Umbilical hernia repair by the eTEP, a reproducible and valuable technique

Umbilical hernia is a common surgical condition, and mesh repair is generally recommended to reduce recurrence rates. Various techniques have been employed, each with its own advantages and disadvantages. The enhanced-view totally extraperitoneal (eTEP) approach offers the benefit of placing the mesh outside the abdominal cavity while maintaining a minimally invasive approach. However, it is associated with longer operative times and requires a higher level of surgical expertise. In this study, we present our method of eTEP for umbilical hernia repair, which has proven to be safe, effective, and highly reproducible.

Patients with umbilical hernias and defect sizes larger than 1 cm were prospectively enrolled. All patients underwent repair using the eTEP technique, which featured an inferior port position and a caudal-to-cranial dissection approach. Detailed procedural techniques and surgical skills are described, and perioperative outcomes were recorded.

A total of 26 umbilical hernias were repaired using the eTEP technique, with no conversions to an open approach. The mean operative time was 101.8 ± 31 min (range: 47 to 185 min), and the average postoperative hospital stay was 1.8 ± 0.8 days (range: 1 to 5 days). There were no cases of surgical site infection, skin necrosis, wound dehiscence, bowel obstruction, urinary complications, or recurrence.

The eTEP approach for umbilical hernia repair is a safe, efficient, and reproducible alternative to traditional methods. Its unique port positioning, tailored dissection, and optional mesh fixation contribute to reduced complications and improved patient outcomes. Future studies should focus on long-term follow-up to validate the durability and effectiveness of this technique.