Evidence map›Paper›PMID 34297175›Full record

ArticleLangenbeck's archives of surgery2021

Subxiphoid top-down endoscopic totally preperitoneal approach (eTPA) for midline ventral hernia repair.

Binggen Li, Changfu Qin, Dingxian Liu, Jinchao Miao, Jiwei Yu, Reinhard Bittner

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Article in Langenbeck's archives of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
  8. Falciform Ligament Laparoscopic Approach for Preperitoneal Ventral Hernia Repair.JSLS : Journal of the Society of Laparoendoscopic Surgeons
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 2 countries.

Binggen LiDepartment of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.
Changfu QinDepartment of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, China.
Dingxian LiuDepartment of Hernia and Abdominal Wall Surgery, Fuyang Hernia Specialty Hospital, Fuyang, 236000, China.
Jinchao MiaoDepartment of General Surgery, Pengpai Memorial Hospital Affiliated to Guangdong Medical University, Shanwei, 516400, China.
Jiwei YuDepartment of General Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 201999, China.
Reinhard BittnerEm. Director Marienhospital Stuttgart, Retirement. Supperstr.19, 70565, Stuttgart, Germany. bittnerfamilie@web.de.ORCID http://orcid.org/0000-0001-7425-9734
Capital Medical University · CNFuyang Maternity and Child Health Care Hospital · CNGuangdong Medical College · CNMarienhospital Stuttgart · DENanfang Hospital · CNShanghai Jiao Tong University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMidline abdominal wall hernia repair is among the most common surgical interventions performed worldwide. However, the optimal surgical technique remains controversial. To overcome the disadvantages of both open and transabdominal procedures, we developed a totally endoscopic preperitoneal approach (eTPA) with placement of a large mesh.

methodsFrom December 2019 to October 2020, 20 consecutive patients with small to medium-sized midline ventral hernias underwent repair using a completely preperitoneal subxiphoid top-down approach. The preperitoneal space was entered directly below the xiphoid, and careful endoscopic development of the plane between the peritoneum and posterior sheath of the rectus fascia was then performed behind the linea alba. The hernia sac and its contents were identified and reduced. The hernia defect was closed with sutures, and a mesh with an adequate high defect: mesh ratio was placed in the newly created preperitoneal space.

resultsTwenty patients were enrolled in this study, including 14 with primary umbilical hernias, 4 with primary epigastric hernias, and 2 with recurrent umbilical hernias. 15 patients suffered from a mild concomitant diastasis recti. All operations were successfully completed without conversion to open repair. The mean operative time was 105.3 min (range, 60-220 min). Postoperative pain was mild, and the mean visual analog scale score for pain was 1.8 on the first postoperative day. The average postoperative hospital stay was 1.8 days (range, 1-4 days). One patient developed a minor postoperative seroma, but it had no adverse impact on the final outcome. No patients developed recurrence during the 3- to 10-month follow-up period.

conclusionsThe subxiphoid top-down totally endoscopic preperitoneal approach (eTPA) technique is feasible and effective. It may become a valuable alternative for the treatment of primary small- (defect size < 2 cm) and medium-sized (2-4 cm) midline ventral hernias, particularly in presence of a concomitant diastasis recti.

Indexed as

Abdominal WallHernia, VentralLaparoscopyEndoscopyHerniorrhaphyHumansSurgical MeshEndoscopic hernia repairEpigastric herniaIncisional ventral herniaPreperitoneal hernia repairPrimary ventral herniaSubxiphoid top-down approachTotally preperitoneal approachUmbilical hernia

Identifiers

PMID34297175
OpenAlexW3184969372

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.