Endoscopic Mini-or Less-Open Sublay Operation (E/MILOS) in ventral hernia repair: a minimally invasive alternative technique

The ideal ventral hernia surgical repair is still in discussion1. The defect closure with a mesh-based repair is the base of surgical repair, in open or minimally invasive techniques2. The open methods lead to a higher surgical site infections incidence, meanwhile, the laparoscopic IPOM (intraperito...

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Published inRevista do Colegio Brasileiro de Cirurgioes Vol. 50; p. e20233405
Main Authors DE-Carvalho, João Paulo Venancio, Pivetta, Luca Giovanni Antonio, Amaral, Pedro Henrique DE Freitas, Dias, Eduardo Rullo Maranhão, Macret, Jessica Zilberman, Ribeiro, Hamilton Brasil, Francis, Maurice Youssef, Antunes, Pedro DE Souza Lucarelli, Reinpold, Wolfgang, Roll, Sergio
Format Journal Article
LanguageEnglish
Published Brazil Colégio Brasileiro de Cirurgiões 2023
Subjects
Brazil
Hand-Assisted Laparoscopy
Hernia, Ventral
Hernia, Ventral - surgery
Herniorrhaphy - methods
Humans
Incisional Hernia - surgery
Laparoscopy
Laparoscopy - methods
Surgical Mesh
Technical Note
Video-Assisted Surgery
Brazil
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Summary:The ideal ventral hernia surgical repair is still in discussion1. The defect closure with a mesh-based repair is the base of surgical repair, in open or minimally invasive techniques2. The open methods lead to a higher surgical site infections incidence, meanwhile, the laparoscopic IPOM (intraperitoneal onlay mesh) increases the risk of intestinal lesions, adhesions, and bowel obstruction, in addition to requiring double mesh and fixation products which increase its costs and could worsen the post-operative pain3-5. The eTEP (extended/enhanced view totally intraperitoneal) technique has also arisen as a good option for this hernia repair. To avoid the disadvantages found in classic open and laparoscopic techniques, the MILOS (Endoscopically Assisted Mini or Less Open Sublay Repair) concept, created by W. Reinpold et al. in 2009, 3 years after eTEP conceptualization, allows the usage of bigger meshes through a small skin incision and laparoscopic retro-rectus space dissection, as the 2016 modification, avoiding an intraperitoneal mesh placement6,7. This new technique has been called E-MILOS (Endoscopic Mini or Less Open Sublay Repair)8. The aim of this paper is to report the E-MILOS techniques primary experience Brazil, in Santa Casa de Misericórdia de São Paulo.
Bibliography:Conflict of interest: no.
ISSN:0100-6991
1809-4546
DOI:10.1590/0100-6991e-20233405-en