Endoscopic-assisted repair of combined ventral hernias and diastasis recti: minimizing seroma incidence by quilting.

BACKGROUND: To reduce the incidence of seromas, we have adapted the quilting procedure used in open abdominoplasty to the endoscopic-assisted repair of concomitant ventral hernia (VH) and diastasis recti (DR). The aim of this study was to describe the technique and assess its efficacy by comparing two groups of patients operated on with the same repair technique before and after introducing the quilting. METHODS: This retrospective study included data prospectively registered in the French Club Hernie database from 176 consecutive patients who underwent surgery for concomitant VH and DR via the double-layer suturing technique. Patients were categorized into two groups: Group 1 comprised 102 patients operated before introducing the quilting procedure and Group 2 comprised 74 operated after introducing the quilting. To carry out comparisons between groups, seromas were classified into two types: type A included spontaneously resorbable seromas and seromas drained by a single puncture and type B included seromas requiring two or more punctures and complicated cases requiring reoperation. RESULTS: The global percentage of seromas was 24.4%. The percentage of seromas of any type was greater in Group 1 (27.5%) than in Group 2 (20.3%). The percentage of Type B seromas was greater in Group 1 (19.6%) than in Group 2 (5.4%), when the percentage of Type A seromas was greater in Group 2 (14.9) than in Group 1 (7.9%). Differences were significant (p = 0.014). The operation duration was longer in Group 2 (83.9 min) than in Group 1 (69.9 min). Four complications requiring reoperation were observed in Group 1: three persistent seromas requiring surgical drainage under general anesthesia and one encapsulated seroma. CONCLUSION: Adapting the quilting technique to the endoscopic-assisted bilayer suturing technique for combined VH and DR repair can significantly reduce the incidence and severity of postoperative seromas.

Correction of Rectus Abdominis Diastasis: A Prospective Comparative Study Between a New Suturable Polypropylene Mesh vs Polypropylene Standard Suture Plication.

BACKGROUND: Duramesh (Mesh Suture Inc., Chicago, IL) is a new suturing concept, combining the principles of mesh with the precision, flexibility, and versatility of a suture, suitable also for abdominal rectus diastasis (ARD) correction. OBJECTIVES: This prospective research aimed to compare mesh with the standard polypropylene suture plication for rectus diastasis repair with regard to safety (infection, seroma, hematoma, surgical wound dehiscence, and fistula rates and hospital stay); effectiveness (ARD recurrence by ultrasound sonography, palpability of the muscular suture, surgical time, and postoperative pain evaluation); and satisfaction of the patients based on the BODY-Q, a patient-reported outcome measure. METHODS: Sixty-five of the initial 70 patients who underwent rectus diastasis repair with a 6-month follow-up were randomly divided into 2 groups, comprising 33 patients treated with Duramesh and 32 patients treated with standard 0 polypropylene suture plication. Data regarding infection, seroma, hematoma, surgical wound dehiscence, and fistula rates; hospital stay; ARD recurrence; palpability of the muscular suture; surgical time; postoperative pain evaluation (measured by visual analog scale, or VAS); and the BODY-Q were analyzed by Prism 9 (GraphPad Software Inc., San Diego, CA). RESULTS: No significant differences were reported between the 2 groups with regard to infection, seroma, hematoma, surgical wound dehiscence, and fistula rates and hospital stay. The mesh decreased the time required to perform plication compared with standard polypropylene detached sutures. No statistically significant differences were found with respect to the VAS and BODY-Q data. CONCLUSIONS: Duramesh 0 application for rectus diastasis repair is safe and effective without compromising aesthetic improvement when compared with standard 0 polypropylene plication.

Comparative analysis of the efficacy and functionality of abdominoplasty versus minimally invasive techniques in the surgical treatment of diastasis rectus abdominis in postpartum women.

INTRODUCTION: This review aims to describe the surgical options available for treatment of diastasis recti in postpartum women, as well as compare the effectiveness of these treatment options. Historically, diastasis recti has been repaired through open procedures, such as abdominoplasty. More recently, studies have explored other methods for the treatment of diastasis recti, including various minimally invasive surgical options. METHODS: Twelve studies ranging from 2015 to 2022 were included in this analysis. Studies were identified using PubMed, EMBASE, and Cochrane Library. Studies that met the inclusion criteria were analyzed descriptively. Statistical comparison of surgical outcomes between studies was performed using Fisher's Exact Test in SPSS. RESULTS: Minimally invasive approaches were categorized as laparoscopic preaponeurotic approaches, robotic approaches, and enhanced-view/extended totally extraperitoneal (eTEP) approaches. These techniques were compared to two open approaches: abdominoplasty and miniabdominoplasty. There were no significant differences in the rate of seromas, surgical site infections/complications, or hematomas between abdominoplasty and minimally invasive surgical techniques (p > 0.05). Among the minimally invasive techniques, no significant differences in readmission rates were reported (p > 0.05). Additionally, no significant differences in recurrence rates were seen following minimally invasive or abdominoplasty repairs, except for the increased recurrence rates seen with the r-TARRD robotic technique (p < 0.05). CONCLUSION: Although current data on minimally invasive approaches is limited, our review reveals that both open and minimally invasive approaches are viable options for diastasis recti repair in postpartum women. Identifying the optimal approach for diastasis recti repair should rely on the patient's desired treatment outcome. If the patient indicates a desire for the removal of excess abdominal subcutaneous tissue, abdominoplasty may be a better surgical approach. Alternatively, if the patient puts a greater emphasis on shorter recovery time and smaller surgical incisions/scars, minimally invasive approaches may be a better surgical option.

Endoscopic treatment of diastasis recti: Training method and literature review.

INTRODUCTION: Endoscopic treatment of diastasis rectus abdominis offers the possibility of correcting the condition without complete abdominoplasty. The purpose of this study was to develop a training method on fresh cadavers models based on a literature review on this surgery. MATERIAL AND METHODS: The endoscopic procedure considered involved the insertion of a 10mm suprapubic trocar and of 5mm trocars in each iliac fossae. The muscle suture is done using running barbed suture. The surgery was performed on eight fresh cadavers to estimate the learning curve for this intervention, which was estimated with the CUSUM method. A systematic literature review in the PubMed database was performed, and 20 articles that met the inclusion criteria were analyzed. RESULTS: The learning curve threshold was reached after 6 operations and can be separated into two phases. The most common complication of this surgery is seroma, it is encountered in 3 to 27% of cases according to the studies. Diastasis recurrence is rare, occurring in less than 2% of cases. In comparison, open surgical treatment of diastasis recti is associated with a higher risk of hematoma, skin necrosis and longer operating times. Recurrence rates are similarly low after open and endoscopic repair. Mesh reinforcement is indicated in cases of diastasis wider than 5cm, diastasis recurrence, severe musculoaponeurotic laxity, or hernia larger than 1cm. CONCLUSION: The data in the literature indicate that laparoscopic surgery is an efficient and safe approach to correct diastasis of the rectus muscles and can be offered by plastic surgeons to selected patients.

Minimally invasive bilayer suturing technique for the repair of concomitant ventral hernias and diastasis recti.

BACKGROUND: According to EHS guidelines, mesh repair is recommended in case of concomitant diastasis recti (DR) and ventral hernia more than 1 cm in diameter. Since in this situation, the higher risk of hernia recurrence may be attributed to the weakness of aponeurotic layers, in our current practice, for hernias up to 3 cm, we use a bilayer suture technique. The study aimed at describing our surgical technique and evaluating the results of our current practice. METHODS: The technique combines suturing repair of the hernia orifice and diastasis correction by suture, and includes an open step through periumbilical incision and an endoscopic step. The study is an observational report on 77 cases of concomitant ventral hernias and DR. RESULTS: The median diameter of the hernia orifice was 1.5 cm (0.8-3). The median inter-rectus distance was 60 mm (30-120) at rest and 38 mm (10-85) at leg raise at tape measurement and 43 mm (25-92) and 35 mm (25-85) at CT scan respectively. Postoperative complications involved 22 seromas (28.6%), 1 hematoma (1.3%) and 1 early diastasis recurrence (1.3%). At mid-term evaluation, with 19 (12-33) months follow-up, 75 (97.4%) patients were evaluated. There were no hernia recurrences and 2 (2.6%) diastasis recurrences. The patients rated the result of their operation as excellent or good in 92% and 80% of the cases at global and esthetic evaluations, respectively. The result was rated bad at esthetic evaluation in 20% of the cases because the skin appearance was flawed, due to discrepancy between the unchanged cutaneous layer and the narrowed musculoaponeurotic layer. CONCLUSION: The technique provides effective repair of concomitant diastasis and ventral hernias up to 3 cm. Nevertheless, patients should be informed that the skin appearance can be flawed, because of the discrepancy between the unchanged cutaneous layer and the narrowed musculoaponeurotic layer.

Alternativa de manejo miniinvasivo para el tratamiento de pacientes con diástasis abdominal y colgajo dermograso mediante la táctica VER: Vaser® + endoscopia + Renuvion® / Minimally invasive management alternative for the treatment of patients with abdominal diastasis and dermo-fat flap using the VER tactic: Vaser® + endoscopy + Renuvion®

El tratamiento de la diástasis abdominal en pacientes con colgajo dermograso no está estandarizado y puede realizarse mediante diferentes técnicas. Presentamos una alternativa para el manejo miniinvasivo de pacientes con diástasis abdominal asociada a colgajo dermograso mediante la combinación de tres procedimientos que denominamos "táctica VER": Vaser® + endoscopia + Renuvion®. Según nuestra experiencia preliminar, la combinación de los 3 procedimientos es segura y efectiva en los casos seleccionados

The treatment of abdominal diastasis in patients with a dermo-fat flap is not standardized and can be performed using different techniques. We present an alternative for the minimally invasive management of patients with abdominal diastasis associated with dermo-fat flap through the combination of three procedures that we call "VER tactic": Vaser® + Endoscopy + Renuvion®. Based on our preliminary experience, the combination of the 3 procedures is safe and effective in selected cases

Preaponeurotic endoscopic repair (REPA) of diastasis recti: a single surgeon's experience.

BACKGROUND: Diastasis recti is a pathology that affects not only the abdominal wall but also the stability of lumbopelvic muscles, consequently altering urinary and digestive functionality. Preaponeurotic endoscopic repair (REPA) is an endoscopic alternative to tummy tuck for the treatment of diastasis. In this study, the outcomes of REPA application by a single surgeon are presented. METHODS: A total of 172 patients underwent REPA for the treatment of diastasis recti between August 2017 and December 2019. One hundred twenty-four patients were followed for at least one year. Sixty-three patients responded to a survey on satisfaction and quality of life 12 months after surgery. RESULTS: Three (2.4%) recurrences occurred, of which two occurred in the same patient. The main postoperative complications observed were 12 (9.7%) seromas, 3 (2.4%) haematomas, a single wound infection, 3 (2.4%) cases of skin fold formation, and a case of trophic skin lesion that required negative pressure therapy. Quality of life after surgery, as reported by 63 patients who responded to the survey, was satisfactory. CONCLUSIONS: REPA is a safe and effective technique for diastasis recti treatment, representing a valid alternative to abdominoplasty. Since there is no need to access the peritoneal cavity and the mesh is onlay, there are no risks of bowel damage or adhesions between the intestine and prosthesis.

The prevalence and consequences of abdominal rectus muscle diastasis among Finnish women: an epidemiological cohort study.

PURPOSE: Post-pregnancy abdominal rectus diastasis (ARD) has raised attention in the field of surgery in recent years, but there is no consensus about when to consider surgery. Our aim was to find out what is the normal inter-rectus distance in fertile aged, female population in Finland and to examine whether there is a linea alba width that would predispose to diastasis-related problems after pregnancy. METHODS: For this prospective cohort study, women participating early pregnancy ultrasound in Helsinki University Hospital Department of Obstetrics and Gynecology during 1.1.2018-8.3.2019, were recruited. The width of linea alba was measured by ultrasound during the early pregnancy ultrasound. Symptoms were measured by questionnaire including Health-Related Quality of Life (RAND-36) and Oswestry Disability Index for back symptoms and disability. RESULTS: Linea alba width was measured in total of 933 women. The average inter-rectus distance (IRD) among nulliparous women was 1.81 ± 0.72 cm. After one previous pregnancy, the average linea alba width was 2.36 cm ± 0.83 cm and after more pregnancies 2.55 ± 1.09 cm. There was a positive correlation between previous pregnancies and the increased linea alba width (p = 0.00004). We did not perceive any threshold value of linea alba width that would predispose to back pain or movement control problems in this cohort, in which severe diastasis (over 5 cm) was rare. CONCLUSION: Mean inter-rectus distance in parous population exceeds stated normative values. Moderate ARD (3.0-5.0 cm) alone does not seem to explain low back pain or functional disability in population level. Severe post-pregnancy diastasis (over 5.0 cm) is rare.

Diagnostic techniques for diastasis recti.

Diastasis recti (DR) is an abnormality of the anterior abdominal wall, characterized by a separation of the rectus abdominis muscles along the linea alba. A thorough history and physical exam can diagnose most cases of diastasis recti. Classification schemes for diastasis recti have been created based on inter-rectus distance and location of the defect, which can help with management decisions. Imaging modalities such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) can aid in the classification of diastasis recti and guide surgical planning. Planning is most important when contemplating the plan of care for the repair of hernias within a rectus diastasis.

Endoscopic onlay repair for ventral hernia and rectus abdominis diastasis repair: Why so many different names for the same procedure? A qualitative systematic review.

BACKGROUND: A subcutaneous endoscopic onlay repair for ventral hernia with an anterior plication of diastasis recti (DR) has been published under different names in different countries. The aim of this systematic review is to assess the safety and feasibility of different named techniques with the same surgical concept. METHODS: The PRISMA guidelines were followed during all stages of this systematic review. The MINORS score system was used to perform qualitative assessment of all studies included in this review. Recommendations were then summarized for the following pre-defined key items: protocol, research question, search strategy, study eligibility, data extraction, study designs, risk of bias, publication bias, heterogeneity, and statistical analysis. RESULTS: The systematic literature search found 2548 articles, 317 of which were duplicates and excluded from analysis. The titles and abstracts from the remaining 2231 articles were assessed. After careful evaluation, 2125 articles were determined to be unrelated to our study and subsequently excluded. The full text of the remaining 106 articles was thoroughly assessed. Case reports, editorials, letters to the editor, and general reviews were then excluded. A total of 13 articles were ultimately included for this review, describing a similar subcutaneous endoscopic approach for repair of concomitant ventral hernias and rectus diastasis defined under nine different named techniques on 716 patients. The number of patients in those studies varied from 10 to 201. The mean operative time varied from 68.5 to 195 min. The most common complication was seroma, followed by pain requiring intervention, hematoma, and surgical site infection. CONCLUSIONS: There are a few technique variations described in different studies, but with no significant differences in outcomes. We, therefore, propose to unify these procedures under one term, ENDoscopic Onlay Repair (ENDOR). This technique has shown to be effective and safe, with seroma being the most common complication.

Effect of re-approximation of the rectus muscles on diastasis recti abdominis at cesarean section - a prospective cross-sectional study.

OBJECTIVES: Caesarean section (CS) is one of the most frequently performed surgical procedures in the world and Turkey. In this study, we aimed to investigate the relationship between re-approximation of the rectus muscles during CS and the severity of diastasis recti abdominis in the first postoperative month. To investigate the relationship between re-approximation of the rectus muscles during CS and the severity of diastasis recti abdominis in the first postoperative month. MATERIAL AND METHODS: The study was designed as a prospective cross-sectional study. Patients were divided into two groups: parietal peritoneum closure only (Group 1), and closure of the parietal peritoneum and re-approximation of rectus muscle (Group 2). The distance between the rectus muscles and the thickest rectus muscle thickness were measured one month after CS from three anatomic regions using superficial ultrasonography by the same blinded physician. The anatomic regions were described as xiphoid, 3 cm above the umbilicus, and 2 cm below the umbilicus. The relation of the measurements between the groups was evaluated. RESULTS: There was a total of 128 patients, 64 in Group 1 and 64 in Group 2. There were no statistical differences between the groups in terms of the distance between rectus muscles and the thickness of rectus muscle at the described anatomic regions (p > 0.05). CONCLUSION: Re-approximation of rectus muscles has no effect on the prevention of diastasis recti, which is an important cosmetic problem.

Corset Autodermis External Obliqueplasty Reinforcement of Rectus Diastasis and Umbilical Hernia Repairs during Abdominoplasty.

SUMMARY: Abdominoplasty is among the most commonly performed aesthetic operations and is frequently combined with rectus abdominis musculoaponeurotic plication of rectus diastasis and repair of umbilical and ventral hernias. The authors present a spare parts technique to assist in reinforcement of both rectus diastasis plication and hernia repair during abdominoplasty operations using an autodermis onlay reinforcement graft. The graft is harvested from the excess abdominal pannus normally discarded during abdominoplasty and is inset on tension between the bilateral semilunar lines and plicated along a concave "corset" contour. This reduces distracting forces on the hernia and diastasis repairs and further augments abdominal contour. This technique has been performed for 8 years on 82 low-surgical-risk patients, without any noted increase in complications. The corset autodermis external obliqueplasty is a spare parts technique that may reduce recurrence of rectus diastasis and abdominal hernias repaired at the time of abdominoplasty and is an alternative strategy to mesh placement in this risk-averse aesthetic surgery population.

Surgical treatment of diastasis recti: the importance of an overall view of the problem.

PURPOSE: Diastasis recti (DR) is characterized by an alteration of the linea alba with increased inter-recti distance (IRD). It is more frequent in females, and when symptomatic or associated with midline hernia it needs to be surgically repaired. This retrospective study aims to demonstrate how an overall approach to DR leads to good results in terms of functional and morphological outcomes and quality of life (QoL). METHODS: From January 2018 to December 2019, 94 patients were operated for DR > 50 mm, with or without midline hernias. Three different surgical approaches were used: complete laparoabdominoplasty, laparominiabdominoplasty and minimally invasive (endoscopic) technique. QoL was assessed with the EuraHS-QoL tool. RESULTS: All patients were female except two males. We performed 26 endoscopic treatments (27.7%), 39 laparoabdominoplasties (41.5%) and 29 laparominiabdominoplasties (umbilical float procedure) (30.9%). The total median operative time was 160 min. No intraoperative complications were registered. In three (4.2%) cases, major surgical complications occurred, all after open operations. In 13 open surgery cases, vacuum-assisted closure (VAC) therapy was used to repair the cutaneous ischemic defect. No recurrence was registered to date. Minimally invasive surgery showed fewer complications and lower hospital stay than the open approach. The QoL was significantly improved. CONCLUSION: Our experience shows the importance of an overall view of the functional and cosmetic impairment created by DR. The surgeon should obtain an optimal repair of the function, by open or minimally invasive surgery, also considering the morphological aspects, which are very important for the patients in terms of QoL.

SubCutaneous OnLay endoscopic Approach (SCOLA) mesh repair for small midline ventral hernias with diastasis recti: An initial US experience.

BACKGROUND: Patients presenting for evaluation of umbilical and epigastric hernias are often found to have diastasis recti (DR). As isolated hernia repair in these patients may be associated with higher rates of recurrence, prior international publications have described a prefascial mesh repair in combination with anterior plication of DR. We present our initial United States (US) experience with a SubCutaneous OnLay endoscopic Approach (SCOLA) to address these concurrent pathologies in a single hybrid procedure. METHODS: Between July 2018 and December 2019, a prospective cohort of 16 patients underwent the SCOLA procedure. Subcutaneous dissection was carried out from the suprapubic region superiorly to the xiphoid process and laterally to the linea semilunaris. Hernia contents were reduced and defects were incorporated into anterior DR plication, which was performed with running barbed suture. Onlay mesh was placed to cover the entire dissected space, and subcutaneous drains were placed. Three separate attendings performed cases with one supervising attending for standard technique. RESULTS: Of 16 patients, 14 (87.5%) were female. The mean age was 45.7 (11.9) years; mean BMI was 29.0 (3.6) kg/m2. The mean hernia defect size was 1.9 (0.7) cm. Mean operative time was 146 (46.3) minutes; two (15%) cases were performed robotically. The mean follow-up time was approximately two months (63 days). Three (18.8%) patients developed seroma, one (6.3%) patient developed an infected seroma, and two (12.5%) patients developed hernia recurrence. CONCLUSIONS: SCOLA technique is shown to be a safe and effective approach for patients presenting with small midline ventral hernias and concomitant DR. Our preliminary US data demonstrates higher rates of post-operative complication in patients with higher BMI, which suggests that patient selection and pre-operative counseling is essential to achieve better technical outcomes in our patient population.

Comorbid rectus abdominis diastasis is a risk factor for recurrence of umbilical hernia in Japanese patients.

INTRODUCTION: Rectus abdominis diastasis (RAD) is characterized by thinning and widening of the linea alba and laxity of the ventral abdominal muscle. RAD, when coexistent with umbilical hernia, is considered a risk factor for hernia recurrence. We investigated the impact of comorbid RAD in patients with umbilical hernia who had undergone hernia repair. METHODS: We enrolled 30 patients who had undergone umbilical hernia repair using either a laparoscopic or anterior approach between April 2006 and May 2018. We diagnosed RAD according to preoperative CT. The outcomes of patients with umbilical hernia, the RAD group, and the non-RAD group were compared, especially in terms of recurrence. RESULTS: Twenty-five patients (83%) presented with RAD, including three patients (12%) with postoperative recurrence who were allocated to the RAD group. The median BMI in the RAD group was 27.2 kg/m2 . In the RAD group, a prosthesis mesh was used in 12 patients (48%), and nonabsorbable suture material was used in four patients (16%). There was no statistically significant difference between the two groups in terms of age, hernial orifice diameter, surgical technique, or operative time. CONCLUSION: The rate of comorbid umbilical hernia in Japanese patients with RAD was high, as was the recurrence rate of umbilical hernia. We strongly recommend preoperative detection of RAD. We also recommend mesh-based repair of the midline and nonabsorbable suture material to decrease the recurrence rate, irrespective of hernia size.

Innovations in surgical treatment of rectus abdominis diastasis: a review of mini-invasive techniques.

Abdominal rectus diastasis (RD) is characterized by thinning and widening of the linea alba, combined with laxity of the ventral abdominal musculature. This condition is associated with bulging of abdominal content, and it is mostly acquired during pregnancy or obesity. Symptoms include pain and discomfort in the abdomen, musculoskeletal and uro-gynecological problems in addition to negative body image and impaired quality of life. In this review we present current knowledge on the novel surgical mini-invasive techniques for treatment of RD. The aim of our study is to discuss the use of a standard classification to define pathological RD and possible indications for a minimally invasive repair, considering complications, patients' satisfaction and recurrence rate. A PubMed search of the literature has been conducted in January 2020 including the most recent articles using the following criteria among the interventions for RD: mini-invasive surgery, laparoscopic, endoscopy and robotic procedures. Minimally invasive surgical treatment options for rectus diastasis are poorly investigated and indications for repair are still debated. Guidelines are mandatory to standardize surgical management of RD.

A Comprehensive, Evidence-Based Literature Review of the Surgical Treatment of Rectus Diastasis.

BACKGROUND: Rectus diastasis is a common condition that can result in a protruding abdomen, causing cosmetic and functional disability. Although it is usually repaired during abdominoplasty or herniorrhaphy, there is a lack of consensus with regard to the repair indications and optimal surgical techniques. The goal of this study is to provide an updated review of the surgical techniques used for rectus diastasis repair and their comparative efficacy. METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed, Embase, and Cochrane databases were searched for articles that discussed the surgical management of rectus diastasis and reported on either outcomes, complications, or recurrence rates. Data detailing surgical techniques were extracted, and pooled analyses of complication and recurrence rates were performed, controlling for surgical approach, common variations in technique, and an associated herniorrhaphy. RESULTS: Thirty-seven studies describing 45 techniques were included. An open rectus diastasis repair was performed in 24 of the studies. After controlling for an associated herniorrhaphy, there was no statistically significant difference in surgical complication and recurrence rates between open and laparoscopic approaches (p = 0.165 and p = 0.133, respectively). Although a double-layer suture closure was associated with a significantly lower rate of complications (p = 0.002), no significant difference was found for suture type absorbability. CONCLUSIONS: Surgical repair of rectus diastasis is safe and effective through both open and laparoscopic approaches. Although suture type absorbability does not affect complication or recurrence rates, a double-layer suture closure can decrease surgical complications. The pooled analysis of complication and recurrence rates can help improve informed consent and patient education.

Abordaje totalmente endoscópico suprapúbico de la hernia ventral. Ventajas de un nuevo procedimiento mínimamente invasivo / Totally endoscopic suprabupic approach to ventral hernia repair: Advantages of a new minimally invasive procedure

El abordaje mínimamente invasivo de la hernia ventral se encuentra en pleno desarrollo con la aparición de técnicas quirúrgicas que intentan disminuir las críticas asociadas al abordaje laparoscópico tradicional. La cirugía totalmente endoscópica subcutánea de acceso suprapúbico de la hernia ventral es una nueva técnica quirúrgica mínimamente invasiva que corrige quirúrgicamente el defecto herniario asociado o no a diástasis de rectos, con las ventajas de no penetrar en el espacio intraabdominal y evitando la colocación de la prótesis en contacto con las vísceras, con las consiguientes complicaciones derivadas de ello (aparición de adherencias o fístulas)

Laparoscopic ventral hernia repair is in full development with the appearance of surgical techniques that try to diminish the disadvantages associated with this procedure. Totally endoscopic subcutaneous ventral hernia surgery with suprapubic access is a new minimally invasive surgical technique that surgically corrects the hernia defect associated or not with diastasis recti with the advantages of not penetrating the intra-abdominal space, thereby avoiding placement of the prosthesis in contact with the viscera and consequent complications (appearance of adhesions or fistulae)