P-097 Minimally Invasive Repair in Severe Rectus Diastasis With Midline Hernia Associated in Males Shows High Recurrence in Mid-Term Follow-Up. Case-Control Study

Abstract

Aim Endoscopic plication could develop excessive midline tension that could increase recurrence rate in patients with severe rectus diastasis (SRD). New minimally invasive endoscopic repair (FESSA technique)(FT) was proposed to corrects both pathologies. Aim: assess clinical results, postoperative pain, functional recovery and recurrence of FT compared to endoscopic anterior rectus sheaths plication and mesh (ARSP). Patients and Methods male patients with ventral/incisional hernia and SRD were included. 2017–2019 patient underwent to ARSP. 2019–2020 patients underwent to FT. data: Defect and diastasis width and length. Surgical results: Operation time, Intraoperative complications, Hospital stay,Postoperative complications,Pain on 1th/7th/30th days, Functional recovery, Hernia recurrence. Statistic variables were compared using nonparametric tests. Results 53 patients were included. 28 patients underwent FT and 25 to ARSP. operative time: 70 +/-9 min in FT, 55+/- 7 min in ARSP with significant differences.Hospital stay:1.4+/- 0,5 days for FT and 2,08+/-0,5 for ARSP with significant differences. one postoperative subcutaneous hematoma, requiring surgical removal (2%) in ARSP. Pain at postoperative day 1:21+/2 in FT and 25 +/-2 in ARSP without differences. Pain after 7 and 30 days,significant improvement were shown in favor of FT. functional recovery at 1 month: 17,8 +/-2,4 in FT and 27,8 +/-3,3 in ARSP with significant improvement in FT. recurrence after 24 months: 1 patient in FT (3.6%) and 9 patient in ARSP(36.0%) with significant differences. Conclusions Minimally invasive endoscopic Anterior rectus sheaths plication with mesh in SRD and midline hernias, shows higher recurrence rate, postoperative pain and worse functional recovery due to probably excessive midline tension.