Li Junsheng, Lu Liangqi, Shao Xiangyu, Wang Yong
Department of General Surgery, Affiliated Zhongda Hospital, Southeast University, Nanjing, 210009, China.
School of Medicine, Southeast University, Nanjing, 210009, China.
Hernia. 2025 May 23;29(1):178. doi: 10.1007/s10029-025-03357-0.
Umbilical hernia is a common surgical condition, and mesh repair is generally recommended to reduce recurrence rates. Various techniques have been employed, each with its own advantages and disadvantages. The enhanced-view totally extraperitoneal (eTEP) approach offers the benefit of placing the mesh outside the abdominal cavity while maintaining a minimally invasive approach. However, it is associated with longer operative times and requires a higher level of surgical expertise. In this study, we present our method of eTEP for umbilical hernia repair, which has proven to be safe, effective, and highly reproducible.
Patients with umbilical hernias and defect sizes larger than 1 cm were prospectively enrolled. All patients underwent repair using the eTEP technique, which featured an inferior port position and a caudal-to-cranial dissection approach. Detailed procedural techniques and surgical skills are described, and perioperative outcomes were recorded.
A total of 26 umbilical hernias were repaired using the eTEP technique, with no conversions to an open approach. The mean operative time was 101.8 ± 31 min (range: 47 to 185 min), and the average postoperative hospital stay was 1.8 ± 0.8 days (range: 1 to 5 days). There were no cases of surgical site infection, skin necrosis, wound dehiscence, bowel obstruction, urinary complications, or recurrence.
The eTEP approach for umbilical hernia repair is a safe, efficient, and reproducible alternative to traditional methods. Its unique port positioning, tailored dissection, and optional mesh fixation contribute to reduced complications and improved patient outcomes. Future studies should focus on long-term follow-up to validate the durability and effectiveness of this technique.
脐疝是一种常见的外科病症，一般建议采用补片修补术以降低复发率。已采用了各种技术，每种技术都有其自身的优缺点。增强视野完全腹膜外（eTEP）入路具有在保持微创入路的同时将补片放置在腹腔外的优点。然而，它与较长的手术时间相关，并且需要更高水平的手术专业知识。在本研究中，我们展示了我们用于脐疝修补的eTEP方法，该方法已被证明是安全、有效且高度可重复的。
前瞻性纳入脐疝且缺损尺寸大于1厘米的患者。所有患者均采用eTEP技术进行修补，该技术的特点是端口位置较低且采用从尾端到颅端的解剖方法。描述了详细的手术步骤和手术技巧，并记录了围手术期结果。
共使用eTEP技术修补了26例脐疝，无一例转为开放手术。平均手术时间为101.8±31分钟（范围：47至185分钟），术后平均住院时间为1.8±0.8天（范围：1至5天）。没有手术部位感染、皮肤坏死、伤口裂开、肠梗阻、泌尿系统并发症或复发的病例。
用于脐疝修补的eTEP入路是一种安全、高效且可重复的传统方法替代方案。其独特的端口定位、量身定制的解剖以及可选的补片固定有助于减少并发症并改善患者预后。未来的研究应侧重于长期随访，以验证该技术的耐久性和有效性。
