Minimally invasive surgery
eTEP ventral hernia repair
An extraperitoneal approach for ventral and incisional hernias, placing mesh behind the rectus muscles and outside the peritoneal cavity.
Indications
- Umbilical and epigastric hernias
- Ventral hernias in the midline or lateral abdomen
- Selected incisional hernias
- Cases where a retromuscular mesh is preferred
Steps
- Creation of the extraperitoneal or retromuscular space
- Dissection and reduction of the hernia sac
- Assessment of the defect and surrounding muscles
- Placement and fixation of the mesh in the retromuscular plane
- Closure of the defect and the access ports
Preoperative assessment
Clinical examination and ultrasound are usually sufficient for small defects. A CT scan is used for larger or recurrent ventral hernias to plan the approach and the mesh size.
Recovery
Early mobilisation is encouraged. Heavy lifting and intense abdominal exercise are gradually reintroduced according to the extent of the repair and the patient's progress.
