A Study on The Concept and Access In E-TEP Hernia Repair: Is E-TEP A New Paradigm?

Abstract

Background: Hernias are a common surgical issue characterized by the protrusion of abdominal contents through a weakened abdominal wall. The extended Totally Extraperitoneal (e-TEP) technique has emerged as a modern approach to ventral and inguinal hernia repairs, allowing the large mesh placement in the retrorectus plane while minimizing intra-abdominal complications. Despite its potential benefits, challenges like retromuscular access and suturing in confined spaces persist.

Aim: This study aims at the effectiveness of the e-TEP technique in hernia repair, focusing on clinical outcomes, postoperative management, and risk factors for recurrence and complications.

Methods: A prospective study was conducted at the Department of General Surgery, Hi-tech Medical College and Hospital, Rourkela, from January 1, 2024, to June 30, 2024. Fourteen patients with ventral and inguinal hernias were treated using the e-TEP and e-TEP-RS techniques. The procedures, complications, and outcomes were recorded and analysed over a mean follow-up period of six months.

Results: The mean surgery duration was 210 minutes, with an average hernia defect size of 5.8 cm in width. A large mesh (mean size 486 cm²) was used in all cases without additional fixation. Postoperative complications were minimal, resolving without intervention. There were no recurrences or significant complications like surgical site infections or bowel obstructions during the follow-up period.

Conclusion: The e-TEP technique is a safe and effective alternative for hernia repair, offering a tension-free repair with low complication rates. The findings suggest that e-TEP may provide a durable and minimally invasive option for hernia surgery.

Recommendations: While these results are promising, further research with a larger sample size and longer follow-up is needed to validate the long-term efficacy and safety of the e-TEP technique.

Keywords: Hernia Repair, e-TEP Technique, Ventral Hernia, Inguinal Hernia, Minimally Invasive Surgery, Mesh Placement.