A Novel Minimally Invasive Retro Rectus Repair of Ventral Hernia

Abstract

Background Ventral hernia repair is one of the common general surgical procedures. A novel eTEP technique has been developed where in a mesh is placed in retro muscular plane through minimally invasive approach. There is scarcity of data on its effectiveness as compared to conventional Laparoscopic IPOM hernioplasty. Aims and Objectives We aim to introduce our innovative Kumar-Subhash’s modified 3 port eTEP technique for ventral hernia repair and compare its clinical effectiveness with conventional IPOM repair.  Methods A prospective comparative study was undertaken at Devagiri Hospital, Bangalore, India from January 2017 to December 2019. 30 patients were included in the study (12 in eTEP group and 18 in IPOM group) based on predefined inclusion and exclusion criteria. Patients were followed up to 30 days post-operatively. The outcomes were compared with respect to postoperative pain, length of hospital stay and early postoperative complications. Results Baseline characteristics and presenting complaints were comparable for both the groups. The mean pain score on POD 1 in eTEP group was 3, and 1 on POD 7 as compared to 7 and 3 in IPOM group on POD1 and 7 respectively, which was statistically significant. Patients in eTEP group had a shorter length of hospital stay (LOS). None of the patients had any complications related to the novel technique. Conclusions Kumar-Subhash’s modified 3 port eTEP technique is a novel and easy approach for laparoscopic repair of ventral hernia with significantly less post-operative pain and LOS with an additional cosmetic advantage for patients.