PMID- 27728955
OWN - NLM
STAT- MEDLINE
DCOM- 20180920
LR  - 20181004
IS  - 1090-3941 (Print)
IS  - 1090-3941 (Linking)
VI  - 29
DP  - 2016 Oct 26
TI  - Laparoscopic Stapled Sublay Repair With Self-Gripping Mesh: A Simplified 
      Technique for Minimally Invasive Extraperitoneal Ventral Hernia Repair.
PG  - 131-139
AB  - INTRODUCTION: Minimally invasive laparoscopic and robotic techniques for ventral 
      hernia repair have evolved to achieve the benefits and minimize the limitations 
      of both the open Rives-Stoppa sublay mesh repair and laparoscopic intraperitoneal 
      onlay mesh (IPOM) repair. By combining the principles of a retromuscular repair 
      with the benefits of a minimally invasive approach, these techniques attempt to 
      decrease recurrence, increase functionality, exclude mesh from the viscera, limit 
      infection and wound complications, and minimize pain. The difficult ergonomics, 
      challenging dissection, and extensive suturing make traditional laparoscopic 
      sublay repair technically challenging and has led to increased robotic 
      utilization to overcome these limitations. We describe a laparoscopic 
      extraperitoneal sublay mesh repair technique using an endoscopic stapler to 
      facilitate reapproximation of the linea alba and creation of the retromuscular 
      space, and self-gripping mesh to position and fixate the prosthetic. MATERIALS 
      AND METHODS: Between January and June 2016, 10 patients with midline ventral and 
      incisional hernias underwent laparoscopic extraperitoneal stapled sublay mesh 
      repair with self-gripping mesh. Three of these cases included a laparoscopic 
      posterior component separation with myofascial release of the transversus 
      abdominis muscle to facilitate midline closure. Intraoperative and perioperative 
      complications, early recurrence, pain, and narcotic usage were measured. RESULTS: 
      There were no significant intraoperative complications or conversions to open 
      surgery. Patients were discharged at 1.2 days on average. Early postoperative 
      complications included a hernia site seroma in one patient, which resolved 
      without intervention. There were no early postoperative infections or 
      recurrences. Compared with traditional laparoscopic IPOM repair, there was less 
      acute postoperative pain and use of analgesics. CONCLUSIONS: Laparoscopic 
      extraperitoneal stapled sublay mesh repair is a safe and effective method for the 
      treatment of medium- to large-sized ventral and incisional hernias. This 
      extraperitoneal stapled approach using self-gripping mesh facilitates a minimally 
      invasive sublay repair and abdominal wall reconstruction using traditional 
      laparoscopic tools.
FAU - Moore, Alexandra M
AU  - Moore AM
AD  - General Surgery, David Geffen School of Medicine at UCLA, Los Angeles, 
      California.
FAU - Anderson, Lisa N
AU  - Anderson LN
AD  - Texas A&M Health Science Center, College of Medicine, Bryan, Texas.
FAU - Chen, David C
AU  - Chen DC
AD  - Clinical Surgery, David Geffen School of Medicine at UCLA, Los Angeles, 
      California.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Surg Technol Int
JT  - Surgical technology international
JID - 9604509
SB  - IM
MH  - Hernia, Ventral
MH  - Herniorrhaphy/*methods
MH  - Humans
MH  - Incisional Hernia
MH  - *Laparoscopy
MH  - Postoperative Complications
MH  - Recurrence
MH  - *Surgical Mesh
EDAT- 2016/10/12 06:00
MHDA- 2018/09/21 06:00
CRDT- 2016/10/12 06:00
PHST- 2016/10/12 06:00 [pubmed]
PHST- 2018/09/21 06:00 [medline]
PHST- 2016/10/12 06:00 [entrez]
AID - sti29/789 [pii]
PST - ppublish
SO  - Surg Technol Int. 2016 Oct 26;29:131-139.