Abstract Introduction: Following previous intraperitoneal onlay mesh (IPOM) plus repairs, laparoscopic enhanced view totally extraperitoneal (ETEP) repair for recurrent incisional hernias (RIH) presents difficulties due to fused planes from the previous mesh, transfascial sutures and tacks. The literature on ETEP in this setting, particularly with retro rectus mesh implantation, is limited. This study details our experience of performing ETEP for RIH following prior laparoscopic IPOM plus repairs. Patients and Methods: This was a retrospective study from a prospective database of 28 patients who underwent Laparoscopic ETEP-Rives Stoppas (RS)/transversus abdominis release (TAR) from January 2022 to June 2025. The operative details, challenges faced and tips to overcome the difficulties are explained. Results: Out of 28 patients (mean age 64 years, 19 women and 9 men), 20 patients required ETEP-TAR and 8 underwent ETEP-RS. The mean operating time was 125 min for ETEP-RS, 155 min for ETEP-right TAR and 185 min for ETEP-bilateral TAR. There was no conversion to open/hybrid procedure. The duration of stay was 2–3 days. There were no recurrences during the follow-up period, which ranged from 2 months to 3.5 years, with a mean follow-up of 2 years. Conclusion: Based on our short-term experience, laparoscopic ETEP for the management of recurrent incisional hernia following previous IPOM plus repairs is technically demanding but can be performed safely and effectively in experienced hands, representing a valuable treatment option.
Shenoy et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: