e-TEP Retromuscular Repair for Recurrent Incisional Hernias: Report of Three Cases

Area of Science:

• Minimally invasive surgery
• Abdominal wall reconstruction
• Laparoscopic surgical techniques

Background:

• Recurrent incisional hernias are challenging to manage due to scar tissue and adhesions.
• Previous repairs can complicate subsequent dissections and mesh placement.
• Identifying new tissue planes is crucial for successful hernia repair.

Observation:

• Three cases of recurrent incisional hernias were treated using the enhanced view totally extraperitoneal (e-TEP) retromuscular technique.
• Patients had prior repairs including open onlay, intraperitoneal onlay mesh hernioplasty (IPOM), and combined approaches.
• The e-TEP technique utilized the retromuscular space (Rives and/or preperitoneal).

Findings:

• The e-TEP retromuscular technique provided a novel laparoscopic approach for recurrent incisional hernias.
• Satisfying short-term results were observed in the treated patients.
• This method allows access to previously unutilized surgical planes.

Implications:

• The e-TEP technique represents a new minimally invasive option for complex recurrent incisional hernias.
• It potentially simplifies repair by accessing the retromuscular space.
• Further studies are warranted to evaluate long-term outcomes of this approach.