Montechiari Digby Aylen, Rossi Micaela Milagros, Soria Maria Belen, Rossini Alejandro, Signorini Franco José
General Surgery Department, Hospital Privado Universitario de Córdoba, Naciones Unidas 346, X5016, Córdoba, Argentina.
Hernia. 2025 Jun 18;29(1):208. doi: 10.1007/s10029-025-03345-4.
Laparoscopic repair of ventral hernias has evolved significantly. The enhanced-view totally extraperitoneal (eTEP) technique, which places the mesh in a retromuscular plane, has emerged as an alternative to traditional open and laparoscopic approaches, particularly in patients with associated diastasis recti. This study evaluates the efficacy and safety of eTEP in patients with ventral hernias and diastasis recti.
A retrospective study was conducted on patients who underwent eTEP for ventral hernia repair at a university hospital between January 2019 and September 2024. Demographic data, hernia characteristics, operative time, postoperative complications, and recurrence were collected. Furthermore, the learning curve for ventral hernia repairs was assessed using the CUSUM statistical method.
163 patients underwent eTEP for ventral hernias. The majority were male (50.3%) with a mean age of 53.5 years. Primary hernias were most common (77.3%), and diastasis recti was present in 82.8% of cases. The mean operative time was 137.2 min. Conversions to open surgery represented 2.5%. The most common postoperative complications were seromas (6.7%) and wound infections (3.1%). The long-term recurrence rate was 0.6%. The average follow-up duration was 15.3 ± 21.3 months. The learning curve for eTEP in umbilical hernia repair was established after performing 14 cases.
eTEP has proven to be a safe and effective technique for ventral hernias, with a seroma incidence of 6.7%, a recurrence rate of 0.6%, and a learning curve of 14 cases.
腹腔镜腹疝修补术已取得显著进展。增强视野完全腹膜外（eTEP）技术将补片置于肌后平面，已成为传统开放和腹腔镜手术方法的替代方案，尤其是对于伴有腹直肌分离的患者。本研究评估eTEP在腹疝合并腹直肌分离患者中的疗效和安全性。
对2019年1月至2024年9月在某大学医院接受eTEP腹疝修补术的患者进行回顾性研究。收集人口统计学数据、疝的特征、手术时间、术后并发症和复发情况。此外，使用累积和（CUSUM）统计方法评估腹疝修补术的学习曲线。
163例患者接受了eTEP腹疝修补术。大多数为男性（50.3%），平均年龄53.5岁。原发性疝最为常见（77.3%），82.8%的病例存在腹直肌分离。平均手术时间为137.2分钟。转为开放手术的比例为2.5%。最常见的术后并发症是血清肿（6.7%）和伤口感染（3.1%）。长期复发率为0.6%。平均随访时间为15.3±21.3个月。脐疝修补术中eTEP的学习曲线在完成14例手术后确立。
eTEP已被证明是一种安全有效的腹疝修补技术，血清肿发生率为6.7%，复发率为0.6%，学习曲线为14例。
