Al-Salemi Asem, El-Sourani Nader, Bockhorn Maximilian, Alfarawan Fadl
Department for General and Visceral Surgery, University Hospital Oldenburg, Klinikum Oldenburg AöR, Rahel-Straus-Straße 10, 26133, Oldenburg, Germany.
Carl von Ossietzky Universität Oldenburg Fakultät VI - Medizin und Gesundheitswissenschaften, Ammerländer Heerstraße 114-118, 26129, Oldenburg, Germany.
Hernia. 2025 Mar 12;29(1):119. doi: 10.1007/s10029-025-03293-z.
The extended totally extraperitoneal technique (eTEP) is a novel approach for ventral hernia repair. This technique has been recently advanced using robotics (r-eTEP). The aim of this study is to perform a comprehensive analysis of the initial results of r-eTEP and to evaluate the safety and efficacy of this technique compared to the eTEP technique.
This is a monocentric retrospective study of patients with ventral hernias who underwent surgery via eTEP or r-eTEP in our department between 2019 and 2023. Propensity score matching was applied to compare the groups. Preoperative patient and hernia characteristics, intraoperative findings, and postoperative outcomes were subsequently analysed.
Patient demographics were comparable between the groups. The r-eTEP group had a significantly greater proportion of M3 hernias (p = 0.006), M4 hernias (p = 0.020), incisional hernias (p = 0.002), and hernias with rectus diastasis (p < 0.001). The r-eTEP group had a significantly larger hernia defect (p = 0.003) and larger mesh size (p = 0.015). The r-eTEP group had a shorter hospital stay (p < 0.001) and shorter operative time, though not statistically significant (p = 0.211). Intraoperative and postoperative complications, as well as postoperative pain, were comparable between the groups.
The findings of the present study show that the r-eTEP technique may offer potential benefits as the overall hospital stay was shorter while intraoperative and postoperative complications were comparable for both techniques.
扩展全腹膜外技术（eTEP）是一种用于腹疝修补的新方法。该技术最近已通过机器人技术得到改进（r-eTEP）。本研究的目的是对r-eTEP的初步结果进行全面分析，并与eTEP技术相比评估该技术的安全性和有效性。
这是一项单中心回顾性研究，研究对象为2019年至2023年期间在我科接受eTEP或r-eTEP手术的腹疝患者。采用倾向得分匹配法对两组进行比较。随后分析术前患者和疝的特征、术中发现及术后结果。
两组患者的人口统计学特征具有可比性。r-eTEP组中M3型疝（p = 0.006）、M4型疝（p = 0.020）、切口疝（p = 0.002）及伴有腹直肌分离的疝（p < 0.001）的比例显著更高。r-eTEP组的疝缺损显著更大（p = 0.003），补片尺寸更大（p = 0.015）。r-eTEP组的住院时间更短（p < 0.001），手术时间也更短，尽管差异无统计学意义（p = 0.211）。两组的术中及术后并发症以及术后疼痛情况相当。
本研究结果表明，r-eTEP技术可能具有潜在优势，因为总体住院时间更短，而两种技术的术中及术后并发症相当。
