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机器人增强视图完全经腹腔腹膜前疝修补术的早期结果:单中心经验。

EARLY OUTCOMES OF ROBOTIC ENHANCED VIEW TOTALLY EXTRAPERITONEAL VENTRAL HERNIA REPAIR: A SINGLE-CENTER EXPERIENCE.

机构信息

Hospital Nossa Senhora das Graças, General and Digestive Surgery Department - Curitiba (PR), Brazil.

Universidade Federal do Rio Grande do Sul, Postgraduate Program in Medicine and Surgical Sciences - Porto Alegre (RS), Brazil.

出版信息

Arq Bras Cir Dig. 2024 Sep 13;37:e1825. doi: 10.1590/0102-6720202400032e1825. eCollection 2024.

Abstract

BACKGROUND

Incisional hernia (IH) is an abdominal wall defect due to a previous laparotomy, and surgical repair is the only treatment. IH has a negative impact on patients' quality of life. In the last decades, the approach has improved from open to laparoscopic and robotic surgery with the objective of promoting better abdominal wall function after reconstruction. Today, robotic enhanced-view totally extraperitoneal (reTEP) is one of the most advanced techniques for abdominal wall reconstruction.

AIMS

The aim of this study was to analyze the early results of patients with incisional hernia submitted to repair with reTEP.

METHODS

This is a retrospective cohort study, and all patients who underwent reTEP surgery for ventral hernia in the years 2021 and 2022 were included. The only exclusion criteria were patients who underwent another type of herniorrhaphy. Statistical analysis was performed using the Stata software.

RESULTS

A total of 32 participants were submitted to reTEP; the majority had an incisional hernia, and according to the European Hernia Society, EUS-M score 3 was the most prevalent. The mean surgical time was 170 min, and the console time was 142 min. Most patients stayed 2 days in the hospital. No intraoperative complications were reported.

CONCLUSIONS

reTEP is a safe and effective technique and has favorable outcomes in the early postoperative period. Further studies with larger sample sizes and longer follow-up periods are needed to confirm these findings.

摘要

背景

切口疝(IH)是由于先前的剖腹手术导致的腹壁缺损,手术修复是唯一的治疗方法。IH 会对患者的生活质量产生负面影响。在过去几十年中,该方法已从开放式手术改进为腹腔镜和机器人手术,其目标是促进重建后更好的腹壁功能。如今,机器人增强视野完全腹膜外(reTEP)是腹壁重建的最先进技术之一。

目的

本研究旨在分析接受 reTEP 修复的切口疝患者的早期结果。

方法

这是一项回顾性队列研究,纳入了 2021 年和 2022 年接受 reTEP 手术治疗腹侧疝的所有患者。唯一的排除标准是接受另一种疝修补术的患者。统计分析使用 Stata 软件进行。

结果

共有 32 名参与者接受了 reTEP 手术;大多数患者患有切口疝,根据欧洲疝学会(EUS-M)评分,EUS-M 3 分是最常见的。手术时间平均为 170 分钟,控制台时间为 142 分钟。大多数患者在医院住 2 天。未报告术中并发症。

结论

reTEP 是一种安全有效的技术,在术后早期有良好的效果。需要进一步的研究,以更大的样本量和更长的随访时间来证实这些发现。

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本文引用的文献

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ONLAY VERSUS RIVES-STOPPA TECHNIQUES IN THE TREATMENT OF INCISIONAL HERNIAS.
Arq Bras Cir Dig. 2023 Oct 13;36:e1766. doi: 10.1590/0102-672020230048e1766. eCollection 2023.
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ROBOTIC-ASSISTED VERSUS LAPAROSCOPIC INCISIONAL HERNIA REPAIR: DIFFERENCES IN DIRECT COSTS FROM A BRAZILIAN PUBLIC INSTITUTE PERSPECTIVE.
Arq Bras Cir Dig. 2023 Jan 9;35:e1714. doi: 10.1590/0102-672020220002e1714. eCollection 2023.
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Short-term quality of life comparison of laparoscopic, open, and robotic incisional hernia repairs.
Surg Endosc. 2021 Jun;35(6):2781-2788. doi: 10.1007/s00464-020-07711-4. Epub 2020 Jul 27.
7
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Hernia. 2021 Jun;25(3):765-774. doi: 10.1007/s10029-020-02233-3. Epub 2020 Jun 3.
8
Comparative review of outcomes: laparoscopic and robotic enhanced-view totally extraperitoneal (eTEP) access retrorectus repairs.
Surg Endosc. 2020 Aug;34(8):3597-3605. doi: 10.1007/s00464-019-07132-y. Epub 2019 Oct 11.
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A direct comparison of robotic and laparoscopic hernia repair: patient-reported outcomes and cost analysis.
Hernia. 2019 Dec;23(6):1115-1121. doi: 10.1007/s10029-019-01943-7. Epub 2019 Apr 29.
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Early operative outcomes of endoscopic (eTEP access) robotic-assisted retromuscular abdominal wall hernia repair.
Hernia. 2018 Oct;22(5):837-847. doi: 10.1007/s10029-018-1795-z. Epub 2018 Jul 4.

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