Evaluation of early outcome and complications of Lap TARM
Author(s): Dr. Rajesh G Chandnani and Dr. Dinesh Prasad
Abstract: LeBlanc and Booth in 1993 first reported application of intra-peritoneal onlay mesh (IPOM) for ventral and incisional hernia. It is based on the principles of Rives-Stoppa technique of repair of ventral hernia in which a large pre-peritoneal mesh is placed and stipulated even distribution of force throughout the mesh area resulting in stronger repair than onlay mesh technique. Laparoscopic technique was adopted in an effort to reduce wound complications, post-operative pain and early return to work. Since then various methods of laparoscopic repair have been performed and studied in an effort to find out the most suitable, least expensive way to deal with ventral hernias. LVHR is a safe alternative to the open method, with the main advantages being minimal postoperative pain, shorter recovery, and decreased wound and mesh infections. This is a retrospective study in which we evaluated the performance of 10 cases of Laparoscopic TARM (Trans Abdominal Retro rectus Mesh repair) from Oct 2018 to Jul 2019. This study is being conducted to evaluate early outcome and complications of this procedure amongst the initial cases at our institute. We chose midline hernias only, both Primary and Incisional, for feasibility to do TARM procedure in retrorectus space. Patients were evaluated for post-operative outcome in terms of pain, local collection and intestinal obstruction. Pain was experienced in mild-moderate degree in four patients, collection in three and small bowel obstruction in two patients. Early results indicate that TARM can be performed as a cheaper alternative to IPOM mesh repair. Further studies are needed to establish this procedure as the preferred method for treatment of midline hernias.