101 - Freie Mitteilung
Bariatry & hernia II
17. Mai 2019, 14:15 - 15:45, Bellavista 5, 6. OG
Video: Simultaneous treatment of incisional umbilical hernia and rectus diastasis: Single Port Endoscopic Linea Alba Reconstruction including stapled sublay repair (SP-ELAR plus) – A technical case report
N. Pfeifer, J. Janczak, R. Strahm, L. Pietrogiovanna, W. Brunner, Presenter: N. Pfeifer (St. Gallen/Rorschach)
Management of a growing number of patients with symptomatic abdominal wall hernias with a concomitant rectus diastasis is a complex situation. Aiming to combine well-established open surgical techniques like an open sublay repair with minimally invasive techniques revealed recently several extraperitoneal repair techniques. We present a video showing a single-port approach for an endoscopic linea alba reconstruction including a stapled sublay repair.
A 45 year old, male patient presented with an incisional umbilical hernia after laparoscopic appendectomy 2 months ago. Besides there was a significant rectus diastasis. No other previous abdominal operations are mentioned, the patient suffers from arterial hypertension and diabetes mellitus type 2, both of them are well medicated.
Through an umbilical single port incision the retromuscular plane was opened and dissected to both sides to allow endoscopic linea alba reconstruction using 4 Endo-GIA 60 magazines. An intraabdominally placed trocar allowed a good overview as well as avoidance of intraabdominal injuries. An extraabdominal mesh (Versatex 28x16cm) was placed on the posterior rectus sheath and fixated with cyanoacrylate glue. The postoperative course was uneventful, the patient was dismissed on the 3rd postoperative day with an excellent cosmetic an functional result.
Single Port Endoscopic Linea Alba Reconstruction including stapled sublay repair (SP ELAR plus) is a safe procedure to simultaneously treat abdominal wall hernias and small rectus diastasis. It is recommended to place an intraabdominal trocar to avoid intraabdominal injuries when using the stapler.