K Bauer, R Vogel, F Heinzelmann, P Büchler, Björn Mück
{"title":"机器人辅助腹侧疝手术 - 用机器人辅助方法重建腹膜后和腹膜前腹壁的经验。","authors":"K Bauer, R Vogel, F Heinzelmann, P Büchler, Björn Mück","doi":"10.1007/s10029-024-03132-7","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Due to the proximity to bony structures and the complex anatomy of the three-layered lateral abdominal wall, the surgical treatment of lateral ventral hernias is technically demanding. With this study we would like to demonstrate how lateral abdominal wall hernias can be treated using new robotic surgical techniques with extraperitoneal mesh placement.</p><p><strong>Objectives: </strong>The purpose of this study is to demonstrate that the application of the robot in minimally invasive treatment of lateral abdominal wall hernias is safe and efficient.</p><p><strong>Materials and methods: </strong>A retrospective analysis of all patients who underwent robotically-assisted lateral ventral hernia repair surgery from June 2019 to December 2023 was performed.</p><p><strong>Results: </strong>A total of 50 ventral hernias were operated robotically due to a lateral hernia in the study period. 45 patients had an incisional hernia and 5 patients a primary spighelian hernia. 27 patients had only lateral findings, whereas 23 patients had combined hernias with lateral and medial hernial defects. 18 patients were treated with a preperitoneal mesh (r-vTAPP). 31 patients required TAR to achieve complete fascial closure and sufficient mesh overlap (24 extraperitoneal approach r-eTAR/7 transperitonel approach r-TAR). One patient had to be converted intraoperatively from a planned preperitoneal mesh to an intraperitoneal mesh repair (r-IPOM). The median hernia defect area was 71 cm² (3-375 cm²). The median mesh size was 600 cm² (150-1290 cm²). The median mesh defect ratio (MDR) was 10 (2,33-133,33). Five postoperative complications were encountered (10%). Two reoperations (4%) were required.</p><p><strong>Conclusion: </strong>The utilization of new robotic surgical techniques provides a safe minimally invasive treatment option even for complex lateral ventral hernias that previously posed difficulties in surgical management. The early postoperative results show promising outcomes.</p>","PeriodicalId":13168,"journal":{"name":"Hernia","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Robotic-assisted surgery for lateral ventral hernias - experience of robot-assisted methods for retromuscular and preperitoneal abdominal wall reconstruction.\",\"authors\":\"K Bauer, R Vogel, F Heinzelmann, P Büchler, Björn Mück\",\"doi\":\"10.1007/s10029-024-03132-7\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Due to the proximity to bony structures and the complex anatomy of the three-layered lateral abdominal wall, the surgical treatment of lateral ventral hernias is technically demanding. With this study we would like to demonstrate how lateral abdominal wall hernias can be treated using new robotic surgical techniques with extraperitoneal mesh placement.</p><p><strong>Objectives: </strong>The purpose of this study is to demonstrate that the application of the robot in minimally invasive treatment of lateral abdominal wall hernias is safe and efficient.</p><p><strong>Materials and methods: </strong>A retrospective analysis of all patients who underwent robotically-assisted lateral ventral hernia repair surgery from June 2019 to December 2023 was performed.</p><p><strong>Results: </strong>A total of 50 ventral hernias were operated robotically due to a lateral hernia in the study period. 45 patients had an incisional hernia and 5 patients a primary spighelian hernia. 27 patients had only lateral findings, whereas 23 patients had combined hernias with lateral and medial hernial defects. 18 patients were treated with a preperitoneal mesh (r-vTAPP). 31 patients required TAR to achieve complete fascial closure and sufficient mesh overlap (24 extraperitoneal approach r-eTAR/7 transperitonel approach r-TAR). One patient had to be converted intraoperatively from a planned preperitoneal mesh to an intraperitoneal mesh repair (r-IPOM). The median hernia defect area was 71 cm² (3-375 cm²). The median mesh size was 600 cm² (150-1290 cm²). The median mesh defect ratio (MDR) was 10 (2,33-133,33). Five postoperative complications were encountered (10%). Two reoperations (4%) were required.</p><p><strong>Conclusion: </strong>The utilization of new robotic surgical techniques provides a safe minimally invasive treatment option even for complex lateral ventral hernias that previously posed difficulties in surgical management. 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Robotic-assisted surgery for lateral ventral hernias - experience of robot-assisted methods for retromuscular and preperitoneal abdominal wall reconstruction.
Background: Due to the proximity to bony structures and the complex anatomy of the three-layered lateral abdominal wall, the surgical treatment of lateral ventral hernias is technically demanding. With this study we would like to demonstrate how lateral abdominal wall hernias can be treated using new robotic surgical techniques with extraperitoneal mesh placement.
Objectives: The purpose of this study is to demonstrate that the application of the robot in minimally invasive treatment of lateral abdominal wall hernias is safe and efficient.
Materials and methods: A retrospective analysis of all patients who underwent robotically-assisted lateral ventral hernia repair surgery from June 2019 to December 2023 was performed.
Results: A total of 50 ventral hernias were operated robotically due to a lateral hernia in the study period. 45 patients had an incisional hernia and 5 patients a primary spighelian hernia. 27 patients had only lateral findings, whereas 23 patients had combined hernias with lateral and medial hernial defects. 18 patients were treated with a preperitoneal mesh (r-vTAPP). 31 patients required TAR to achieve complete fascial closure and sufficient mesh overlap (24 extraperitoneal approach r-eTAR/7 transperitonel approach r-TAR). One patient had to be converted intraoperatively from a planned preperitoneal mesh to an intraperitoneal mesh repair (r-IPOM). The median hernia defect area was 71 cm² (3-375 cm²). The median mesh size was 600 cm² (150-1290 cm²). The median mesh defect ratio (MDR) was 10 (2,33-133,33). Five postoperative complications were encountered (10%). Two reoperations (4%) were required.
Conclusion: The utilization of new robotic surgical techniques provides a safe minimally invasive treatment option even for complex lateral ventral hernias that previously posed difficulties in surgical management. The early postoperative results show promising outcomes.
期刊介绍：
Hernia was founded in 1997 by Jean P. Chevrel with the purpose of promoting clinical studies and basic research as they apply to groin hernias and the abdominal wall . Since that time, a true revolution in the field of hernia studies has transformed the field from a ”simple” disease to one that is very specialized. While the majority of surgeries for primary inguinal and abdominal wall hernia are performed in hospitals worldwide, complex situations such as multi recurrences, complications, abdominal wall reconstructions and others are being studied and treated in specialist centers. As a result, major institutions and societies are creating specific parameters and criteria to better address the complexities of hernia surgery.
Hernia is a journal written by surgeons who have made abdominal wall surgery their specific field of interest, but we will consider publishing content from any surgeon who wishes to improve the science of this field. The Journal aims to ensure that hernia surgery is safer and easier for surgeons as well as patients, and provides a forum to all surgeons in the exchange of new ideas, results, and important research that is the basis of professional activity.
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