Endoscopic Mini-or Less-Open Sublay Operation (E/MILOS) in ventral hernia repair: a minimally invasive alternative technique

DE-CARVALHO, JOÃO PAULO VENANCIO; Pivetta, Luca Giovanni Antonio; Amaral, Pedro; Dias, Eduardo Rullo Maranhão; Macret, J. Z.; RIBEIRO, HAMILTON BRASIL; FRANCIS, MAURICE YOUSSEF; Antunes, Pedro de Souza Lucarelli; Reinpold, Wolfgang; Roll, Sérgio

doi:10.1590/0100-6991e-20233405-en

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…When it comes to repairing VH, MILOS is just as effective as more conventional methods, but with significantly lesser postoperative problems, reoperations, and unexpected readmissions. It is verified that the method is simple to replicate and workable at a public hospital [13,14]. vTAPP appears to be a safe and effective therapy for VHR, superior to or comparable to other minimally invasive methods in terms of perioperative characteristics and short-term outcomes [15].…”

Section: Valid Options For Mas In Vhmentioning

confidence: 84%

Ventral hernia repair in India: a Delphi consensus

Chowbey,

Wadhawan,

Subramanian

et al. 2024

Hernia

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Purpose While research on inguinal hernias is well-documented, ventral/incisional hernias still require investigation. In India, opinions on laparoscopic ventral hernia repair (LVHR) techniques are contested. The current consensus aims to standardize LVHR practice and identify gaps and unfulfilled demands that compromise patient safety and therapeutic outcomes. Methods Using the modified Delphi technique, panel of 14 experts (general surgeons) came to a consensus. Two rounds of consensus were conducted online. An advisory board meeting was held for the third round, wherein survey results were discussed and the final statements were decided with supporting clinical evidence. Results Experts recommended intraperitoneal onlay mesh (IPOM) plus/trans-abdominal retromuscular/extended totally extraperitoneal/mini- or less-open sublay operation/transabdominal preperitoneal/trans-abdominal partial extra-peritoneal/subcutaneous onlay laparoscopic approach/laparoscopic intracorporeal rectus aponeuroplasty as valid minimal access surgery (MAS) options for ventral hernia (VH). Intraperitoneal repair technique is the preferred MAS procedure for primary umbilical hernia < 4 cm without diastasis; incisional hernia in the presence of a vertical single midline incision; symptomatic hernia, BMI > 40 kg/m2, and defect up to 4 cm; and for MAS VH surgery with grade 3/4 American Society of Anaesthesiologists. IPOM plus is the preferred MAS procedure for midline incisional hernia of width < 4 cm in patients with a previous laparotomy. Extraperitoneal repair technique is the preferred MAS procedure for L3 hernia < 4 cm; midline hernias < 4 cm with diastasis; and M5 hernia. Conclusion The consensus statements will help standardize LVHR practices, improve decision-making, and provide guidance on MAS in VHR in the Indian scenario.

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Section: Valid Options For Mas In Vhmentioning

confidence: 84%

Ventral hernia repair in India: a Delphi consensus

Chowbey,

Wadhawan,

Subramanian

et al. 2024

Hernia

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Laparoendoscopic extraperitoneal surgical techniques for ventral hernias and diastasis recti repair: a systematic review

Ferrara,

Fiori

2024

Hernia

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Purpose this systematic review aims to classify and summarize the characteristics and outcomes of the different laparoendoscopic extraperitoneal approaches for the repair of ventral hernias and diastasis recti described in the last 10 years. Methods a literature search was performed by two reviewers in December 2023 including articles from January 2013, 01 to December 2023, 15. The techniques were selected according to the surgical access site (anterior or posterior to the rectus sheath), the access type (laparoendoscopic, single incision laparoscopic, mini or less open), the main space used to repair the defect (subcutaneous or retromuscular) and the mesh place (onlay, sublay-retromuscular or sublay-preperitoneal) and classified as anterior or posterior approaches. Results the literature search retrieved 1755 results and 27 articles were included in the study. The studies included 1874 patients, the mean age ranged from 37.8 to 60.2 years. The access site was anterior in 16 cases and posterior in 11 cases. The mesh was positioned onlay in 13 cases and sublay in 13 cases, with only one study using no mesh. Complications were: seroma, ranging from 0.8 to 81%, followed by skin complications (leak, ischemia, necrosis) from 0.8 to 6.4%, surgical site infections and bleeding. Recurrences ranged from 0% to 12,5%, with a mean follow-up from 1 to 24 months. Conclusion this systematic review confirms the presence of several new minimally invasive extraperitoneal techniques for the repair of abdominal wall defects, with different advantages and disadvantages. Further studies, with more extensive follow-up data and wider patient groups, are necessary to define specific indications for each technique.

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Endoscopic Mini-or Less-Open Sublay Operation (E/MILOS) in ventral hernia repair: a minimally invasive alternative technique

Cited by 2 publications

References 11 publications

Ventral hernia repair in India: a Delphi consensus

Ventral hernia repair in India: a Delphi consensus

Laparoendoscopic extraperitoneal surgical techniques for ventral hernias and diastasis recti repair: a systematic review

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