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Minimally Invasive Sublay Mesh Repair of Abdominal Wall Hernias with the MILOS Technique (Mini or Less Open Sublay Repair)

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Management of Abdominal Hernias

Abstract

The novel endoscopic assisted Mini- or Less Open Sublay (MILOS) operation is described and the results of the first large series of minimally invasive sublay repair of incisional hernias are given. The MILOS technique allows minimally invasive transhernial repair of incisional hernias using large retromuscular / preperitoneal meshes with low morbidity. The technique is reproducible, cost effective, easy to standardize and combines the advantages of open sublay and laparoscopic IPOM repair.

Primary abdominal wall and incisional hernia repair figure among the most frequent operations in surgery. The risk of incarceration is 1–2% per year. The main cause seems to be genetically determined insufficient cross-links between the collagen molecules. Since the advent of synthetic mesh [1], recurrence rates could be reduced from 25–60% to below 15%.

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References

  1. Usher FC, Ochsner J, Tuttle LL Jr. Use of marlex mesh in the repair of incisional hernias. Am Surg. 1958;24(12):969–74.

    CAS  Google Scholar 

  2. Rives J, Pire JC, Flament JB, Convers G. Treatment of large eventrations (apropos of 133 cases). Minerva Chir. 1977;32(11):749–56.

    CAS  Google Scholar 

  3. Stoppa R, Warlaumont C, Chantriaux JF. Prosthetic surgical treatment of inguinal hernias. Parietalization of the spermatic cord. Presse Med. 1984;13(38):2317–8.

    CAS  PubMed  Google Scholar 

  4. Stoppa RE, Rives JL, Warlaumont CR, Palot JP, Verhaeghe PJ, Delattre JF. The use of Dacron in the repair of hernias of the groin. Surg Clin North Am. 1984;64(2):269–85.

    Article  CAS  Google Scholar 

  5. Conze J, Binnebösel M, Junge K, Schumpelick V. Narbenhernie – Wie ist zu verfahren? Chirurgische Standardversorgung. Chirurg. 2010;81(3):192–200.

    Article  CAS  Google Scholar 

  6. Muysoms FE, Miserez M, Berrevoet F, Campanelli G, Champault GG, Chelala E, Dietz UA, Eker HH, El Nakadi I, Hauters P, Hidalgo Pascual M, Hoeferlin A, Klinge U, Montgomery A, Simmermacher RK, Simons MP, Smietański M, Sommeling C, Tollens T, Vierendeels T, Kingsnorth A. Classification of primary and incisional abdominal wall hernias. Hernia. 2009;13(4):407–14. Epub 2009 Jun 3.

    Article  CAS  Google Scholar 

  7. Amid PK, Lichtenstein IL. Retromuscular alloplasty of large scar hernias: a simple staple attachment technique. Chirurg. 1996;67(6):648–52.

    CAS  PubMed  Google Scholar 

  8. den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW. Open surgical procedures for incisional hernias. Cochrane Database Syst Rev. 2008;3:CD006438. Review.

    Google Scholar 

  9. Forbes SS, Eskicioglu C, McLeod RS, Okrainec A. Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg. 2009;96(8):851–8.

    Article  CAS  Google Scholar 

  10. Sajid MS, Bokhari SA, Mallick AS, Cheek E, Baig MK. Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg. 2009;197(1):64–72. Epub 2008 Jul 9. Review.

    Article  Google Scholar 

  11. Kapischke M, Schulz T, Schipper T, Tensfeldt J, Caliebe A. Open versus laparoscopic incisional hernia repair: something different from a meta-analysis. Surg Endosc. 2008;22(10):2251–60. Epub 2008 Mar 5. Review.

    Article  Google Scholar 

  12. Reinpold W. Endoskopisch totalextraperitonealer transhernialer sublay –Bauchwand-Hernienverschluss in single-port-technik. In: Schumpelick V, Arlt G, Conze J, Junge K, editors. Hernien. 5th ed. Stuttgart: Thieme; 2015. p. 301–4.

    Google Scholar 

  13. Seiler CM, Deckert A, Diener MK, Knaebel HP, Weigand MA, Victor N, Büchler MW. Midline versus transverse incision in major abdominal surgery: a randomized, double-blind equivalence trial (POVATI: ISRCTN60734227). Ann Surg. 2009;249(6):913–20.

    Article  Google Scholar 

  14. Seiler CM, Bruckner T, Diener MK, Papyan A, Golcher H, Seidlmayer C, Franck A, Kieser M, Büchler MW, Knaebel HP. Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg. 2009;249(4):576–82.

    Article  Google Scholar 

  15. Rosen MJ, Jin J, McGee MF, Williams C, Marks J, Ponsky JL. Laparoscopic component separation in the single-stage treatment of infected abdominal wall prosthetic removal. Hernia. 2007;11(5):435–40. Epub 2007 Jul 24.

    Article  CAS  Google Scholar 

  16. Schroeder AD, Debus ES, Schroeder M, Reinpold WM. Laparoscopic transperitoneal sublay mesh repair: a new technique for the cure of ventral and incisional hernias. Surg Endosc. 2013;27(2):648–54.

    Article  Google Scholar 

  17. Bittner R, Bingener-Casey J, Dietz U, Fabian M, Ferzli GS, Fortelny RH, Köckerling F, Kukleta J, Leblanc K, Lomanto D, Misra MC, Bansal VK, Morales-Conde S, Ramshaw B, Reinpold W, Rim S, Rohr M, Schrittwieser R, Simon T, Smietanski M, Stechemesser B, Timoney M, Chowbey P, International Endohernia Society (IEHS). Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (international Endohernia society IEHS)-part 1. Surg Endosc. 2014;28(1):2–29. Epub 2013 Oct 11.

    Article  CAS  Google Scholar 

  18. Köckerling F, Botsinis MD, Rohde C, Reinpold W. Endoscopic-assisted Linea Alba reconstruction plus mesh augmentation for treatment of umbilical and/or Epigastric hernias and rectus Abdominis diastasis - early results. Front Surg. 2016;3:27.

    PubMed  PubMed Central  Google Scholar 

  19. W. Reinpold, M. Schröder, A. Schröder, C. Berger, J. Nehls, W. Stoltenberg, F. Köckerling. Minimally invasive sublay mesh repair of incisional and primary abdominal wall hernias using the MILOS technique. European Surg. 2017;49(2):59–64.

    Google Scholar 

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Authors and Affiliations

  1. Department of Surgery and Reference Hernia Center, Gross Sand Hospital Hamburg Wilhelmsburg, Gross-Sand 3, D-21107, Hamburg, Germany

    Wolfgang Reinpold

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  1. Wolfgang Reinpold
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Correspondence to Wolfgang Reinpold .

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Editors and Affiliations

  1. Surgeons Group of Baton Rouge of Our Lady of the Lake Physician Group, Baton Rouge, Louisiana, USA

    Karl A. LeBlanc

  2. Peninsula College of Medicine and Dentistry (Emeritus), Plymouth, United Kingdom

    Andrew Kingsnorth

  3. North Devon District Hospital, Barnstaple, United Kingdom

    David L. Sanders

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Reinpold, W. (2018). Minimally Invasive Sublay Mesh Repair of Abdominal Wall Hernias with the MILOS Technique (Mini or Less Open Sublay Repair). In: LeBlanc, K., Kingsnorth, A., Sanders, D. (eds) Management of Abdominal Hernias. Springer, Cham. https://doi.org/10.1007/978-3-319-63251-3_27

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  • DOI: https://doi.org/10.1007/978-3-319-63251-3_27

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63250-6

  • Online ISBN: 978-3-319-63251-3

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