Laparoscopic Etep (Extended Totally Extraperitonal Repair) Ventral Hernia Surgery – Results From 2021 to 2023

Abstract Background In our surgical department, we've recently shifted to ETEP surgery with retromuscular mesh placement as our preferred technique for both primary ventral hernias and recurrent hernias with prior implants. This abstract outlines the outcomes of 30 cases treated with ETEP surgery between 2021 and 2023. Methods The cohort of 30 patients presents a diverse range of hernia complexities, from umbilical hernias with diastasis recti to large ventral hernias with prior implants. Results Our surgical times varied widely, spanning from 122 to 420 minutes, with a median of 197 minutes. Hospital stays with a median of 3 days (range 1–12). Six cases required bilateral Transversus Abdominis Release (TAR), while five patients needed unilateral TAR. Two patients underwent hybrid surgery with both open and laparoscopic surgery. Postoperative complications included four cases of bleeding, with two necessitating laparoscopic reoperation within 24 hours. Follow-up comprised clinical assessments and CT scans 1–3 months post-surgery, with additional CT scans for some patients one year post-surgery. Except for one early breakdown of the posterior layer and one small linea alba injury, CT scans showed adequate abdominal wall reconstruction in all patients. To date, we have not encountered any hernia recurrences or wound or mesh infections, with only one patient developing a symptomatic seroma after surgery. Conclusion Laparoscopic retromuscular mesh placement via ETEP surgery appears promising for achieving superior anatomical abdominal wall reconstruction compared to IPOM. Our results thus far indicate favorable outcomes based on post-surgery CT evaluations and clinical follow-up.