Single-center experience in robotic-assisted colorectal surgery during COVID pandemic: First 72 cases

Introduction: Minimally invasive techniques for diastasis recti and ventral hernia repair achieve the benefits and minimize the limitations of the open Rives-Stoppa sublay mesh repair. The principles of a retromuscular repair decrease recurrence, increase functionality, exclude mesh from the viscera, limit infection and wound complications. The laparoscopic extraperitoneal sublay mesh repair technique using an endoscopic stapler facilitate re-approximation of the linea alba and creation of the retromuscular space, and allow the apposition of a prosthetic mesh.
Materials and methods: We report our first case of laparoscopic stapled sublay repair in a 30y.o. lady with a 4cm sovraumbilical ventral hernia associated with diastasis of recti abdominis. This technique combines Rives-Stoppa principles and minimally invasive access using a surgical stapler to plicate the posterior sheaths of the recti abdominis.
Intraoperative and perioperative complications, early recurrence, pain, and narcotic usage were measured.
Results: There were no significant intraoperative complications nor conversion to open surgery. The patient was discharged on postoperative day 2. There were no early postoperative infections or recurrences. The patient required postoperative analgesics in the early period and was feeling well at a week follow up.
Conclusions: Laparoscopic extraperitoneal stapled sublay mesh repair seems a safe and effective technique for the treatment of medium- to large-sized ventral and incisional hernias. Further studies and follow-up will be necessary to evaluate long-term results.
 
 

Keywords: Abdominal Wall Hernia, Postoperative Hernia, Abdominal Wall Reconstruction, Mesh, Laparoscopy..