Northwest Minimally Invasive Surgery, 1040 NW 22Nd Ave, Suite 470, Portland, OR, USA.
Hernia. 2024 Feb;28(1):249-254. doi: 10.1007/s10029-023-02903-y. Epub 2023 Oct 12.
Thoracoabdominal hernias remain a rare and poorly understood entity. Data remain sparse as terminology varies in the literature and case reports demonstrate wide variability in technique. We present a novel approach for repair of thoracoabdominal hernias using the robotic platform.
Two patients underwent a robotic thoracoabdominal hernia repair in June 2022. They were followed for 1 year with CT scans every 6 months to exclude recurrence. Patient demographics and peri-operative details including defect size, closure technique, mesh size, length of stay, and complications were reported.
Both patients successfully underwent a robotic repair of a thoracoabdominal hernia, addressing the intercostal hernia, diaphragmatic disruption, and flank hernia discretely during the operation. One patient had an uneventful recovery and discharged on post-operative day 3; the other developed a small bowel obstruction due to an early port site hernia which required surgical intervention. He eventually discharged on post-operative day 9. At one year, there is no clinical or radiographic evidence of recurrence for either patient.
Robotic thoracoabdominal hernia repair is feasible and offers a minimally invasive repair option for these extremely complex hernias.
胸腹疝仍然是一种罕见且尚未被充分认识的疾病。由于文献中的术语存在差异,且病例报告显示技术存在广泛的变异性,因此数据仍然很少。我们提出了一种使用机器人平台修复胸腹疝的新方法。
2022 年 6 月,2 例患者接受了机器人胸腹疝修补术。对他们进行了为期 1 年的随访,每 6 个月进行一次 CT 扫描以排除复发。报告了患者的人口统计学和围手术期细节,包括缺陷大小、闭合技术、网片大小、住院时间和并发症。
2 例患者均成功接受了机器人修复胸腹疝,在手术过程中分别解决了肋间隙疝、膈肌破裂和侧腹疝。1 例患者术后恢复顺利,术后第 3 天出院;另 1 例患者因早期端口疝发生小肠梗阻而需要手术干预,最终于术后第 9 天出院。1 年后,2 例患者均无临床或影像学复发证据。
机器人胸腹疝修补术是可行的,为这些极其复杂的疝提供了一种微创修复选择。