPP are more common; however with eTEP, proceed surgery without veress needle decompression and seroma. Considering the average operative time of eTEP and TEP, as well as the bigger defect size that eTEP can readily handle. For new surgeons, eTEP is a more straightforward procedure. Moreover, our study findings showed that e-TEP mesh repair of inguinal hernia showed more firm and efficacious results than TEP repair. We suggest that long-term randomized control trials with enhanced sample size and reduced confounding factors are still required to establish the absolute superiority of e-TEP over TEP.

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Section: Discussionmentioning

confidence: 99%

A prospective randomized study of eTEP and TEP repair for inguinal hernia in terms of ease of operability, complication and recurrences

Singh

Kala

et al. 2022

Asian J Med Sci

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“…The length of stay was reported by 3 studies,10,11,16 eTEP technique was associated with significant short hospital stay, as compared with IPOM technique (MD=−0.56; 95% CI: −0.74,−0.39; P =0.00001). Overall heterogeneity was low in this analysis ( I 2 =0%, P =0.64), and the fixed model was used in this analysis.…”

Section: Resultsmentioning

confidence: 97%

The Comparison of eTEP and IPOM in Ventral and Incisional Hernia Repair: A Systematic Review and Meta-analysis

Wang

2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Open sublay technique and laparoscopic intraperitoneal onlay mesh (IPOM) technique are the most common used procedures in ventral and incisional hernia repair, however, each technique has its own disadvantages. The enhanced view total extraperitoneal technique (eTEP) aims to put the mesh in the retromuscular space by minimal invasive technique. This study is to investigate the efficacy and safety of eTEP and IPOM approach in ventral and incisional hernia repair.Methods: The major databases (PubMed, Embase, Springer, and Cochrane Library) were searched, and all studies published through May 1, 2021, using the keywords "enhanced view extraperitoneal," "extended view totally extraperitoneal," "eTEP," "TEP," "laparoscopic retromuscular," "ventral hernia," "incisional hernia," "laparoscopic intraperitoneal onlay mesh," "IPOM." All relevant articles and reference lists in these original studies were also obtained from the above databases.Results: Five trials containing 433 patients were included in the present study. Compared with the IPOM technique, the eTEP ventral/incisional hernia repair was associated a longer operative time [mean difference = 44.79; 95% confidence interval (CI): 26.57, 63; P = 0.00001], less acute pain on postoperative day 1 (standardized mean difference = −3.90; 95% CI: −4.42, −3.38; P < 0.00001), and day 7 (standardized mean difference = −3.72; 95% CI: −6.09, 1.35; P = 0.002), and the eTEP group had a shorter hospital stay compared with the IPOM group (mean difference = −0.56; 95% CI: −0.74, −0.39; P = 0.00001). There was no significant difference concerning the incidence of seroma, hematoma, intraoperative complication, and postoperative ileus between eTEP and IPOM groups. Conclusions:The eTEP technique in ventral and incisional hernia repair shows significantly lower acute postoperative pain and shorter hospital study but a longer operative time. In addition, there is no significant difference in terms of intraoperative or postoperative complications. Further randomized controlled studies with long-term follow-up are needed to evaluate the eTEP technique.

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“…Overall, patient mean age was 54.29 years (± 1.28) with a mean BMI of 29.16 kg/m 2 (± 0.58) with five studies [10,[18][19][20][21] presenting an obese population with a mean BMI ≥ 30 kg/m 2 (Supplementary material Table 2S). Nine studies [11,[18][19][20][22][23][24][25][26] reported the hernia etiology, with 45.7% primary ventral hernia. Nine studies [11,18,19,22,23,[25][26][27][28] provided data on hernia location according to the EHS classification [13] resulting in 96.2% of midline hernias and 3.8% of lateral hernias.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…However, dissecting the retromuscular plane requires the correct restoration of this space prior to the placement of the mesh. During eTEP, the incomplete closure of the posterior layer due to technical demanding maneuvers or the breakdown of the posterior layer because of increased tension are specific limitations that may increase recurrence and complications [11]. For this reason, after appropriate training, it is recommended to start using this technique by repairing small midline hernias associated with diastasis recti [29] The rate of recurrence after one-year follow-up of laparoscopic IPOM and sublay OVHR according to Kökerling et al [32] was 4.2% and 4.1%, respectively.…”

Section: Postoperative Characteristicsmentioning

confidence: 99%

Short-term outcomes of minimally invasive retromuscular ventral hernia repair using an enhanced view totally extraperitoneal (eTEP) approach: systematic review and meta-analysis

Aliseda

Sánchez-Justicia

Zozaya

et al. 2022

Hernia

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Background The enhanced view totally extraperitoneal (eTEP) approach is becoming increasingly more widely accepted as a promising technique in the treatment of ventral hernia. However, evidence is still lacking regarding the perioperative, postoperative and long-term outcomes of this technique. The aim of this meta-analysis is to summarize the current available evidence regarding the perioperative and short-term outcomes of ventral hernia repair using eTEP. Study design A systematic search was performed of PubMed, EMBASE, Cochrane Library and Web of Science electronic databases to identify studies on the laparoscopic or robotic-enhanced view totally extraperitoneal (eTEP) approach for the treatment of ventral hernia. A pooled meta-analysis was performed. The primary end point was focused on short-term outcomes regarding perioperative characteristics and postoperative parameters. Results A total of 13 studies were identified involving 918 patients. Minimally invasive eTEP resulted in a rate of surgical site infection of 0% [95% CI 0.0–1.0%], a rate of seroma of 5% [95% CI 2.0–8.0%] and a rate of major complications (Clavien–Dindo III–IV) of 1% [95% CI 0.0–3.0%]. The rate of intraoperative complications was 2% [95% CI 0.0–4.0%] with a conversion rate of 1.0% [95% CI 0.0–3.0%]. Mean hospital length of stay was 1.77 days [95% CI 1.21–2.24]. After a median follow-up of 6.6 months (1–24), the rate of recurrence was 1% [95% CI 0.0–1.0%]. Conclusion Minimally invasive eTEP is a safe and effective approach for ventral hernia repair, with low reported intraoperative complications and good outcomes.

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A comparative prospective study of short-term outcomes of extended view totally extraperitoneal (e-TEP) repair versus laparoscopic intraperitoneal on lay mesh (IPOM) plus repair for ventral hernia

Cited by 38 publications

References 14 publications

A prospective randomized study of eTEP and TEP repair for inguinal hernia in terms of ease of operability, complication and recurrences

A prospective randomized study of eTEP and TEP repair for inguinal hernia in terms of ease of operability, complication and recurrences

The Comparison of eTEP and IPOM in Ventral and Incisional Hernia Repair: A Systematic Review and Meta-analysis

Short-term outcomes of minimally invasive retromuscular ventral hernia repair using an enhanced view totally extraperitoneal (eTEP) approach: systematic review and meta-analysis

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