Laparoendoscopic extraperitoneal surgical techniques for ventral hernias and diastasis recti repair: a systematic review
- PMID: 39312025
- DOI: 10.1007/s10029-024-03144-3
Laparoendoscopic extraperitoneal surgical techniques for ventral hernias and diastasis recti repair: a systematic review
Abstract
Purpose: this systematic review aims to classify and summarize the characteristics and outcomes of the different laparoendoscopic extraperitoneal approaches for the repair of ventral hernias and diastasis recti described in the last 10 years.
Methods: a literature search was performed by two reviewers in December 2023 including articles from January 2013, 01 to December 2023, 15. The techniques were selected according to the surgical access site (anterior or posterior to the rectus sheath), the access type (laparoendoscopic, single incision laparoscopic, mini or less open), the main space used to repair the defect (subcutaneous or retromuscular) and the mesh place (onlay, sublay-retromuscular or sublay-preperitoneal) and classified as anterior or posterior approaches.
Results: the literature search retrieved 1755 results and 27 articles were included in the study. The studies included 1874 patients, the mean age ranged from 37.8 to 60.2 years. The access site was anterior in 16 cases and posterior in 11 cases. The mesh was positioned onlay in 13 cases and sublay in 13 cases, with only one study using no mesh. Complications were: seroma, ranging from 0.8 to 81%, followed by skin complications (leak, ischemia, necrosis) from 0.8 to 6.4%, surgical site infections and bleeding. Recurrences ranged from 0% to 12,5%, with a mean follow-up from 1 to 24 months.
Conclusion: this systematic review confirms the presence of several new minimally invasive extraperitoneal techniques for the repair of abdominal wall defects, with different advantages and disadvantages. Further studies, with more extensive follow-up data and wider patient groups, are necessary to define specific indications for each technique.
Keywords: Abdominal wall surgery; Diastasis recti; Endoscopy; Hernia; Laparoscopy.
© 2024. The Author(s).
References
-
- Silecchia G, Campanile FC, Sanchez L et al (2015) Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference. Surg Endosc 29:2463–2484. https://doi.org/10.1007/s00464-015-4293-8
-
- ElHawary H, Barone N, Zammit D, Janis JE (2021) Closing the gap: evidence-based surgical treatment of rectus diastasis associated with abdominal wall hernias. Hernia 25:827–853. https://doi.org/10.1007/s10029-021-02460-2 - DOI - PubMed
-
- ElHawary H, Chartier C, Alam P, Janis JE (2022) Open Versus Laparoscopic Surgical Management of Rectus Diastasis: systematic review and pooled analysis of complications and recurrence rates. World J Surg 46:1878–1885. https://doi.org/10.1007/s00268-022-06550-9 - DOI - PubMed
-
- Bittner R, Bain K, Bansal VK et al (2019) Update of guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))—Part A. Surg Endosc 33:3069–3139. https://doi.org/10.1007/s00464-019-06907-7 - DOI - PubMed - PMC
-
- LeBlanc KA, Booth WV (1993) Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc 3:39–41 - PubMed
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