A Retrospective Cohort Study Comparing Short-Term Outcomes of Enhanced Total Extraperitoneal (eTEP) and Robotic Transabdominal Pre-peritoneal (rTAPP) Mesh Repairs for Primary Midline Ventral Hernias (PMVH)
摘要
Minimally invasive sublay repair is increasingly being accepted as the preferred operation for primary midline ventral hernias (PMVHs). Enhanced total extraperitoneal (eTEP) and robotic transabdominal pre-peritoneal (rTAPP) repairs involve placement of mesh in the sublay plane. We evaluated both techniques and presented our experience. This cohort study involved a retrospective analysis of prospectively collected data from a single specialized minimally invasive surgical unit of a tertiary care hospital. The data of all patients who underwent the eTEP and rTAPP procedures for PMVHs between December 2022 and March 2024 were analysed. Primary outcomes analysed were operative time, defect size, mesh size, postoperative pain, length of stay, and early complications. The eTEP and rTAPP groups were compared using chi-square and independent sample t tests. A brief description of both operative techniques has been provided. Data of 90 patients (49 in the eTEP group vs. 41 in the rTAPP group) were analysed. Both the groups had similar preoperative characteristics. For the rTAPP approach, the operative time was longer (p < 0.0001), while postoperative pain was less (p < 0.0001) than that in the eTEP group. Both rTAPP and eTEP appeared to be safe and reproducible for the repair of PMVHs. rTAPP seems to be beneficial for smaller PMVHs with minimal or no divarication of the recti, as it has a better pain profile. eTEP may be a better choice for larger PMVHs associated with significant divarication of the recti. The use of a robotic platform increased operative time.