Surgical endoscopy · 2018
Step-by-step guide to safe removal of pre-peritoneal inguinal mesh.
СтатьяVideo-Audio MediaНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Truong Adam, Al-Aufey Badr Saad, Towfigh Shirin
Аннотация
BACKGROUND: Inguinal hernia repairs are among the most common operations performed worldwide. An increasing number is performed minimally invasively with mesh placed pre-peritoneally. Some situations may require mesh removal. This can be complex and challenging. We share our technique to remove pre-peritoneal mesh using a minimally invasive approach.
METHODS: The multiple steps involved in robotic-assisted pre-peritoneal mesh removal are reviewed in detail, including preoperative planning, intraoperative positioning, review of anatomic landmarks, and systematic approach with technical tips to reduce complications.
RESULTS: We provide an attached narrated video guide with a written summary to outline pre-peritoneal inguinal mesh removal. The steps are applicable to both robotic-assisted and laparoscopic approaches. We present a video of the robotic-assisted approach. We prefer the robotic-assisted approach for most pre-peritoneal mesh removal based on results of our retrospective series of 26 patients undergoing 31 mesh removals. We noted that our robotic-assisted approach was more effective than the laparoscopic approach, with significantly less incidence of vascular injury (0 vs 5, p < 0.05) and less nerve (1 vs 4) and spermatic cord injuries (0 vs 1).
CONCLUSIONS: As pre-peritoneal inguinal mesh implantation becomes more popular, surgeons may be seeing more patients with complications who may require mesh removal. We provide a detailed step-by-step approach with video to serve as a guide to surgeons who are planning for safe removal of pre-peritoneal inguinal hernia mesh.
METHODS: The multiple steps involved in robotic-assisted pre-peritoneal mesh removal are reviewed in detail, including preoperative planning, intraoperative positioning, review of anatomic landmarks, and systematic approach with technical tips to reduce complications.
RESULTS: We provide an attached narrated video guide with a written summary to outline pre-peritoneal inguinal mesh removal. The steps are applicable to both robotic-assisted and laparoscopic approaches. We present a video of the robotic-assisted approach. We prefer the robotic-assisted approach for most pre-peritoneal mesh removal based on results of our retrospective series of 26 patients undergoing 31 mesh removals. We noted that our robotic-assisted approach was more effective than the laparoscopic approach, with significantly less incidence of vascular injury (0 vs 5, p < 0.05) and less nerve (1 vs 4) and spermatic cord injuries (0 vs 1).
CONCLUSIONS: As pre-peritoneal inguinal mesh implantation becomes more popular, surgeons may be seeing more patients with complications who may require mesh removal. We provide a detailed step-by-step approach with video to serve as a guide to surgeons who are planning for safe removal of pre-peritoneal inguinal hernia mesh.