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Related Experiment Video

Updated: Dec 29, 2025

Procurement for a Vascularized and Reinnervated Abdominal Wall Allotransplantation
09:30

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Published on: July 18, 2025

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Totally extraperitoneal approach for open complex abdominal wall reconstruction.

Shyanie Kumar1, R Wesley Edmunds2, Michael J Nisiewicz3

  • 1General Surgery Residency Program, University of Kentucky Graduate Medical Education, Lexington, KY, USA.

Surgical Endoscopy
|February 8, 2020
PubMed
Summary

Totally extraperitoneal ventral hernia repair (TEVHR) offers a safe alternative for hernia repair, avoiding peritoneal entry. This approach demonstrated low complication rates and few recurrences in a recent study.

Keywords:
Hernia repairRives-StoppaTotally extraperitoneal approachTransabdominal approach

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Area of Science:

  • Surgical Innovation
  • Abdominal Wall Reconstruction
  • Minimally Invasive Surgery

Background:

  • Traditional ventral hernia repair involves transabdominal access, necessitating peritoneal cavity entry.
  • Totally extraperitoneal ventral hernia repair (TEVHR) allows dissection without entering the peritoneal cavity, potentially reducing complications.

Purpose of the Study:

  • To evaluate the technique, decision-making, and outcomes of open totally extraperitoneal ventral hernia repair (TEVHR).

Main Methods:

  • Retrospective review of 166 patients undergoing open TEVHR between January 2012 and December 2016.
  • Data collected included demographics, operative details, postoperative outcomes, readmissions, and reoperations.

Main Results:

  • TEVHR was performed for primary/recurrent hernias (86%) with a median defect size of 135 cm².
  • Wound complication rate was 27% (9% seroma, 18% superficial SSI, 2% deep SSI), with 3% requiring reoperation.
  • Recurrence rate was 2% at 12-month follow-up; low rates of bowel obstruction and enterotomy were observed.

Conclusions:

  • TEVHR is a safe and effective alternative to transabdominal ventral hernia repair.
  • The extraperitoneal approach may decrease operative times and avoid adhesiolysis.
  • Further prospective studies are needed to confirm long-term outcomes.