eTEP RS Approach for Ventral Hernia - A Short Term Observational Case Series of Our Initial Experience

Background: There has been a significant increase in ventral hernia surgeries over the last few decades. The operative modalities have changed from open surgery to a wide variety of laparoscopic surgery procedures. Our objective of this study is to present the early clinical results of the procedure, its feasibility and key technical aspects.

Methods: This is a prospective short term 6 months analysis of 15 patients in our hospital who underwent eTEP RS surgery for small to medium size ventral hernias between December 2021 and December 2022. We performed an observational study of the feasibility and clinical outcome of the procedure and analysis of the data in terms of operative details, intraoperative and postoperative complications.

Results: Out of 15 patient, 1 patient required conversion to Open Rives Stoppa procedure and was excluded from the study. 14 patients underwent eTEP RS procedure. One patient required additional Transversus Abdominis Release (TAR) procedure for tension free posterior wall closure. The mean duration was 187.5 min and mean postoperative stay was 2.07 days. The mean defect size was 15.28 cm2 and average mesh size 359.64 cm2. At 6 months follow up, there was no recurrence on clinical examination. However 2 patients had seroma which was managed conservatively.

Conclusion: eTEP RS Procedure is a safe and effective procedure for ventral hernia repair. However surgeons need to have a reasonable skill and expertise in minimally invasive surgery with an understanding of anterior abdominal wall anatomy. Proper case selection in the initial few patients is important.