Centro de Patología Herniaria Argentina, Cerviño, 4449 (Zip Code 1425), Buenos Aires, Argentina.
Hernia. 2024 Dec;28(6):2403-2409. doi: 10.1007/s10029-024-03151-4. Epub 2024 Sep 6.
There are many surgical techniques for ventral hernias and diastasis recti, both conventional or video-endoscopic, with or without mesh placement, detailed in the literature. Using some details of the techniques proposed by Wolfgang Reinpold (Mini- or Less Open Sublay Operation, MILOS) and Federico Fiori (Totally Endoscopic Sublay Anterior Repair, TESAR) we found modifications that allowed repairing and reinforcement of the posterior fascia with a retro-muscular mesh and achieve primary fascial closure by minimally umbilical access and searching for the best anatomical, functional, and aesthetic results.
Describe the surgical technique step by step and analyze 629 surgical treatments. The cohort comprises the period January 2018 to January 2023. Our Database registered 318 men and 311 women who underwent video endoscopicassisted Rives-Stoppa techniques to treat umbilical and epigastric hernias with diastasis RESULTS: All patients were treated on an outpatient basis and discharged home on the same day. The most frequent complications were seromas with conservative management. Other complications recorded were omphalitis in 6 patients, and three patients presented hematomas, one of whom performed surgical evacuation. There were ten patients with recurrences.
These hybrid approaches provide the advantages of mini-invasive techniques with a lower rate of complications and a high standard of quality of life, providing anatomical, functional, and aesthetic benefits.
文献中详细介绍了许多治疗腹疝和腹直肌分离的手术技术,包括传统的和视频内镜的,有或没有网片放置。我们借鉴了 Wolfgang Reinpold(Mini-或 Less Open Sublay Operation,MILOS)和 Federico Fiori(Totally Endoscopic Sublay Anterior Repair,TESAR)提出的一些技术细节,并进行了改良,使用一种后筋膜修补和加强的方法,即在肌肉后放置补片,通过最小的脐部切口实现筋膜的一期关闭,并寻找最佳的解剖学、功能和美学效果。
逐步描述手术技术,并分析 629 例手术治疗。该队列包括 2018 年 1 月至 2023 年 1 月期间的患者。我们的数据库记录了 318 名男性和 311 名女性患者,他们接受了视频内镜辅助的 Rives-Stoppa 技术治疗脐疝和上腹疝合并腹直肌分离。
所有患者均在门诊治疗,当天出院。最常见的并发症是经保守治疗的血清肿。其他记录的并发症包括 6 例脐炎和 3 例血肿,其中 1 例血肿患者需要手术清除。有 10 例患者复发。
这些混合方法结合了微创技术的优势,并发症发生率较低,生活质量较高,同时提供了解剖学、功能和美学方面的益处。