Rectus abdominis lateral approach totally endoscopic retromuscular repair: clinical analysis of 11 cases of ventral hernia repair

doi:10.3877/cma.j.issn.1674-392X.2021.06.004

Abstract

Abstract:

Objective

To investigate the surgical procedure and technical points of rectus abdominis lateral approach totally endoscopic retromuscular repair (RALTER), and to analyze the safety and efficacy of this procedure.

Methods

During October to November 2019, eleven consecutive cases of primary ventral hernia were treated using the RALTER procedure. A large piece of mesh was placed in the retromuscular plane for reinforcement of the closure. All operations were performed in accordance with the RALTER standard procedure.

Results

All 11 operations were successful without conversion. The average operation time was 142 (80 to 245) minutes. The average blood loss during the operation was 10 ml. The postoperative pain score (NRS) was 1 to 2 points on the second day after surgery. The average postoperative hospital stay was 4.3 (3 to 7) days. During a follow-up of 66 to 100 days, there was no recurrence or postoperative complication.

Conclusion

RALTER is safe and feasible for ventral hernia repair. The outcome is favorable with mild postoperative pain and rapid recovery. Besides there is no need for expensive anti-adhesion mesh and fixation tacker which make it more cost effective. RALTER is a reliable method for treating midline ventral hernia and anterior abdominal wall marginal incisional hernia.

Key words: Ventral hernia, Retromuscular repair, Laparoscopy, Herniorrhaphy

Yilin Zhu, Zhenyu Zou, Yuchen Liu, Xuefei Zhao, Huiqi Yang, Minggang Wang, Jie Chen. Rectus abdominis lateral approach totally endoscopic retromuscular repair: clinical analysis of 11 cases of ventral hernia repair[J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(06): 556-560.

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References 19

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序号	性别	年龄(岁)	体质量指数(kg/m²)	诊断/位置	疝环最大直径(cm)	补片大小(cm×cm)	手术时间(min)	术后住院时间(d)
1	女性	42	25.2	切口疝/右上腹	8	25×15	110	4
2	女性	70	26.7	切口疝/右上腹	6	25×15	80	3
3	男性	48	27.7	切口疝/右下腹	15	30×20	190	5
4	女性	83	25.4	切口疝/上腹正中	5	25×15	105	4
5	男性	69	23.7	切口疝/右下腹	4	25×15	115	3
6	女性	70	34.2	切口疝/下腹正中	6	25×15	185	7
7	女性	67	24.7	切口疝/右下腹	7	30×20	165	5
8	男性	65	25.6	切口疝/右下腹	8	30×20	245	5
9	男性	32	27.2	切口疝/右下腹	10	30×20	180	4
10	女性	37	23.5	脐疝	3	25×15	90	4
11	男性	28	28.4	腹白线疝	3	25×15	95	3

序号	性别	年龄(岁)	体质量指数(kg/m²)	诊断/位置	疝环最大直径(cm)	补片大小(cm×cm)	手术时间(min)	术后住院时间(d)
1	女性	42	25.2	切口疝/右上腹	8	25×15	110	4
2	女性	70	26.7	切口疝/右上腹	6	25×15	80	3
3	男性	48	27.7	切口疝/右下腹	15	30×20	190	5
4	女性	83	25.4	切口疝/上腹正中	5	25×15	105	4
5	男性	69	23.7	切口疝/右下腹	4	25×15	115	3
6	女性	70	34.2	切口疝/下腹正中	6	25×15	185	7
7	女性	67	24.7	切口疝/右下腹	7	30×20	165	5
8	男性	65	25.6	切口疝/右下腹	8	30×20	245	5
9	男性	32	27.2	切口疝/右下腹	10	30×20	180	4
10	女性	37	23.5	脐疝	3	25×15	90	4
11	男性	28	28.4	腹白线疝	3	25×15	95	3

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