LAUSR

Umbilical hernias with combined rectusdiastasis have a higher risk für recurrence after single repair of the umbilical hernia. The E- MILOS concept enables the minimal invasive sublay mesh repair realizing the benefits of minimally invasive surgery and placing the mesh in the retromuscular position. All E- MILOS operations were documented prospectively. For 1 year follow-up all patients received a questionnaire. From January 2019 to December 2022, 89 patients (24 female/65 male) with umbilical hernia and a coexisting rectus diastasis (median hernia size 2 cm/diastasis recti 5,5 cm) and median age of 61 yrs were operated by 3 experienced surgeons. In all cases a polypropylene mesh (median size 40×12 cm) was implanted in the retromuscular space without any fixation and continuous suture (V-Loc 2–0) of the anterior and posterior rectus sheet was achieved for reconstructing the midline. The average skin incision was 4,5 cm; median operation time was 125 min. The median hospital stay was 5 days, the postoperative median pain score (VAS) was 2. Two patients needed reoperation due to a retromuscular haematoma. Chronic pain was reported by 13 patients, no postoperative infection and 4 recurrences were observed. Not satisfied with the cosmetic result (subcutaneous bulging) were 4 female patients. The E- MILOS technique allows minimally invasive transhernial repair of umbilical hernias with combined rectusdiastasis using large retromuscular meshes with low morbidity. The technique is reliable and easy to standardize and shows mostly good cosmetic results.