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| Name | Preperitoneal eTEP – A Game Changer in Ventral Hernia Repair at WALS 2025 by Dr Brijendra Singh |
| Video Uploader | Video From wals |
| Upload Date | This Video Uploaded At 10-03-2025 04:30:35 |
| Video Discription | The 8th World Congress of Laparoscopic Surgeons (WALS 2025) witnessed a groundbreaking discussion by Dr. Brijendra Singh on Preperitoneal Enhanced View Totally Extraperitoneal (eTEP) Repair—a revolutionary approach in ventral hernia surgery. This technique, which refines the principles of the extended totally extraperitoneal (eTEP) method, is transforming the management of ventral hernias by providing a minimally invasive yet highly effective alternative to traditional approaches. Evolution of eTEP in Ventral Hernia Repair The eTEP technique was initially conceptualized for inguinal hernia repair but has now evolved as a promising modality for ventral hernias, particularly in midline and lateral abdominal wall defects. Unlike conventional intraperitoneal onlay mesh (IPOM) or transabdominal preperitoneal (TAPP) repairs, eTEP offers a completely extraperitoneal approach, minimizing peritoneal breach and its associated complications. Advantages of Preperitoneal eTEP Dr. Brijendra Singh emphasized several key advantages of preperitoneal eTEP repair, making it a game changer in ventral hernia surgery: 1. Minimal Intraperitoneal Adhesions – The preperitoneal dissection avoids direct peritoneal entry, significantly reducing the risk of postoperative adhesions and bowel-related complications. 2. Improved Mesh Placement – By placing the mesh in the preperitoneal space, the technique mimics the physiological principles of the Stoppa repair, leading to better integration and lower recurrence rates. 3. Lower Risk of Bowel Injury – Unlike traditional IPOM techniques, where mesh is placed intraperitoneally, eTEP ensures mesh positioning outside the peritoneal cavity, eliminating direct contact with viscera. 4. Reduced Postoperative Pain – The extraperitoneal placement reduces the inflammatory response, leading to decreased postoperative pain and faster recovery. 5. Enhanced Cosmetic Outcomes – Smaller port incisions, combined with the avoidance of midline laparotomies, provide superior cosmetic results. Technical Insights and Challenges The eTEP technique for ventral hernia repair requires precise anatomical knowledge and meticulous dissection to develop the preperitoneal space adequately. The key technical steps include: • Creation of a working space using lateral ports to facilitate dissection without peritoneal breach. • Identification and preservation of the neurovascular bundles to prevent chronic pain and neuromas. • Adequate closure of the defect before mesh placement, ensuring long-term durability of the repair. • Secure fixation of the mesh using fibrin glue or tacking devices to prevent migration or recurrence. Despite its advantages, eTEP is technically demanding, requiring a steep learning curve. However, with increasing experience and refinement of technique, it is rapidly gaining popularity among laparoscopic and robotic surgeons. Future of eTEP in Ventral Hernia Surgery The session at WALS 2025 concluded with an engaging discussion on the future of preperitoneal eTEP in the evolving landscape of hernia surgery. With advancements in robotic platforms, enhanced imaging, and AI-assisted navigation, eTEP is set to become the preferred approach for complex ventral hernias, offering a perfect blend of safety, efficacy, and patient comfort. Dr. Brijendra Singh’s insights reaffirm that preperitoneal eTEP is indeed a game changer—ushering in a new era of minimally invasive, durable, and patient-centric hernia repair strategies. |
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