Short-term outcomes of minimally invasive retromuscular ventral hernia repair using an enhanced view totally extraperitoneal (eTEP) approach: systematic review and meta-analysis

Hernia. 2022 Dec;26(6):1511-1520. doi: 10.1007/s10029-021-02557-8. Epub 2022 Jan 19.

Abstract

Background: The enhanced view totally extraperitoneal (eTEP) approach is becoming increasingly more widely accepted as a promising technique in the treatment of ventral hernia. However, evidence is still lacking regarding the perioperative, postoperative and long-term outcomes of this technique. The aim of this meta-analysis is to summarize the current available evidence regarding the perioperative and short-term outcomes of ventral hernia repair using eTEP.

Study design: A systematic search was performed of PubMed, EMBASE, Cochrane Library and Web of Science electronic databases to identify studies on the laparoscopic or robotic-enhanced view totally extraperitoneal (eTEP) approach for the treatment of ventral hernia. A pooled meta-analysis was performed. The primary end point was focused on short-term outcomes regarding perioperative characteristics and postoperative parameters.

Results: A total of 13 studies were identified involving 918 patients. Minimally invasive eTEP resulted in a rate of surgical site infection of 0% [95% CI 0.0-1.0%], a rate of seroma of 5% [95% CI 2.0-8.0%] and a rate of major complications (Clavien-Dindo III-IV) of 1% [95% CI 0.0-3.0%]. The rate of intraoperative complications was 2% [95% CI 0.0-4.0%] with a conversion rate of 1.0% [95% CI 0.0-3.0%]. Mean hospital length of stay was 1.77 days [95% CI 1.21-2.24]. After a median follow-up of 6.6 months (1-24), the rate of recurrence was 1% [95% CI 0.0-1.0%].

Conclusion: Minimally invasive eTEP is a safe and effective approach for ventral hernia repair, with low reported intraoperative complications and good outcomes.

Keywords: Enhanced view totally extraperitoneal; Minimally invasive surgery; Ventral hernia; eTEP.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Hernia, Ventral* / surgery
  • Herniorrhaphy / adverse effects
  • Herniorrhaphy / methods
  • Humans
  • Incisional Hernia* / surgery
  • Intraoperative Complications
  • Laparoscopy* / adverse effects
  • Laparoscopy* / methods
  • Surgical Mesh