Our Summary
This research paper is about a surgical technique called e-TEP-RS, which is used to repair large and complex hernias in the abdomen. The paper discusses the benefits of this technique, which allows a large artificial mesh to be placed in a specific area, separate from the abdominal cavity and its contents. The researchers modified this technique to overcome some challenges and make it easier to reproduce.
They retrospectively examined the medical records of 58 patients with large, complex, ventral abdominal hernias who underwent the e-TEP-RS procedure, with or without an additional procedure called Transversus Abdominis Release (TAR). They also included patients with a condition called Diastasis of Rectus Abdominis Muscle (DRAM). They measured things like post-operative pain, complications during or after surgery, readmission to the hospital, quality of life, and whether the hernia came back.
The results showed that the average size of the hernia was 41.0 ± 28 cm² and the average size of the mesh used was 473.5 ± 165 cm². On average, the surgery lasted about 156.2 ± 40 minutes and the average blood loss was 40.5 ± 26 cc. They found no complications during surgery. Quality of life scores improved from 34.6 (± 2) before surgery to 27.2 (± 4) six months after surgery. Only one patient had a recurrence of the hernia. The most common major complications were seroma formation (accumulation of fluid) and prolonged ileus (delay in the ability of the intestines to contract).
In conclusion, the researchers believe that the e-TEP-RS technique can be used with great results and an acceptable level of complications for large, complex, midline, ventral abdominal hernias. However, they caution that the technique is technically challenging and should be mastered in smaller hernias before attempting it in larger, more complex ones.
FAQs
- What is the e-TEP-RS surgical technique and how is it used in hernia repair?
- What were the results of the study on patients who underwent the e-TEP-RS procedure?
- What are the potential complications of the e-TEP-RS technique and how common are they?
Doctor’s Tip
A doctor might tell a patient undergoing hernia repair to follow post-operative care instructions carefully, including avoiding heavy lifting or strenuous activity for a certain period of time to allow proper healing of the surgical site. They may also recommend maintaining a healthy weight and practicing good posture to prevent future hernias. Additionally, they may advise the patient to schedule regular follow-up appointments to monitor the healing process and address any concerns or complications that may arise.
Suitable For
Patients who are typically recommended hernia repair include those with large, complex, ventral abdominal hernias, as well as those with Diastasis of Rectus Abdominis Muscle (DRAM). These patients may experience symptoms such as pain, discomfort, and a visible bulge in the abdomen. In addition, patients with hernias that are at risk of complications such as bowel obstruction or strangulation may also be recommended for hernia repair. It is important for patients to consult with a healthcare provider to determine the best course of treatment for their specific condition.
Timeline
Overall, the timeline of what a patient experiences before and after hernia repair can be summarized as follows:
Before surgery:
- Patient experiences symptoms of a hernia, such as pain, discomfort, and bulging in the abdomen.
- Patient consults with a healthcare provider, who diagnoses the hernia and recommends surgery.
- Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for surgery.
- Patient may need to make lifestyle changes or medications to prepare for surgery.
- Patient undergoes hernia repair surgery, in this case using the e-TEP-RS technique.
After surgery:
- Patient experiences post-operative pain, which is managed with medication.
- Patient may experience complications such as seroma formation or prolonged ileus, which are monitored and treated as needed.
- Patient is discharged from the hospital and instructed on post-operative care, including wound care and activity restrictions.
- Patient follows up with their healthcare provider for post-operative appointments to monitor their recovery and assess for any complications.
- Patient’s quality of life improves over time, with decreased pain and improved function.
- Patient may experience a recurrence of the hernia, although the risk is low with the e-TEP-RS technique.
- Patient resumes normal activities and enjoys the benefits of hernia repair surgery.
What to Ask Your Doctor
Some questions a patient should ask their doctor about hernia repair using the e-TEP-RS technique include:
- What specific benefits does the e-TEP-RS technique offer compared to other hernia repair methods?
- How many procedures have you performed using the e-TEP-RS technique, and what is your success rate?
- Will I need any additional procedures, such as TAR, in conjunction with the e-TEP-RS technique for my hernia repair?
- What is the expected recovery time and post-operative pain level associated with the e-TEP-RS technique?
- What are the potential complications or risks associated with the e-TEP-RS technique, and how are they typically managed?
- How likely is it that my hernia will recur after undergoing the e-TEP-RS procedure?
- Can you provide me with information on the long-term outcomes and quality of life improvements seen in patients who have undergone hernia repair using the e-TEP-RS technique?
- Are there any specific factors about my hernia that may make me a better or worse candidate for the e-TEP-RS technique?
- What steps can I take to prepare for the e-TEP-RS procedure and optimize my recovery process?
- Are there any alternative treatment options for my hernia that I should consider before deciding on the e-TEP-RS technique?
Reference
Authors: Khetan M, Dey A, Bindal V, Suviraj J, Mittal T, Kalhan S, Malik VK, Ramana B. Journal: Hernia. 2021 Dec;25(6):1635-1646. doi: 10.1007/s10029-021-02397-6. Epub 2021 Apr 7. PMID: 33826031