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Research article
Francesco Mongelli
Ospedale Regionale di Lugano Civico e Italiano
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8824-651X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Robotic ventral hernia repair has shown itself to be feasible and safe in abdominal wall surgery. Presently, the ports are commonly placed laterally to meet the distance from the fascial defect. The aim of our study is to reort our experience of epigastric hernias treatment with the trocars’ insertion in the suprapubic region.
Methods
A retrospective search on a prospectively collected dataset was performed to identify patients treated for primary or incisional hernias of the epigastric region with a robotic-assisted approach. In all cases, three 8-mm trocars were inserted in the suprapubic area and the preperitoneal or the posterior rectus sheath spaces dissected to ensure a proper mesh overlap. After hernia reduction, the fascia was closed with a running suture, the mesh placed and the peritoneum sutured.
Results
Twelve patients were selected. Median age was 58.5 years (interquartile range (IQR) 47.8–67.3) and four patients were male (33.3%). All patients were referred to surgery because of pain. The median measure of the hernia defect was 30 mm (IQR 13.75-31), median larger mesh diameter was 13.5 cm (IQR 9.5–15.0) and median operative time was 136.5 minutes (IQR 120-186.5). No intraoperative complication or conversion to open surgery occurred. Postoperatively, two patients presented a seroma and the median length of hospital stay was 2.0 days (IQR 1.75-3).
Conclusions
In the robot-assisted treatment of hernias of the epigastric region, a suprapubic port placement can be considered instead of a lateral one. Further studies are needed to assess the benefits and limitations of such technique.
Trial registration
Retrospectively registered (Comitato Etico Cantonale Ticino n. 2019-01132 CE3495)
Keywords
robotic-assisted, epigastric, ventral hernia, mesh, suprapubic port placement
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- Video1.mp4
Epigastric hernia repair with the robotic-assisted suprapubic approach.
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Francesco Mongelli
Ospedale Regionale di Lugano Civico e Italiano
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8824-651X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
View the published article at Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.
Version 1
Posted 26 Aug, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.
Background
Robotic ventral hernia repair has shown itself to be feasible and safe in abdominal wall surgery. Presently, the ports are commonly placed laterally to meet the distance from the fascial defect. The aim of our study is to reort our experience of epigastric hernias treatment with the trocars’ insertion in the suprapubic region.
Methods
A retrospective search on a prospectively collected dataset was performed to identify patients treated for primary or incisional hernias of the epigastric region with a robotic-assisted approach. In all cases, three 8-mm trocars were inserted in the suprapubic area and the preperitoneal or the posterior rectus sheath spaces dissected to ensure a proper mesh overlap. After hernia reduction, the fascia was closed with a running suture, the mesh placed and the peritoneum sutured.
Results
Twelve patients were selected. Median age was 58.5 years (interquartile range (IQR) 47.8–67.3) and four patients were male (33.3%). All patients were referred to surgery because of pain. The median measure of the hernia defect was 30 mm (IQR 13.75-31), median larger mesh diameter was 13.5 cm (IQR 9.5–15.0) and median operative time was 136.5 minutes (IQR 120-186.5). No intraoperative complication or conversion to open surgery occurred. Postoperatively, two patients presented a seroma and the median length of hospital stay was 2.0 days (IQR 1.75-3).
Conclusions
In the robot-assisted treatment of hernias of the epigastric region, a suprapubic port placement can be considered instead of a lateral one. Further studies are needed to assess the benefits and limitations of such technique.
Trial registration
Retrospectively registered (Comitato Etico Cantonale Ticino n. 2019-01132 CE3495)
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- Video1.mp4
Epigastric hernia repair with the robotic-assisted suprapubic approach.
Loading...