Robotic hernia repair III. English version: Robotic incisional hernia repair with transversus abdominis release (r‑TAR). Video report and results of a cohort study Robotische Hernienchirurgie III: Robotische Inzisionalhernienversorgung mit „transversus abdominis release“ (r‑TAR). Videobeitrag und Ergebnisse einer Kohortenstudie

Dietz U. A., Kudsi O. Y., Garcia-Ureña M., Baur J., Ramser M., Maksimovic S., ...Daha Fazla

Chirurg, cilt.92, ss.28-39, 2021 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 92
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1007/s00104-021-01500-y
  • Dergi Adı: Chirurg
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.28-39
  • Anahtar Kelimeler: Incisional hernia, Posterior component separation, Retromuscular mesh, Robotic surgical procedures, Ventral hernia
  • Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır

Özet

The principle of targeted separation or weakening of individual components of the abdominal wall to relieve tension in the median line during major abdominal reconstruction has been known for over 30 years as anterior component separation (aCS) and is an established procedure. In search of alternatives with lower complication rates, posterior component separation (pCS) was developed; transversus abdominis release (TAR) is a nerve-sparing modification of pCS. With the ergonomic resources of robotics (e.g., angled instruments), TAR can be performed in a minimally invasive manner (r-TAR): hernia gaps of up to 14 cm can be closed and a large extraperitoneal mesh implanted. In this video article, the treatment of large incisional hernias using the r‑TAR technique is presented. Exemplary results of a cohort study in 13 consecutive patients are presented. The procedure is challenging, but our own results—as well as reports from the literature—are encouraging. The r‑TAR is becoming the pinnacle procedure for abdominal wall reconstruction.