Endoscopic Subcutaneous Onlay Laparoscopic Approach

Abstract

AbstractIn recent years, abdominal wall surgery has shown a clear interest in reproducing traditional open techniques and avoiding intraperitoneal mesh placement. The endoscopic Subcutaneous Onlay Laparoscopic Approach (SCOLA) is very popular in South American countries, especially for small umbilical and epigastric hernias with concomitant rectus muscles diastasis. In these cases, a full midline reconstruction should be scheduled, because hernia repair alone is affected by a higher recurrences rate compared to simultaneous hernia and diastasis repair [1–5]. Through an endoscopic dissection of the preaponeurotic subcutaneous space is possible to reconstruct the abdominal wall by placing an onlay prosthesis in those patients without excess skin or subcutaneous tissue. Although SCOLA repair is safe and feasible to correct diastasis recti and symptomatic midline hernias with excellent cosmetic results, seroma and abdominal numbness are frequent complications.