Comparative study between sharp dissection and electro cautery dissection in incisional hernia surgery.

Abstract Aim The aim of this study is to present a single centre’s experience in Robotic and Laparoscopic eTEP TAR technique in ventral and incisional hernia repair. Additionally, the purpose of this study is to compare these Robotic and Laparoscopic techniques in terms of feasibility, efficacy, safety, advantages and disadvantages. Material and Methods This is a case-series comparative study of patients with M1-M5 / W3 ventral and incisional hernia that underwent Robotic or Laparoscopic eTEP-TAR repair in a single institution. Patients’ characteristics were reviewed and perioperative outcomes were extracted. All patients were followed-up at the outpatient surgical unit. Intraoperative and postoperative parameters were analyzed. Results 35 patients (19 males) with a mean age of 57 years underwent Robotic eTEP-TAR (21 patients) and Laparoscopic eTEP-TAR (14 patients) repair of M1-M3/W3 ventral (12 patients) and M2-M5/W3 incisional hernia. There were 3 conversions to open repair in the Robotic group (Rg) and 1 for the Laparoscopic group (Lg). The mean operative time in Rg was 345 minutes, while in Lg was 320 min. All patients were discharged between the first and fifth postoperative day. No major complications or recurrences were revealed during a mean postoperative follow-up time of 26 months. Conclusions Both techniques are feasible, reproducible, and safe, with no major differences in operative time, recurrence and complications rate. Nevertheless, these techniques are highly demanding procedures that should be performed by experienced hernia surgeons, in well-organized centers of excellence in hernia surgery.

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OV10 LAPAROSCOPIC-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN HERNIA SURGERY - HOW WE DO IT

British Journal of Surgery ◽

10.1093/bjs/znab396.061 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Mário Rui Gonçalves ◽

Conceição Antunes ◽

Mariana Capinha ◽

Ana Rita Arantes ◽

Paulo Almeida ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Ventral Hernia ◽

Incisional Hernia Repair ◽

Transversus Abdominis ◽

Direct Visualization ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Hernia Surgery ◽

Surgical Department

Abstract Aim “COVID has been a great challenge for Hospitals around the world. At our surgical department a new protocol of TAP block was designed and implemented in our laparoscopic incisional ventral hernia repairs, to allow these patients to be operated in ambulatory regime, without compromising pain control and the outcomes. In this video we aim to present the technique for the Laparoscopic-guided TAP Block during a Laparoscopic IPOM Plus ventral hernia repair.” Material and Methods “We implemented this protocol in July 2020 and since then, we performed 18 TAP block in laparoscopic incisional hernia repairs, laparoscopic guided by the Surgeon or ultrasound-guided by the Anesthesiologist. In this case, the video reports to a Laparoscopic IPOM Plus incisional hernia repair performed on a 54-year-old patient, male, with obesity, arterial hypertension and dyslipidemia. He had a 6 centimeter incisional hernia post-colorectal surgery in 2013.” Results “As detailed in the video, we show all the steps to perform a TAP block under laparoscopic direct visualization” Conclusions “TAP block can be performed by the Surgeon, with direct visualization at the beginning of the laparoscopic procedure.”

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