Minimally Invasive Approach to Supra-pubic and Non-Midline Lower Abdominal Ventral Hernia: An Extended Indication of TAPE Technique.
10.7602/jmis.2017.20.3.84
- Author:
Joe King Man FAN
1
;
Jeremy YIP
;
Matrix FUNG
;
Oswens Siu Hung LO
;
Jianwen LIU
;
Xuefei YANG
;
Kejin CHEN
;
Wai Lun LAW
Author Information
1. Department of Surgery, The University of Hong Kong, Li Ka Shing Faculty of Medicine, HKSAR, China. drjoefan@hku.hk
- Publication Type:Review
- Keywords:
Supra-pubic;
Non-midline Ventral Hernia;
Ventral Hernia;
TAPE;
Laparoscopic
- MeSH:
Fibrosis;
Follow-Up Studies;
Hernia;
Hernia, Abdominal;
Hernia, Ventral*;
Incisional Hernia;
Ligaments
- From:Journal of Minimally Invasive Surgery
2017;20(3):84-92
- CountryRepublic of Korea
- Language:English
-
Abstract:
Repair of lower abdominal incisional hernia is always a surgical challenge. TAPE technique has been described for the repair of supra-pubic midline incisional hernia with satisfactory outcome. Its indication can be extended for treatment of non-midline lower abdominal hernia. Peritoneal incision is created just below the hernia defect with pre-peritoneal dissection to expose supra-pubic preperitoneal space with Cooper's ligament exposed. Non-adhesive mesh then placed over preperitoneal space and partially intra-peritoneally, and cover the whole extra-peritoneal space prepared to ensure enough overlapping. Mesh is fixed by tackers for intra-peritoneal part, most inferior fixation points were at peritoneal incision line. Extra-peritoneal part of meshes is fixed at the safety zone and covered up by the peritoneal flap to avoid mesh migration. Fixation of the meshes at the lateral aspects were facilitated by the peritoneal flap and subsequent fibrosis and adhesion to the extra-peritoneal structures in cases of lateral lower abdominal hernia. Repair of midline and lateral lower abdominal incisional hernia with this novel modified technique with prosthetic mesh is safe and effective. A larger case series and longer follow-up is required for validation of this technique.
