Köckerling Ferdinand, Botsinis Marinos Damianos, Rohde Christine, Reinpold Wolfgang, Schug-Pass Christine
Department of Surgery and Center for Minimally Invasive Surgery, Academic Teaching Hospital of Charité Medical School, Vivantes Hospital, Neue Bergstrasse 6, 13585 Berlin, Germany.
Department of Surgery and Hernia Center, Wilhelmsburg Hospital Gross-Sand, Gross-Sand 3, 21107 Hamburg, Germany.
Eur Surg. 2017;49(2):71-75. doi: 10.1007/s10353-017-0473-1. Epub 2017 Mar 10.
Patients with symptomatic umbilical, trocar, and/or epigastric hernias and concomitant rectus abdominis diastasis represent a growing clinical problem. The optimal management of this complex hernia situation is the subject of debate in the literature. This paper reports the early results of an innovative surgical technique aimed at managing this hernia situation.
Endoscopic-assisted linea alba reconstruction (ELAR) with mesh augmentation is a surgical technique long known in the literature for its good outcome for incisional hernia repair (myofascial release, overlapping herniorrhaphy, Gibson's operation, shoelace repair, anterior rectus sheath repair, dynamic patch plasty) via a small access route. The early results for 140 patients are presented here.
Two patients (1.4%) developed postoperative complications requiring redo surgery. These were two cases of diffuse secondary bleeding without an identifiable bleeding source, in one patient with liver cirrhosis and portal hypertension and in another patient receiving treatment with platelet aggregation inhibitors. All other complications were successively managed with conservative treatment. After 1 year, two of 30 patients reported occasional pain, including pain at rest in one patient.
The ELAR technique with mesh augmentation is an innovative, minimally invasive surgical procedure for treatment of patients with a complex abdominal wall hernia comprising symptomatic umbilical, trocar, and/or epigastric hernias with concomitant rectus abdominis diastasis.
有症状的脐疝、套管针疝和/或上腹部疝且伴有腹直肌分离的患者代表了一个日益严重的临床问题。这种复杂疝情况的最佳治疗方法在文献中存在争议。本文报告了一种旨在处理这种疝情况的创新手术技术的早期结果。
内镜辅助白线重建术（ELAR）联合补片加强是一种在文献中早已为人所知的手术技术，因其通过小切口路径对切口疝修补（肌筋膜松解、重叠疝修补术、吉布森手术、鞋带修补术、腹直肌前鞘修补术、动态补片成形术）有良好效果。本文展示了140例患者的早期结果。
两名患者（1.4%）出现术后并发症，需要再次手术。这两例均为弥漫性继发性出血，未发现明确出血源，一例患者患有肝硬化和门静脉高压，另一例患者正在接受血小板聚集抑制剂治疗。所有其他并发症均通过保守治疗相继得到处理。1年后，30例患者中有2例报告偶尔疼痛，其中1例患者静息时疼痛。
ELAR联合补片加强技术是一种创新的、微创的手术方法，用于治疗患有复杂腹壁疝的患者，这些患者包括有症状的脐疝、套管针疝和/或上腹部疝且伴有腹直肌分离。
