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Endoscopic mini/less open sublay technique (EMILOS)-a new technique for ventral hernia repair
J Schwarz1, W Reinpold2, Reinhard Bittner1
1Hernia Center Rottenburg, Röntgenstr.38, 72108, Rottenburg a.N, Germany.
Langenbeck'S Archives of Surgery
|October 22, 2016
Summary
The endoscopic mini/less open sublay (EMILOS) repair offers a minimally invasive approach for abdominal wall hernias. This technique allows for retromuscular mesh placement with smaller incisions and shorter recovery times.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Hernia Repair
Background:
- The MILOS concept (mini/less open sublay repair) was developed to improve abdominal wall hernia repair using minimally invasive techniques.
- It allows retromuscular mesh placement without entering the abdominal cavity or large incisions.
- Dissection can be open (MILOS) or endoscopic (EMILOS).
Purpose of the Study:
- To describe the operative steps and outcomes of the novel endoscopic variation, the EMILOS procedure.
- To evaluate the feasibility and effectiveness of the EMILOS technique for abdominal wall hernia repair.
Main Methods:
- 33 patients underwent MILOS concept repair (8 MILOS, 25 EMILOS) between June 2015 and July 2016.
- The EMILOS procedure involves endoscopic dissection of the retromuscular plane.
- Large meshes were implanted in the retromuscular space without fixation for midline umbilical, epigastric, or incisional hernias with rectus diastasis.
Main Results:
- Average skin incision was 5.2 cm.
- Mean operative time decreased to 122 minutes in the last five cases.
- Average hospital stay was 3.2 days, with a median pain score of 2.7 under stress.
Conclusions:
- The EMILOS operation is a reliable, reproducible, and easily standardizable supplementary method for abdominal wall hernia repair.
- It demonstrates potential as a valuable addition to the surgical techniques available for hernia repair.
