Epigastric Ventral Hernia Repair Through Vaginal Natural Orifice Transluminal Endoscopic Surgery.

Abstract

<h4>Objective</h4>Ventral hernia repair is a commonly performed operation and can be executed by open or laparoscopic approach. The search for even less invasive techniques continues. Natural orifice transluminal endoscopic surgery (NOTES) is a known method of minimally invasive surgery.<h4>Methods</h4>We performed an epigastric ventral hernia repair through vaginal NOTES during a concurrent hysterectomy and bilateral salpingectomy. We used the access to do a synchronous hernia repair with mesh augmentation. The technique of repair was identical to the laparoscopic intraperitoneal onlay mesh repair (Lap. IPOM).<h4>Results</h4>We reported a sufficient hernia repair without intra-operative complications. Also, post-operatively, no problems were encountered. Follow-up after 4 weeks showed a good and strong hernia repair. The complaints of the patient were relieved. CT scan 10 months after operation showed no recurrence nor signs of mesh infection.<h4>Conclusions</h4>Ventral hernia repair through vaginal NOTES can be considered a possible new and minimal invasive (scarless) technique for ventral hernia repair but further investigations on a larger scale are needed to confirm feasibility & safety.