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

Abstract

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.

Outcomes of Robotic Transabdominal Retromuscular Repair: 3-Year Follow-up

“…Our study’s 3-year follow-up demonstrated a low recurrence rate of 2.97%, comparable to other MIS retromuscular repairs described by Aliseda et al [ 40 ] We noted that hernia recurrence showed no significant dependence on mesh type. Instead, recurrence rates were related to surgical technique rather than mesh selection.…”

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“…Our study's 3-year follow-up demonstrated a low recurrence rate of 2.97%, comparable to other MIS retromuscular repairs described by Aliseda et al [40] We noted that hernia recurrence showed no significant dependence on mesh type. Instead, recurrence rates were related to surgical technique rather than mesh selection.…”

Manejo laparoscópico de las hernias ventrales mediante abordaje totalmente extraperitoneal (eTEP): experiencia inicial y resultados a corto plazo

“…Sin embargo, aparecen las complicaciones relacionadas con la colocación de la malla en posición intraperitoneal (IPOM o IPOM-plus), como las adherencias de asas intestinales a la malla y las fístulas (13,14). Además, se sabe que la fijación de la malla durante la reparación tipo IPOM o IPOM plus mediante la utilización de tackers produce altos niveles de dolor postoperatorio y, a veces, dolor crónico que requiere cirugía adicional para la extracción de estos (15).…”