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Extended View: Totally Extra Peritoneal (e-TEP) Approach for Ventral and Incisional Hernia—Early results from a single center

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Abstract

Background

Laparoscopy for ventral hernia repair is now an established technique with its proven benefits of less pain, early recovery, low-recurrence rate as compared to open repair. Several techniques have been described such as IPOM, MILOS, TES, EMILOS, SCOLA, e-TEP. e-TEP was originally conceptualized as an alternative approach to inguinal hernia in difficult cases (obese, previous scars) and for training surgery residents. Application of this approach for ventral hernia repair has recently been reported by few surgeons. We present our experience of e-TEP approach for ventral hernia from a tertiary care center in South India over one year duration.

Materials and methods

Electronically maintained data of patients who underwent e-TEP for ventral hernia during a period of November 2017 to November 2018 was reviewed retrospectively. Their demographic data, intraoperative details, postoperative complications and follow up data for a period of 6 months was noted.

Results

171 patients underwent e-TEP approach ventral hernia repair. Mean age was 49.34 ± 10.75 years with hypertension being most common comorbidity. Mean BMI was 29.2 ± 4.1 kg/m2. Mean defect area was 51.35 ± 45.09 cm2 and mean mesh size used was 397.56 ± 208.83 cm2. Fifty patients required TAR. Mean duration of surgery was 176.75 ± 62.42 min and blood loss was 78.7 ± 24.4 ml. Mean length of stay was 2.18 ± 1.27 days. Seven cases had paralytic ileus, 5 cases had surgical site infection, and 3 cases had recurrence at 6 months follow up.

Conclusion

e-TEP is a minimally invasive approach which is safe, feasible and also avoids placement of mesh in peritoneal cavity. Since it is a relatively new approach it requires further studies for standardization of techniques, criteria for patient selection and to study long-term outcomes.

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Authors and Affiliations

  1. GEM Hospital and Research Center, 45 Pankaja Mills Road, Coimbatore, Tamil Nadu, 641045, India

    Gupta Prakhar, Ramakrishnan Parthasarathi, Bharath Cumar, Rajapandian Subbaiah, V. P. Nalankilli, P. Praveen Raj & Chinnusamy Palanivelu

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  1. Gupta Prakhar
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  2. Ramakrishnan Parthasarathi
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  3. Bharath Cumar
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  4. Rajapandian Subbaiah
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  5. V. P. Nalankilli
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Correspondence to Gupta Prakhar.

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Dr. Gupta Prakhar, Dr. Ramakrishnan Parthasarathi, Dr. Bharath Cumar, Dr. Rajapandian Subbaiah, Dr. V.P Nalankilli, Dr. P Praveen Raj and Dr. Chinnusamy Palanivelu have no conflicts of interest or no financial ties to disclose.

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Prakhar, G., Parthasarathi, R., Cumar, B. et al. Extended View: Totally Extra Peritoneal (e-TEP) Approach for Ventral and Incisional Hernia—Early results from a single center. Surg Endosc 35, 2005–2013 (2021). https://doi.org/10.1007/s00464-020-07595-4

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