Robotic-assisted repair of perineal hernia after extralevator abdominoperineal resection

Maurissen, J.; Schoneveld, Martijn; Eetvelde, Ellen Van; Allaeys, Mathias

doi:10.1007/s10151-019-01969-0

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…3,8,9,10 También puede llevarse a cabo por abordaje robótico. 11 El abordaje combinado se considera cuando no es posible reducir completamente el contenido y realizar una adecuada adhesiolisis por una sola vía. La reparación con tejido o colocación de prótesis puede ser necesaria ya que en la mayoría de los casos el cierre del periné es dificultoso porque los bordes no pueden aproximarse sin tensión y esto conlleva más riesgo de recurrencia.…”

Section: Discussionunclassified

Hernia Perineal Secundaria a Operación De Miles Reporte De Nuestros Casos Y Estado Del Arte

Rodríguez¹,

Canesín²,

Palmisano³

2023

Rev. Argent. Coloproctol.

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La presencia de hernia perineal secundaria supone un reto para el cirujano cuando requiere reparación quirúrgica ya que no hay una vía de abordaje o técnica superior a otra. Mostramos nuestra experiencia con esta entidad, secundaria a Operación de Miles. Entre 2005 y 2021, de 23 resecciones radicales llevadas a cabo, 2 pacientes (8,6%) presentaron hernia perineal secundaria sintomática que requirieron reparación. De nuestros pacientes reconstruidos, un hombre fue abordado por vía perineal y una mujer por vía abdominal laparoscópica. En ambos casos se reforzó el piso pelviano con malla con buena evolución postoperatoria, sin presentar recurrencia a 12 meses. Esta entidad es infrecuente, sinembargo su incidencia parece aumentar. Cuando necesita resolución se puede abordar por vía perineal, abdominal o combinada con similares resultados. El uso de mallas reemplazó a la sutura primaria de la brecha. La profilaxis es importante, aunque faltan estudios que determinen su real utilidad

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Section: Discussionunclassified

Hernia Perineal Secundaria a Operación De Miles Reporte De Nuestros Casos Y Estado Del Arte

Rodríguez¹,

Canesín²,

Palmisano³

2023

Rev. Argent. Coloproctol.

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“…Perineal hernia repair is well suited for the robotic approach given the excellent 3-D visualization, ability to work in a limited space and precise suturing of mesh to close defects. However, only a handful of institutions have published their experience using the robotic platform [5][6][7][8][9][10][11]. In this study, we sought to review the existing literature on robotic repair of perineal hernias, provide a video vignette that illustrates the principles of robotic repair, and provide practical tips for surgeons interested in adopting a robotic approach.…”

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confidence: 99%

Robotic repair of perineal hernias: a video vignette and review of the literature

et al. 2022

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Background Perineal hernias can be secondarily acquired following abdominoperineal resection of the rectum. While transabdominal minimally invasive techniques have traditionally used laparoscopy, there are few studies published on the robotic platform, which has been gaining popularity for other types of hernia repairs. We review the existing literature, share a video vignette, and provide practical tips for surgeons interested in adopting this approach. Methods A literature search in Pubmed was performed to include all articles in English describing robotic repair of perineal hernias with identification of variables of interest related to repair. A case presentation with an accompanying video vignette and lessons learned from the experience are provided. Results Seven case reports (four containing video) published between 2019 and 2022 were included. Most articles (n = 5) utilized the Da Vinci Si or Xi, and most patients (n = 5) had undergone abdominoperineal resection with neoadjuvant chemotherapy to treat rectal cancer. Patients were positioned in Trendelenburg with rightward tilt (n = 2), modified lithotomy (n = 1), or a combination of the two (n = 1). All articles (n = 7) reported closing the defect and using mesh. Three articles describe placing five ports (one camera, three robotic, one assistant). There were no significant intraoperative or postoperative complications reported, and no recurrence noted at 3–27 months follow-up. Based on our experience, as shown in the video vignette, we recommend lithotomy positioning, using porous polypropylene mesh anchored to the periosteum of the sacrum and peritoneum overlying the bladder and side wall, and placing a drain above the mesh. Conclusions A robotic transabdominal approach to perineal hernia repair is a viable alternate to laparoscopy based on low complication rates and lack of recurrence. Prospective and longer duration data are needed to compare the techniques.

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“…Anteriorly, the mesh was fixed to the posterior wall of the vagina using glue (Glubran ® ). We finally performed a running suture for peritoneal closure using a barbed suture (V‐lock ® ) .…”

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confidence: 99%

Laparoscopic repair of perineal hernia after abdominoperineal excision of the rectum and anus – a video vignette

Coratti¹,

Nelli

Cianchi

2020

Colorectal Disease

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Robotic-assisted repair of perineal hernia after extralevator abdominoperineal resection

Cited by 7 publications

References 5 publications

Hernia Perineal Secundaria a Operación De Miles Reporte De Nuestros Casos Y Estado Del Arte

Hernia Perineal Secundaria a Operación De Miles Reporte De Nuestros Casos Y Estado Del Arte

Robotic repair of perineal hernias: a video vignette and review of the literature

Laparoscopic repair of perineal hernia after abdominoperineal excision of the rectum and anus – a video vignette

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