Robotic assisted eTEP ventral hernia repair: Brazilian early experience

Purpose The enhanced view totally extraperitoneal (eTEP) concept first applied to inguinal hernias has become an important tool in the armamentarium of ventral hernia repair. The purpose of this report is to date the first brazilian robotic-assisted eTEP ventral hernia repair case series. Methods A...

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Veröffentlicht in:Hernia : the journal of hernias and abdominal wall surgery 2021-06, Vol.25 (3), p.765-774
Hauptverfasser: Morrell, A. L. G., Morrell, A. C., Cavazzola, L. T., Pereira, G. S. S., Mendes, J. M., Abdalla, R. Z., Garcia, R. B., Costa, T. N., Morrell-Junior, A. C., Malcher, F.
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container_end_page 774
container_issue 3
container_start_page 765
container_title Hernia : the journal of hernias and abdominal wall surgery
container_volume 25
creator Morrell, A. L. G.
Morrell, A. C.
Cavazzola, L. T.
Pereira, G. S. S.
Mendes, J. M.
Abdalla, R. Z.
Garcia, R. B.
Costa, T. N.
Morrell-Junior, A. C.
Malcher, F.
description Purpose The enhanced view totally extraperitoneal (eTEP) concept first applied to inguinal hernias has become an important tool in the armamentarium of ventral hernia repair. The purpose of this report is to date the first brazilian robotic-assisted eTEP ventral hernia repair case series. Methods A review of a prospectively maintained database was conducted in patients who underwent robotic-assisted enhanced view totally extraperitoneal (eTEP) for ventral hernia repair between June 2018 and January 2020. Patients demographics, preoperative hernia characteristics, intraoperative variables and postoperative outcomes were evaluated. Results Our review identified 74 patients submitted to the procedure. Thirty-one patients (41.8%) presented primary ventral hernias (PVHs) and 43 patients (58.2%) presented incisional hernias (IHs). Female patients were predominant in both groups PVHs and IHs with 17 (22.9%) and 22 (29.7%) respectively, with a total of 39 patients (52.7%). Mean BMI was 29.1 kg/m 2 (range 21.3–48.0 kg/m 2 ) with higher mean BMI rates of 30.3 kg/m 2 in the IHs group (range 22–48 years). A lateral dock setup was utilized in 55 cases (74.4%), having the inferior and superior dock setup in 18 (24.3%) and 1 (1.3%) cases respectively. Mean console time was 148.3 (range 75–277 min) and 192.6 min (range 66–301 min) in the PVHs and IHs groups respectively. There were no intraoperative complications or conversions. Average length of stay was 1.5 days. Four patients were readmitted within 30 days of surgery. There were no reoperation or cases of intraparietal herniation in this cohort. No hernia recurrence was verified during the mean 230.7 days of follow up in both groups. Conclusion We present the first brazilian series to-date of the robotic assisted eTEP approach for ventral hernia repairs. Although long term outcomes require further analysis, its feasibility and reproducibility in experienced surgeons hands are evident, with safe and acceptable early postoperative outcomes.
doi_str_mv 10.1007/s10029-020-02233-3
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L. G. ; Morrell, A. C. ; Cavazzola, L. T. ; Pereira, G. S. S. ; Mendes, J. M. ; Abdalla, R. Z. ; Garcia, R. B. ; Costa, T. N. ; Morrell-Junior, A. C. ; Malcher, F.</creator><creatorcontrib>Morrell, A. L. G. ; Morrell, A. C. ; Cavazzola, L. T. ; Pereira, G. S. S. ; Mendes, J. M. ; Abdalla, R. Z. ; Garcia, R. B. ; Costa, T. N. ; Morrell-Junior, A. C. ; Malcher, F.</creatorcontrib><description>Purpose The enhanced view totally extraperitoneal (eTEP) concept first applied to inguinal hernias has become an important tool in the armamentarium of ventral hernia repair. The purpose of this report is to date the first brazilian robotic-assisted eTEP ventral hernia repair case series. Methods A review of a prospectively maintained database was conducted in patients who underwent robotic-assisted enhanced view totally extraperitoneal (eTEP) for ventral hernia repair between June 2018 and January 2020. Patients demographics, preoperative hernia characteristics, intraoperative variables and postoperative outcomes were evaluated. Results Our review identified 74 patients submitted to the procedure. Thirty-one patients (41.8%) presented primary ventral hernias (PVHs) and 43 patients (58.2%) presented incisional hernias (IHs). Female patients were predominant in both groups PVHs and IHs with 17 (22.9%) and 22 (29.7%) respectively, with a total of 39 patients (52.7%). Mean BMI was 29.1 kg/m 2 (range 21.3–48.0 kg/m 2 ) with higher mean BMI rates of 30.3 kg/m 2 in the IHs group (range 22–48 years). A lateral dock setup was utilized in 55 cases (74.4%), having the inferior and superior dock setup in 18 (24.3%) and 1 (1.3%) cases respectively. Mean console time was 148.3 (range 75–277 min) and 192.6 min (range 66–301 min) in the PVHs and IHs groups respectively. There were no intraoperative complications or conversions. Average length of stay was 1.5 days. Four patients were readmitted within 30 days of surgery. There were no reoperation or cases of intraparietal herniation in this cohort. No hernia recurrence was verified during the mean 230.7 days of follow up in both groups. Conclusion We present the first brazilian series to-date of the robotic assisted eTEP approach for ventral hernia repairs. Although long term outcomes require further analysis, its feasibility and reproducibility in experienced surgeons hands are evident, with safe and acceptable early postoperative outcomes.</description><identifier>ISSN: 1265-4906</identifier><identifier>EISSN: 1248-9204</identifier><identifier>DOI: 10.1007/s10029-020-02233-3</identifier><identifier>PMID: 32495056</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Abdominal Surgery ; Demography ; Early experience ; Female ; Hernia ; Hernia, Ventral - surgery ; Hernias ; Herniorrhaphy - adverse effects ; Humans ; Incisional Hernia - surgery ; Laparoscopy ; Medicine ; Medicine &amp; Public Health ; Original Article ; Postoperative period ; Reproducibility of Results ; Retrospective Studies ; Robotic surgery ; Robotic Surgical Procedures - adverse effects ; Robotics ; Surgery ; Surgical Mesh</subject><ispartof>Hernia : the journal of hernias and abdominal wall surgery, 2021-06, Vol.25 (3), p.765-774</ispartof><rights>Springer-Verlag France SAS, part of Springer Nature 2020</rights><rights>Springer-Verlag France SAS, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-5be775c54718e941a74b776a7494ed41f35f75c359a70d61d886e418563b4913</citedby><cites>FETCH-LOGICAL-c441t-5be775c54718e941a74b776a7494ed41f35f75c359a70d61d886e418563b4913</cites><orcidid>0000-0003-1644-9921 ; 0000-0003-2356-2789 ; 0000-0002-8700-0067 ; 0000-0001-9337-2759 ; 0000-0003-3971-349X ; 0000-0002-4603-6004</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10029-020-02233-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10029-020-02233-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32495056$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morrell, A. L. G.</creatorcontrib><creatorcontrib>Morrell, A. C.</creatorcontrib><creatorcontrib>Cavazzola, L. T.</creatorcontrib><creatorcontrib>Pereira, G. S. S.</creatorcontrib><creatorcontrib>Mendes, J. M.</creatorcontrib><creatorcontrib>Abdalla, R. Z.</creatorcontrib><creatorcontrib>Garcia, R. B.</creatorcontrib><creatorcontrib>Costa, T. N.</creatorcontrib><creatorcontrib>Morrell-Junior, A. C.</creatorcontrib><creatorcontrib>Malcher, F.</creatorcontrib><title>Robotic assisted eTEP ventral hernia repair: Brazilian early experience</title><title>Hernia : the journal of hernias and abdominal wall surgery</title><addtitle>Hernia</addtitle><addtitle>Hernia</addtitle><description>Purpose The enhanced view totally extraperitoneal (eTEP) concept first applied to inguinal hernias has become an important tool in the armamentarium of ventral hernia repair. The purpose of this report is to date the first brazilian robotic-assisted eTEP ventral hernia repair case series. Methods A review of a prospectively maintained database was conducted in patients who underwent robotic-assisted enhanced view totally extraperitoneal (eTEP) for ventral hernia repair between June 2018 and January 2020. Patients demographics, preoperative hernia characteristics, intraoperative variables and postoperative outcomes were evaluated. Results Our review identified 74 patients submitted to the procedure. Thirty-one patients (41.8%) presented primary ventral hernias (PVHs) and 43 patients (58.2%) presented incisional hernias (IHs). Female patients were predominant in both groups PVHs and IHs with 17 (22.9%) and 22 (29.7%) respectively, with a total of 39 patients (52.7%). Mean BMI was 29.1 kg/m 2 (range 21.3–48.0 kg/m 2 ) with higher mean BMI rates of 30.3 kg/m 2 in the IHs group (range 22–48 years). A lateral dock setup was utilized in 55 cases (74.4%), having the inferior and superior dock setup in 18 (24.3%) and 1 (1.3%) cases respectively. 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L. G.</au><au>Morrell, A. C.</au><au>Cavazzola, L. T.</au><au>Pereira, G. S. S.</au><au>Mendes, J. M.</au><au>Abdalla, R. Z.</au><au>Garcia, R. B.</au><au>Costa, T. N.</au><au>Morrell-Junior, A. C.</au><au>Malcher, F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic assisted eTEP ventral hernia repair: Brazilian early experience</atitle><jtitle>Hernia : the journal of hernias and abdominal wall surgery</jtitle><stitle>Hernia</stitle><addtitle>Hernia</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>25</volume><issue>3</issue><spage>765</spage><epage>774</epage><pages>765-774</pages><issn>1265-4906</issn><eissn>1248-9204</eissn><abstract>Purpose The enhanced view totally extraperitoneal (eTEP) concept first applied to inguinal hernias has become an important tool in the armamentarium of ventral hernia repair. The purpose of this report is to date the first brazilian robotic-assisted eTEP ventral hernia repair case series. Methods A review of a prospectively maintained database was conducted in patients who underwent robotic-assisted enhanced view totally extraperitoneal (eTEP) for ventral hernia repair between June 2018 and January 2020. Patients demographics, preoperative hernia characteristics, intraoperative variables and postoperative outcomes were evaluated. Results Our review identified 74 patients submitted to the procedure. Thirty-one patients (41.8%) presented primary ventral hernias (PVHs) and 43 patients (58.2%) presented incisional hernias (IHs). Female patients were predominant in both groups PVHs and IHs with 17 (22.9%) and 22 (29.7%) respectively, with a total of 39 patients (52.7%). Mean BMI was 29.1 kg/m 2 (range 21.3–48.0 kg/m 2 ) with higher mean BMI rates of 30.3 kg/m 2 in the IHs group (range 22–48 years). A lateral dock setup was utilized in 55 cases (74.4%), having the inferior and superior dock setup in 18 (24.3%) and 1 (1.3%) cases respectively. Mean console time was 148.3 (range 75–277 min) and 192.6 min (range 66–301 min) in the PVHs and IHs groups respectively. There were no intraoperative complications or conversions. Average length of stay was 1.5 days. Four patients were readmitted within 30 days of surgery. There were no reoperation or cases of intraparietal herniation in this cohort. No hernia recurrence was verified during the mean 230.7 days of follow up in both groups. Conclusion We present the first brazilian series to-date of the robotic assisted eTEP approach for ventral hernia repairs. 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1248-9204
language eng
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subjects Abdominal Surgery
Demography
Early experience
Female
Hernia
Hernia, Ventral - surgery
Hernias
Herniorrhaphy - adverse effects
Humans
Incisional Hernia - surgery
Laparoscopy
Medicine
Medicine & Public Health
Original Article
Postoperative period
Reproducibility of Results
Retrospective Studies
Robotic surgery
Robotic Surgical Procedures - adverse effects
Robotics
Surgery
Surgical Mesh
title Robotic assisted eTEP ventral hernia repair: Brazilian early experience
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