إصلاح الفتق السري بعملية eTEP: الشبكة ورا العضلات | eTEP Ventral Hernia Repair: Retromuscular Mesh Placement
الشبكة ورا العضلات | Mesh Behind the Muscles
عملية الـ eTEP من أنسب العمليات لمعظم حالات الفتق السُري والجار سُري (Umbilical hernia). د. محمد حسام زيدان بيشرح إن المنظار بيشتغل جوه جدار البطن نفسه، مش جوه تجويف البطن زي عمليات الـ TAPP والـ IPOM+، فبيصلّح جدار البطن والفتق ويحط الشبكة ورا العضلات، وميزتها إن ضغط البطن بيثبّت الشبكة أكتر. وبيذكر دراسة مجمّعة على 860 مريض قارنت eTEP بالـ IPOM+: ألم أقل، وإقامة أقصر في المستشفى، وشكل تجميلي أفضل، ومعدل رجوع 1.8% وتجمّع مائي 0.7%. وعشان كده السؤال الصح مش «بكام؟» لكن «إيه أنسب عملية ليّا؟». | eTEP is one of the most suitable operations for most umbilical and paraumbilical hernias. Dr. Mohamed H. Zidan explains that the laparoscope works within the abdominal wall itself rather than inside the abdominal cavity, as in TAPP or IPOM+, so the surgeon repairs the abdominal wall and the hernia and places the mesh behind the muscles. A key advantage is that rising abdominal pressure holds the mesh more firmly in place. He cites a pooled analysis of 860 patients comparing eTEP with IPOM+: less pain, a shorter hospital stay, a better cosmetic result, a recurrence rate of 1.8% and a seroma rate of 0.7%. That's why the right question isn't "How much?" but "Which operation suits me best?"
Key Takeaways
Full Transcript
Host: Doctor, which operation works for most cases?
Dr. Zidan: The operation that works for most umbilical and paraumbilical hernias is eTEP. So what makes eTEP different from the other operations? In eTEP, we repair the abdominal wall using a laparoscope placed almost within the abdominal wall itself, not inside the abdominal cavity as in TAPP or IPOM Plus. On that basis, we repair the abdominal wall and the hernia and place the mesh within the abdominal wall, behind the muscles. The advantage of this operation is that the higher the abdominal pressure, the more firmly the mesh is held, which is the opposite of most other hernia operations. A pooled study of 860 patients comparing eTEP with IPOM Plus showed that pain after eTEP is lower, the hospital stay is shorter, and cosmetically it is the best. Most importantly, the recurrence rate is lower, at 1.8%, and the seroma rate is only 0.7%, the lowest figure among laparoscopic umbilical and paraumbilical hernia repairs. That's why "How much is the operation?" isn't the right question; the better question is "Which operation suits me best?"