V-046 LIRA (LAPAROSCOPIC INTRACORPOREAL RECTUS APONEUROPLASTY) WITH A MANUAL ROBOTIC LAPAROSCOPIC ARM: TECHNICAL STEPS

Abstract Introduction LIRA (Laparoscopic Intracorporeal Rectus Aponeuroplasty) is a minimally invasive technique for the tension-free repair of incisional hernias from M2 to M4, with low recurrence rate and less postoperative bulging seroma formation than classic IPOM lap repair. Objective To describe main steps focusing on midline closure. The use robotic laparoscopic arm1 improved surgeon's mobility range ergonomy, facilitating procedure. Methods A 42-year-old obese woman (BMI 34 Kg/m2), presented recurrent umbilical hernia M3W2, Hernia defect: 6cm.in width, (previous onlay polypropylene mesh in 2020). Access: 3 Trocars at midaxillary line. Posterior rectus sheaths were divided, defect was closed running 2/0 barbed suture. Then, reinforced tailored, round-shaped 15 cm. composite mesh2 fixed double crown absorbable tacks3. No drain used. Results Operating time: 85 minutes. procedure performed an outpatient setting. course uneventful. Follow-up: 9 months. patient remains asymptomatic highly satisfied (9/10). nor has been observed. Conclusions allowed reconstruction abdominal when dealing ventral hernias, without remarkable complications. provides advantages surgery terms pain, morbidity (e.g. seroma, risk infection), no bulging. robotized arms facilitates these quite complex procedures. References: 1. Dex Surgical© 2. Symbotex® (composite mesh: polyester + collagen; Medtronic) 3. Reliatack DEEP® (Medtronic)