Laparoscopic repair of suprapubic hernias: transabdominal partial extraperitoneal (TAPE) technique

Sharma, Anil; Dey, Ashish; Khullar, Rajesh; Soni, Vandana; Baijal, Manish; Chowbey, Pradeep

doi:10.1007/s00464-010-1513-0

Cited by 32 publications

(42 citation statements)

References 16 publications

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“…The concept of laparoscopic trans-abdominal partial extra-peritoneal (TAPE) technique was further consolidated by Sharma et al and published in 2011. 8 With this hybrid approach, part of the prosthetic mesh is being placed intra-peritoneally to cover the defect, where the inferior part is being placed at pre-peritoneal space and covered up by the peritoneal flap after completion of procedure (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Approach to Supra-pubic and Non-Midline Lower Abdominal Ventral Hernia - An Extended Indication of TAPE Technique

Fan¹,

Yip²,

Fung³

et al. 2017

J Minim Invasive Surg

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Repair of lower abdominal incisional hernia is always a surgical challenge. TAPE technique has been described for the repair of supra-pubic midline incisional hernia with satisfactory outcome. Its indication can be extended for treatment of non-midline lower abdominal hernia. Peritoneal incision is created just below the hernia defect with pre-peritoneal dissection to expose supra-pubic preperitoneal space with Cooper's ligament exposed. Non-adhesive mesh then placed over preperitoneal space and partially intra-peritoneally, and cover the whole extra-peritoneal space prepared to ensure enough overlapping. Mesh is fixed by tackers for intra-peritoneal part, most inferior fixation points were at peritoneal incision line. Extra-peritoneal part of meshes is fixed at the safety zone and covered up by the peritoneal flap to avoid mesh migration. Fixation of the meshes at the lateral aspects were facilitated by the peritoneal flap and subsequent fibrosis and adhesion to the extra-peritoneal structures in cases of lateral lower abdominal hernia. Repair of midline and lateral lower abdominal incisional hernia with this novel modified technique with prosthetic mesh is safe and effective. A larger case series and longer follow-up is required for validation of this technique.

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Section: Introductionmentioning

confidence: 99%

Minimally Invasive Approach to Supra-pubic and Non-Midline Lower Abdominal Ventral Hernia - An Extended Indication of TAPE Technique

Fan¹,

Yip²,

Fung³

et al. 2017

J Minim Invasive Surg

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“…Since the first report in 2001 [176], experience with laparoscopic treatment of such hernias is limited and longterm follow-up between 2.6 months [177] and 4.8 years [178] in the four largest series. Authors agree that laparoscopy allows complete assessment of both the hernia defect and prior scar with reduced chance of ''missed'' defects [177,178].…”

Section: Suprapubic Incisional Herniasmentioning

confidence: 97%

“…No comparative studies with the open technique were found, and only one article was published on this specific topic since 2009; this retrospective study of 72 patients over a period of 10 years is the largest series of laparoscopic repair of suprapubic hernias to date [179]. All the authors underline the importance of preperitoneal surgical dissection by developing a peritoneal flap with direct visualization of the pubic bone, Cooper's ligaments, and the inferior epigastric and iliac vessels to obtain sufficient mesh overlap in an area with limited space [177][178][179][180]. Most of the authors advocate the elevation of the peritoneum flap with the bladder at the end of the procedure to cover Cooper's ligaments and the inferior mesh edge, repositioning the bladder to its normal anatomic position [176][177][178][179].…”

Section: Suprapubic Incisional Herniasmentioning

confidence: 97%

“…All the authors underline the importance of preperitoneal surgical dissection by developing a peritoneal flap with direct visualization of the pubic bone, Cooper's ligaments, and the inferior epigastric and iliac vessels to obtain sufficient mesh overlap in an area with limited space [177][178][179][180]. Most of the authors advocate the elevation of the peritoneum flap with the bladder at the end of the procedure to cover Cooper's ligaments and the inferior mesh edge, repositioning the bladder to its normal anatomic position [176][177][178][179]. The meshes are most frequently fixated to the periosteum of the posterior pubis and Cooper's ligaments bilaterally [180,181] and then to the aponeurosis in a double-crown fashion.…”

Section: Suprapubic Incisional Herniasmentioning

confidence: 99%

“…Authors agree that laparoscopy allows complete assessment of both the hernia defect and prior scar with reduced chance of ''missed'' defects [177,178]. No comparative studies with the open technique were found, and only one article was published on this specific topic since 2009; this retrospective study of 72 patients over a period of 10 years is the largest series of laparoscopic repair of suprapubic hernias to date [179].…”

Section: Suprapubic Incisional Herniasmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

et al. 2015

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The availability of recent level 1 evidence (a meta-analysis of 10 RCTs) allowed to recommend that not only laparoscopic repair is an acceptable alternative to the open repair, but also it is advantageous in terms of shorter hospital stay and wound infection rate. This conclusion appears to be extremely relevant in a clinical setting. Indications about specific conditions could also be issued: laparoscopy is recommended for the treatment of recurrent ventral hernias and obese patients, while it is a potential option for compensated cirrhotic and childbearing-age female patients. Many relevant and controversial topics were thoroughly examined by this consensus conference for the first time. Among them are the issue of safety of the intraperitoneal mesh placement, traditionally considered a major drawback of the laparoscopic technique, the role for the biologic meshes, and various aspects of the laparoscopic approach for particular locations of the defect such as the abdominal border or parastomal hernias.

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Biomechanical abdominal wall model applied to hernia repair

Lyons

Mohan

Winter

et al. 2015

British Journal of Surgery

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Background: Most surgical innovations require extensive preclinical testing before employment in the operative environment. There is currently no way to develop and test innovations for abdominal wall surgery that is cheap, repeatable and easy to use. In hernia repair, the required mesh overlap relative to defect size is not established. The aims of this study were to develop a biomechanical model of the abdominal wall based on in vivo pressure measurements, and to apply this to study mesh overlap in hernia repair.Methods: An observational study of intra-abdominal pressure (IAP) levels throughout abdominal surgery was conducted to identify the peak perioperative IAP in vivo. This was then applied in the development of a surrogate abdominal wall model. An in vitro study of mesh overlap for various defect sizes was then conducted using this clinically relevant surrogate abdomen model. Results:The mean peak perioperative IAP recorded in the clinical study was 1740 Pa, and occurred during awakening from anaesthesia. This was reproduced in the surrogate abdomen model, which was also able to replicate incisional hernia formation. Using this model, the mesh overlap necessary to prevent hernia formation up to 20 kPa was found, independent of anatomical variations, to be 2 × (defect diameter) + 25 mm. Conclusion:This study demonstrated that a surgically relevant surrogate abdominal wall model is a useful translational tool in the study of hernia repair. Surgical relevanceThis study examined the mesh overlap requirements for hernia repair, evaluated in a biomechanical model of the abdomen. Currently, mesh size is selected based on empirical evidence and may underpredict the requirement for large meshes.The study proposes a relationship between the defect size and mesh size to select the appropriate mesh size. Following further trials and investigations, this could be used in clinical practice to reduce the incidence of hernia recurrence.Click here to listen to the author discuss the contents of this article.

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Laparoscopic repair of suprapubic hernias: transabdominal partial extraperitoneal (TAPE) technique

Abstract: A mesh overlap of at least 5 cm and fixation of the lower margin of the mesh under direct vision to Cooper's ligaments appears to confer increased strength and durability and contribute to low hernia recurrence rates in patients with suprapubic hernias.

Cited by 32 publications

References 16 publications

Minimally Invasive Approach to Supra-pubic and Non-Midline Lower Abdominal Ventral Hernia - An Extended Indication of TAPE Technique

Minimally Invasive Approach to Supra-pubic and Non-Midline Lower Abdominal Ventral Hernia - An Extended Indication of TAPE Technique

Laparoscopic ventral/incisional hernia repair: updated guidelines from the EAES and EHS endorsed Consensus Development Conference

Biomechanical abdominal wall model applied to hernia repair

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