Total endoscopic anterior pelvic approach (TAPA) - A new approach to the internal fixation of the symphysis. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Kabir, Koroush; Lingohr, Philipp; Jaenisch, Max; Hackenberg, Roslind Karolina; Sommer, Nils; Ossendorff, Robert; Welle, Kristian; Gathen, Martin
• Is Part Of: Injury. Volume 53:Issue 2(2022)
• Page Start: 802
• Page End: 808
• Publication Date: 2022-02
• Subjects: Pelvic ring -- Symphysis -- Endoscopic approach -- Plate fixation -- Minimally invasive -- Pelvis fracture; Wounds and injuries -- Surgery -- Periodicals; Accidents -- Periodicals; Wounds and Injuries -- surgery -- Periodicals; Lésions et blessures -- Chirurgie -- Périodiques; Electronic journals; Electronic journals; 617.1
• DOI: 10.1016/j.injury.2021.09.043
• Languages: English
• ISSNs: 0020-1383

Abstract

Abstract: This study presents a detailed documentation of a total endoscopic anterior pelvic approach (TAPA) for plate fixation of a symphyseal disruption. The purpose of this work is to describe a minimally invasive technique as a possible method for reducing complications and hospitalization. Other goals included giving technical recommendations and assessing potential pitfalls and problems of this new surgical approach. Surgery was performed in an interdisciplinary setting by an experienced orthopaedic and general surgeon. The first endoscopic approach used to visualize the injury was the same as is used for endoscopic hernia surgery. The repositioning of the symphysial rupture was achieved either through external fixation or indirectly with traction and a pelvic binder. Plate positioning and fixation were achieved through two additional, minimally invasive incisions. The endoscopic approach shows multiple advantages, such as no detachment of the rectus abdominis muscle and smaller skin incisions. Furthermore, this approach could lessen the incidence of hernia and postoperative pain. We see the presented technique as a simple and innovative surgical method for treating symphyseal disruption.