Stapler-assisted endoscopic mini- or less-open sublay technique: How do I do it?

Area of Science:

• Minimally Invasive Surgery
• Abdominal Wall Reconstruction
• Surgical Innovation

Background:

• Ventral hernia repair presents challenges in achieving durable closure and minimizing recurrence.
• Minimally invasive techniques aim to improve patient outcomes and reduce surgical morbidity.

Purpose of the Study:

• To evaluate the clinical efficacy of the endoscopic mini- or less-open sublay (EMILOS) technique with stapler-assisted fascial closure for ventral hernia repair.
• To assess short-term outcomes, including complications and recurrence rates.

Main Methods:

• A cohort of 12 patients underwent EMILOS with stapler-assisted fascial closure.
• Mean follow-up duration was 12.4 months.
• Data collected included operative time, complication rates, recurrence, and quality of life.

Main Results:

• The mean defect size was 4.9 cm × 5.2 cm, with a mean operative time of 95 minutes.
• Complications included seroma (17%), surgical site infection (8%), and small bowel obstruction (8%).
• The hernia recurrence rate was 8%, and patient-reported excellent quality of life increased from 17% to 50% postoperatively.

Conclusions:

• EMILOS with stapler-assisted closure is a safe and efficient approach for ventral hernia repair, particularly for obese patients and medium-sized hernias.
• The technique offers enhanced visualization and efficient fascial closure, resulting in favorable short-term outcomes and an 8% recurrence rate.
• Larger studies with longer follow-up are warranted to confirm long-term efficacy.