Videoendoscopic assisted Rives-Stoppa technique. "Treatment for epigastric and umbilical hernias with diastasis...

Area of Science:

• Minimally invasive surgery
• Abdominal wall reconstruction
• Hernia repair

Background:

• Ventral hernias and diastasis recti have numerous surgical repair techniques.
• Conventional and video-endoscopic methods, with or without mesh, are documented.
• Existing techniques present opportunities for refinement in outcomes.

Purpose of the Study:

• To present modifications of the MILOS and TESAR techniques for ventral hernia and diastasis recti repair.
• To achieve anatomical, functional, and aesthetic improvements through retro-muscular mesh reinforcement and primary fascial closure.
• To utilize a minimally invasive umbilical access for enhanced patient recovery.

Main Methods:

• A step-by-step description of the modified surgical technique is provided.
• Analysis of 629 surgical treatments performed between January 2018 and January 2023.
• Video endoscopic-assisted Rives-Stoppa techniques were used for umbilical and epigastric hernias with diastasis.

Main Results:

• All 629 patients were treated on an outpatient basis with same-day discharge.
• The most common complication was seroma, managed conservatively.
• Other complications included omphalitis (6 patients) and hematomas (3 patients), with one requiring surgical evacuation. Ten patients experienced recurrence.

Conclusions:

• The hybrid approach combines mini-invasive benefits with reduced complication rates.
• This technique offers significant anatomical, functional, and aesthetic advantages.
• Patients experience a high standard of quality of life post-procedure.