Umbilical hernia repair by the eTEP, a reproducible and valuable technique.

Abstract

<h4>Background</h4>Umbilical hernia is a common surgical condition, and mesh repair is generally recommended to reduce recurrence rates. Various techniques have been employed, each with its own advantages and disadvantages. The enhanced-view totally extraperitoneal (eTEP) approach offers the benefit of placing the mesh outside the abdominal cavity while maintaining a minimally invasive approach. However, it is associated with longer operative times and requires a higher level of surgical expertise. In this study, we present our method of eTEP for umbilical hernia repair, which has proven to be safe, effective, and highly reproducible.<h4>Methods</h4>Patients with umbilical hernias and defect sizes larger than 1 cm were prospectively enrolled. All patients underwent repair using the eTEP technique, which featured an inferior port position and a caudal-to-cranial dissection approach. Detailed procedural techniques and surgical skills are described, and perioperative outcomes were recorded.<h4>Results</h4>A total of 26 umbilical hernias were repaired using the eTEP technique, with no conversions to an open approach. The mean operative time was 101.8 ± 31 min (range: 47 to 185 min), and the average postoperative hospital stay was 1.8 ± 0.8 days (range: 1 to 5 days). There were no cases of surgical site infection, skin necrosis, wound dehiscence, bowel obstruction, urinary complications, or recurrence.<h4>Conclusion</h4>The eTEP approach for umbilical hernia repair is a safe, efficient, and reproducible alternative to traditional methods. Its unique port positioning, tailored dissection, and optional mesh fixation contribute to reduced complications and improved patient outcomes. Future studies should focus on long-term follow-up to validate the durability and effectiveness of this technique.