It is obvious that the results of conventional open and minimally invasive procedures for inguinal hernia repair have stagnated in terms of quality for the past 30 years: 10–12% recurrences, 5–8% chronic pain. It is therefore justified to look for new approaches. This chapter describes the robot-assisted r-TAPP and illustrates the extensive resources available with the robotic platform using special intraoperative findings, dealing with the anatomy and the fascinating possibilities of morphological reconstruction of the posterior wall of the inguinal canal; this justifies calling it r-TAPP 2.0. The concept of parietalization described here, which follows Hesselbach’s ligament and the iliopubic tract (HIP concept, or Hesselbach-iliopubic-tract-concept), is new and has the potential to improve the anatomical quality of care beyond the limits of known concepts. The surgical steps are described individually and the results of the literature are discussed. This chapter includes a video contribution on r-TAPP 2.0.

错误:搜索内容不能为空,请输入英文关键词
错误:关键词超出字数限制,请精简
高级检索

Robotic Transabdominal Inguinal and Femoral Hernia Repair (r-TAPP 2.0)

  • Ulrich A. Dietz,
  • Michaela Ramser,
  • Johannes Baur

摘要

It is obvious that the results of conventional open and minimally invasive procedures for inguinal hernia repair have stagnated in terms of quality for the past 30 years: 10–12% recurrences, 5–8% chronic pain. It is therefore justified to look for new approaches. This chapter describes the robot-assisted r-TAPP and illustrates the extensive resources available with the robotic platform using special intraoperative findings, dealing with the anatomy and the fascinating possibilities of morphological reconstruction of the posterior wall of the inguinal canal; this justifies calling it r-TAPP 2.0. The concept of parietalization described here, which follows Hesselbach’s ligament and the iliopubic tract (HIP concept, or Hesselbach-iliopubic-tract-concept), is new and has the potential to improve the anatomical quality of care beyond the limits of known concepts. The surgical steps are described individually and the results of the literature are discussed. This chapter includes a video contribution on r-TAPP 2.0.