Radiologic transversus abdominis muscle retraction after unilateral transversus abdominis release via etep

Abstract Aim Our principal aim is to determine the retraction distance (RD) of the transverse abdominis muscle after unilateral endoscopic transversus abdominis release (eTAR) for the treatment of midline and lateral hernias, and compare it with the same patient contralateral unreleased side. Material and Methods We performed a retrospective analysis of a prospective database collection. We defined the RD as the measure between the lateral edge of the rectus abdominis muscle and the medial edge of the transversus abdominis muscle at the level of L3-L4 and at the defect´s maximum diameter. RD was measured pre and postoperatively and compared in the eTAR side with the contralateral (non- eTAR) side. Results 94 midline and 63 lateral hernias underwent hernia repair via endoscopic totally extraperitoneal (eTEP). Thirtyfive patients required unilateral TAR, including 1 primary and 34 incisional hernias. Lateral (65,7%) and medial (34,3%) defects were both included. The mean hernia defect was 49mm transverse diameter and 52mm longitudinal. We compared the postoperative RD at L4, obtaining 45,8mm on the eTAR side and 42,2mm on the non-eTAR side (p=0,284). At the defect site a mean of 38,3mm on the eTAR side was compared with 35,5mm (p=0.363). In our series we didn't find any statistically significant differences in the transversus muscle retraction after unilateral eTAR when compared with the unreleased side. Conclusions eTAR is a safe technique especially during the treatment of lateral hernias, allowing a proper mesh placement without significant transverse muscle retraction.