Cirugía endoscópica de la hernia de Spiegel: implementación de los abordajes IPOM, TAPP y TEP.

Introduction: Spiegelian hernia is an extremely rare ventral hernia, with an incidence of less than 2 %. The laparoendoscopic approach has become the surgical method of choice, with successful use of transabdominal (IntraPeritoneal Onlay Mesh [IPOM]) and preperitoneal (TransAbdomino-PrePeritoneal [TAPP] and Totally ExtraPeritoneal [TEP]) techniques. We present our experience in the implementation of these techniques, over the last 10 years, in an outpatient and short stay surgery hospital. Methods: We present a series of 31 patients operated by laparoendoscopic approach between February 2011 and June 2021. The three techniques were used according to the location of the defect and the progressively acquired experience in laparoendoscopic abdominal wall surgery. Demographic, clinical, diagnostic, surgical and postoperative characteristics are evaluated in the short and medium term. Results: 33 hernias were operated on in 31 patients (22 females and 9 males) with a mean age of 66.43 years, all ASA I-II. 14 IPOM were performed at the beginning of the series, 11 TAPP and 8 TEP with subsequent implementation. The mean operative time was 58.14 minutes. The mean hospital stay was 24.76 hours. The most frequent complication was seroma. Follow-up was between 1 month and 2 years. All histories were reviewed and no recurrence was found in any patient. Conclusion: Laparoendoscopic surgery offers excellent results and should become the standard of care. It has not been demonstrated which technique is superior and the choice will depend on the type of patient and the surgeon's expertise, experience and results. [ABSTRACT FROM AUTHOR]