CAN ETEP APPROACH IMPROVE COMPLEX INCISIONAL HERNIA REPAIR OUTCOMES?

Aim To compare postoperative results of two cohorts of patients with simple and complex incisional hernias, operated using the extended totally extraperitoneal technique (eTEP). Materials and Methods Retrospective comparative multicenter study based on prospective database conducted at the Fundación Jiménez Díaz University Hospital and La Paz Hospital in Madrid, including eTEP repairs performed between March 2019 and January 2023. Patients were classified as complex hernias if they met at least one criterion according to the Slater definition (1). If no criteria were met, it was classified as a simple hernia. Results 159 patients were operated on via eTEP during the study period, and 111 incisional hernias were analyzed according to the EHS classification: 38 complex cases and 73 simple cases. The median defect size was 50mm (40–97) in simple cases and 66mm (24–126) (p<0.01), the median surgical time was 130min (59–360) and 145min (63–240) respectively without significant differences. TAR was required in 26 (35.6%) simple cases versus 23 (60.5%) complex cases (<0.01). One (1.4%) recurrence was observed in simple cases and 2 (5.3%) in complex cases, as well as 7 (9.6%) complications in simple cases and 5 (13.2%) in complex cases, both without statistical significance. The median follow-up was 26 months in simple cases and 11 months in complex cases (p<0.01). Conclusions The application of the eTEP approach in selected complex cases can improve postoperative results close to simple hernias. 1. Slater NJ et al. Criteria for definition of a complex abdominal wall hernia. Hernia 2014, 18:7–17.