The Extended Totally Extraperitoneal (eTEP) hernia surgery repair technique is a novel and advanced approach for the treatment of ventral and inguinal hernias. eTEP is a minimally invasive approach that can be performed laparoscopically or with robotic assistance, rather than being an open surgery technique. This technique was first introduced by Jorge Daes in 2012 and has since been adapted and refined by other surgeons for various types of hernias, including ventral hernias. The eTEP technique is characterized by its minimally invasive approach, which involves creating a large surgical workspace in the extraperitoneal space without entering the abdominal cavity. This is achieved through a series of surgical maneuvers and strategies aimed at enhancing the extraperitoneal work area and allowing for the placement of a larger surgical mesh to repair the hernia defect. The eTEP Hernia Repair Technique Procedure StepsThe procedural steps for an eTEP (Extended Totally Extraperitoneal) hernia repair can vary depending on the type of hernia being treated (inguinal, ventral, or lumbar). However, the general steps for the eTEP approach are as follows:
Key Features of eTEP Hernia Surgery
Advantages of eTEP Technique for Hernia Repair
What are the success rates of eTEP hernia repair?Here are the key findings from a recent study, explained in laypersons’ terms: The study involved surgeons who did eTEP hernia surgery on 150 patients over three years. Out of the 150 patients:
Most of the patients were females (74%). Primary hernias happened equally in males and females, but incisional and recurrent hernias were more common in females. For smaller hernias, doctors used a method called eTEP RS (Rives-Stoppa). For larger hernias, they used eTEP TAR which also relaxes some muscles to help close the hernia. The eTEP RS repair took about 2 hours to do, while eTEP TAR took about 3.5 hours. After the surgery:
This study shows the eTEP method worked well to repair different kinds of hernias, even complicated ones, with few problems afterward. The study reports it is a good option, especially for hernias on the sides of the belly. Surgeons need a lot of special training to do it well. Dr. Mazen Iskandar is thoroughly trained and experienced in eTEP surgery. You can view a video of Dr. Iskandar performing a complex eTEP procedure (Note: contains images of surgery). What types of hernias can be repaired with the eTEP technique?The eTEP (Extended Totally Extraperitoneal) technique can be used to repair various types of hernias, including:
What kind of hernias cannot be treated with eTEP?There are certain situations where the eTEP technique might not be the best choice or could be contraindicated:
Final ThoughtsThe eTEP hernia surgery repair technique represents a significant advancement in the field of hernia repair. Its minimally invasive nature, combined with the strategic placement of mesh and the potential for component separation, offers a comprehensive solution for hernia repair that is associated with improved patient outcomes, including reduced complication rates, faster recovery times, and lower recurrence rates. Surgeons seeking to adopt this technique should have detailed knowledge of the anatomy of the extraperitoneal space and undergo formal training, ideally including practice on fresh cadavers under mentorship, to ensure the safety and effectiveness of the procedure.
Via https://iskandarcenter.com/hernia-surgery/extended-totally-extraperitoneal-etep-hernia-repair-technique/
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