1
|
Aliseda D, Sanchez-Justicia C, Zozaya G, Lujan J, Almeida A, Blanco N, Martí-Cruchaga P, Rotellar F. 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; 26:1511-1520. [PMID: 35044545 PMCID: PMC9684241 DOI: 10.1007/s10029-021-02557-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/27/2021] [Indexed: 12/02/2022]
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. Supplementary Information The online version contains supplementary material available at 10.1007/s10029-021-02557-8.
Collapse
Affiliation(s)
- D Aliseda
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain.
| | - C Sanchez-Justicia
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain.,Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
| | - G Zozaya
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain.,Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
| | - J Lujan
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain
| | - A Almeida
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain
| | - N Blanco
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain
| | - P Martí-Cruchaga
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain.,Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
| | - F Rotellar
- Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain.,Institute of Health Research of Navarra (IdisNA), Pamplona, Spain
| |
Collapse
|
2
|
Rotellar F, Pardo F, Benito A, Martí-Cruchaga P, Zozaya G, Lopez L, Hidalgo F, Sangro B, Herrero I. Totally laparoscopic right-lobe hepatectomy for adult living donor liver transplantation: useful strategies to enhance safety. Am J Transplant 2013; 13:3269-73. [PMID: 24266975 DOI: 10.1111/ajt.12471] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 07/31/2013] [Accepted: 08/19/2013] [Indexed: 01/25/2023]
Abstract
The overriding concern in living donor liver transplantation is donor safety. A totally laparoscopic right hepatectomy without middle hepatic vein for adult living donor liver transplantation is presented. The surgical procedure is described in detail, focusing on relevant technical aspects to enhance donor safety, specifically the hanging maneuver and dynamic fluoroscopy-controlled bile duct division.
Collapse
Affiliation(s)
- F Rotellar
- Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, University Clinic, Universidad de Navarra, Pamplona, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Bueno-Delgado A, Martínez-Regueira F, Martí-Cruchaga P, Zozaya-Larequi G, García-Lallana A, Rábago G, A-Cienfuegos J. Cecal volvulus in a cardiac transplant patient. Report of a case and critical review. Rev Esp Enferm Dig 2010; 102:338-9. [PMID: 20524765 DOI: 10.4321/s1130-01082010000500011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
4
|
Cienfuegos JA, Rotellar F, Martí-Cruchaga P, Valentí V, Zozaya G, Bueno A, Pedano N, Lozano MD, Sola JJ, Pardo F. Intraductal papillary mucinous neoplasms (IPMN) of the pancreas: clinico-pathologic results. Rev esp enferm dig 2010; 102:314-20. [DOI: 10.4321/s1130-01082010000500005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
5
|
Rotellar F, Pastor C, Baixauli J, Gil A, Valetí V, Poveda I, Martí-Cruchaga P. [Laparoscopic bariatric surgery: proximal gastric bypass]. An Sist Sanit Navar 2006. [PMID: 16511577 DOI: 10.4321/s1137-66272005000600005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The spectacular increase in the prevalence of obesity in our society and the significant complications and comorbidities that it gives rise to have stimulated the interest of scientists and public in this pathology. Surgical treatment is at present the only efficient and lasting treatment for morbid obesity and in many cases it appreciably improves, and even definitively cures, associated complications such as the case of diabetes or hypertension. Amongst the different techniques of bariatric surgery, the gastric bypass (GBP) seems to be definitively establishing itself, since it offers an excellent balance between loss of weight (>70% of the excess), surgical risk and subsequent quality of life. The possibility of carrying out this technique employing a laparoscopic approach has improved its acceptance by doctors and patients while it has made it possible to reduce morbidity and mortality, length of hospital stay and costs. Proximal GBP is carried on those patients with an BMI <60 Kg/m2; for BMI >60 Kg/m2 the GBP employed is denominated distal. Between October 2003 and November 2005, our centre performed 55 laparoscopic proximal Roux-en-Y gastric bypasses via laparoscopy. These involved 42 women and 13 males with an average age of 44 years. The average BMI was 43.5 (35-55.8). The average basal weight was 116.15 Kg. There was no peroperative mortality, nor reinterventions. The BMI after 12 months was 28.4. The average basal weight was 74.2 Kg. Laparoscopic Roux-en-Y proximal gastric bypass is a safe and efficient technique for the treatment of morbid obesity.
Collapse
Affiliation(s)
- F Rotellar
- Departamento de cirugía General, Clínica Universitaria de Navarra, Pamplona.
| | | | | | | | | | | | | |
Collapse
|
6
|
Pardo F, Rotellar F, Valentí V, Pastor C, Poveda I, Martí-Cruchaga P, Zozaya G. [Hepatic and pancreatic laparoscopic surgery]. An Sist Sanit Navar 2005; 28 Suppl 3:51-9. [PMID: 16511579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The development of laparoscopic surgery also includes the more complex procedures of abdominal surgery such as those that affect the liver and the pancreas. From diagnostic laparoscopy, accompanied by laparoscopic echography, to major hepatic or pancreatic resections, the laparoscopic approach has spread and today encompasses practically all of the surgical procedures in hepatopancreatic pathology. Without forgetting that the aim of minimally invasive surgery is not a better aesthetic result but the reduction of postoperative complications, it is undeniable that the laparoscopic approach has brought great benefits for the patient in every type of surgery except, for the time being, in the case of big resections such as left or right hepatectomy or resections of segments VII and VIII. Pancreatic surgery has undergone a great development with laparoscopy, especially in the field of distal pancreatectomy due to cystic and neuroendocrine tumours where the approach of choice is laparoscopic. Laparoscopy similarly plays an important role, together with echolaparoscopy, in staging pancreatic tumours, prior to open surgery or for indicating suitable treatment. In coming years, it is to be hoped that it will continue to undergo an exponential development and, together with the advances in robotics, it will be possible to witness a greater impact of the laparoscopic approach on the field of hepatic and pancreatic surgery.
Collapse
Affiliation(s)
- F Pardo
- Departamento de Cirugía General, Clínica Universitaria de Navarra, Pamplona.
| | | | | | | | | | | | | |
Collapse
|
8
|
Rotellar F, Pastor C, Baixauli J, Gil A, Valetí V, Poveda I, Martí-Cruchaga P. [Laparoscopic bariatric surgery: proximal gastric bypass]. An Sist Sanit Navar 2005; 28 Suppl 3:33-40. [PMID: 16511577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
The spectacular increase in the prevalence of obesity in our society and the significant complications and comorbidities that it gives rise to have stimulated the interest of scientists and public in this pathology. Surgical treatment is at present the only efficient and lasting treatment for morbid obesity and in many cases it appreciably improves, and even definitively cures, associated complications such as the case of diabetes or hypertension. Amongst the different techniques of bariatric surgery, the gastric bypass (GBP) seems to be definitively establishing itself, since it offers an excellent balance between loss of weight (>70% of the excess), surgical risk and subsequent quality of life. The possibility of carrying out this technique employing a laparoscopic approach has improved its acceptance by doctors and patients while it has made it possible to reduce morbidity and mortality, length of hospital stay and costs. Proximal GBP is carried on those patients with an BMI <60 Kg/m2; for BMI >60 Kg/m2 the GBP employed is denominated distal. Between October 2003 and November 2005, our centre performed 55 laparoscopic proximal Roux-en-Y gastric bypasses via laparoscopy. These involved 42 women and 13 males with an average age of 44 years. The average BMI was 43.5 (35-55.8). The average basal weight was 116.15 Kg. There was no peroperative mortality, nor reinterventions. The BMI after 12 months was 28.4. The average basal weight was 74.2 Kg. Laparoscopic Roux-en-Y proximal gastric bypass is a safe and efficient technique for the treatment of morbid obesity.
Collapse
Affiliation(s)
- F Rotellar
- Departamento de cirugía General, Clínica Universitaria de Navarra, Pamplona.
| | | | | | | | | | | | | |
Collapse
|