Ueda Sho, Saito Takuya, Yasui Kohei, Shinohara Kentaro, Fukami Yasuyuki, Kaneko Kenitiro, Sano Tsuyoshi
Department of Gastroenterological Surgery Aichi Medical University Aichi Japan.
Ann Gastroenterol Surg. 2025 Apr 21;9(5):1086-1092. doi: 10.1002/ags3.70026. eCollection 2025 Sep.
We successfully established the stapler repair technique (SRT), a straightforward laparoscopic Rives-Stoppa approach utilizing a linear stapler. This study retrospectively evaluated its short-term outcomes to determine its safety and efficacy.
The surgical outcomes of 87 patients who underwent laparoscopic median incisional hernia repair at our hospital were reviewed between August 2017 and May 2024. Patients were treated with intraperitoneal onlay mesh (IPOM), laparoscopic trans-abdominal retromuscular (TARM), or SRT.
Among these patients, 37 were treated with IPOM, 16 with TARM, and 34 with SRT, with no significant differences in patient characteristics. The median surgical time (range) was 96 min (50-211) for IPOM, 256 min (196-300) for TARM, and 112 min (60-289) for SRT, respectively. The median mesh areas (ranges) were 210 cm (80-500) for IPOM, 500 cm (270-780) for TARM, and 379 cm (176-864) for SRT, respectively. The SRT group had significantly shorter operative times ( < 0.001) and smaller mesh areas ( = 0.005) than the TARM group. Compared to the IPOM group, there was no significant difference in operative time in the SRT group ( = 0.444), but the mesh area was significantly larger ( < 0.001). The SRT group had no significant intraoperative complications or conversions to open surgery.
SRT offers a comparable operative time to IPOM and a significantly shorter time than TARM. Additionally, SRT can be performed extraperitoneally with no significant intraoperative complications or conversion to open surgery. These findings suggest that SRT is a safe and effective minimally invasive approach in median laparoscopic incisional hernia repair.
我们成功建立了吻合器修复技术（SRT），这是一种使用线性吻合器的简单腹腔镜里夫斯 - 斯托帕手术方法。本研究回顾性评估其短期疗效，以确定其安全性和有效性。
回顾了2017年8月至2024年5月在我院接受腹腔镜正中切口疝修补术的87例患者的手术结果。患者接受腹膜内补片修补术（IPOM）、腹腔镜经腹肌肉后补片修补术（TARM）或SRT治疗。
在这些患者中，37例接受IPOM治疗，16例接受TARM治疗，34例接受SRT治疗，患者特征无显著差异。IPOM的中位手术时间（范围）为96分钟（50 - 211分钟），TARM为256分钟（196 - 300分钟），SRT为112分钟（60 - 289分钟）。IPOM的中位补片面积（范围）为210平方厘米（80 - 500平方厘米），TARM为500平方厘米（270 - 780平方厘米），SRT为379平方厘米（176 - 864平方厘米）。SRT组的手术时间明显短于TARM组（<0.001），补片面积也明显小于TARM组（=0.005）。与IPOM组相比，SRT组的手术时间无显著差异（=0.444），但补片面积明显更大（<0.001）。SRT组无明显术中并发症或转为开放手术的情况。
SRT的手术时间与IPOM相当，比TARM明显更短。此外，SRT可在腹膜外进行，无明显术中并发症或转为开放手术的情况。这些发现表明，SRT是腹腔镜正中切口疝修补术中一种安全有效的微创方法。
