A giant inguinal hernia in a patient with Ehlers-Danlos syndrome
Abstract
BACKGROUND: Inguinal hernia formation is a common event in patients with Ehlers-Danlos syndrome. Minimally invasive surgical technique for inguinal hernia repair is the same used in patients without EDS but it is related to more intraoperative and postoperative complications.
AIM: Inour study, we present a case of inguinal hernia in a EDS patient successfully treated with a robotic transabdominal preperitoneal procedure (TAPP procedure).
MATERIAL AND METHODS: We decided to perform a robotic TAPP with the DaVinci Xi® platform (Intuitive Surgical, Sunnyvale, USA) under general anaesthesia. A robotic docking was performed and three arms were positioned in the abdomen. Total operative timing was 45 mins.
RESULTS: During the robotic procedure no intraoperative complications were recorded and no drains were applied. The postoperative period was uneventful and the patient was discharged in the first postoperative day.
DISCUSSION: Inguinal hernia occurs more frequently in patients with EDS, mainly men. Many surgeons believe that EDS may have a negative effect on the clinical outcome of hernioplasty because of postoperative complication and recurrence rates. Our strategy has been robotic technology to facilitate the surgical approach.
CONCLUSION: Robotic technology is feasible and associated with a shorted recovery and better cosmetic results. The endowrist movement of the robotic arms allows wide instrument articulation in a confined space, bypassing the limitis of laparoscopic…
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