Separación de componentes videoscópica en el tratamiento de eventraciones y otros defectos de la pared abdominal: análisis de una serie inicial / Endoscopic component separaton technique in the repair of incisional hernia and other abdominal wall defects: analysis of an inital series

RESUMEN

Antecedentes la eventroplasta laparoscópica es una técnica con ventajas comprobadas, pero con limitaciones en defectos grandes de pared. Se ha postulado que la separación videoscópica de componentes (SCV) podría mejorar los resultados en estos casos. Objetivo: evaluar una serie de pacientes a quienes se les realizó la SCV, como complemento en la reparación de los defectos de la pared abdominal. Material y métodos: se registran el tipo y el tamaño del defecto de la pared abdominal, el tamaño de la malla utilizada, el número de fjaciones, el tempo quirúrgico, el tempo de SCV, la morbimortalidad y la recidiva. Resultados: el diámetro de los defectos fue de 12 cm y se logró el cierre en todos los casos. No hubo complicaciones intraoperatorias. En cuanto a la morbilidad posoperatoria se registraron 3 casos 1 dolor abdominal no habitual, 1 complicación cardiológica y 1 obstrucción intestinal posoperatoria.No hubo recidivas durante el tempo de seguimiento (18,5 meses). Conclusiones: la SCV es un procedimiento de gran utilidad como complemento en la reparación de los defectos de la pared abdominal. Logra un deslizamiento de 6 a 8 cm de cada lado en los rectos abdominales hacia la línea media, permitendo disminuir el tamaño del defecto o lograr su cierre.

ABSTRACT

Background: although laparoscopic incisional hernia repair has proven advantages limitatons should be considered when applied to large abdominal wall defects. The endoscopic component separaton (ECS) technique could achieve beter results in those patents. Objective: to evaluate a number of patents who were treated with ECS as a complement of the laparoscopic repair of large wall defects. Methods: descriptive analysis of a prospective series of patents. Patents with abdominal wall defects that were treated laparoscopically associating ECS were included. The type and size of the abdominal wall defect, size of mesh the fxaton used, surgical and ECS technique tme, morbimortality and recu-rrence were recorded. Results: sixteen patents were included, the average size of the defects was 12 cm in diameter and closure was accomplished in every patent. There were no intraoperative complicatons .There were 3 cases of post operative morbidity one patent had abdominal pain and required more painkillers than usual, one patent without cardiac history had a cardiac event and one patent had post-operative intestinal obstructon. There were no recurrences during the follow up (18 months). Conclusion: the ECS technique is a useful procedure as a complement in the repair of abdominal wall defects. A displacement of 6-8 cm of the rectus abdominis to the middle line is achieved,, allowing the reducton or the closure of the abdominal wall defect.