Rives-Stoppa Retromuscular Repair for Incisional Hernia
Katherine Albutt, MD; Peter Fagenholz, MD
Massachusetts General Hospital
There is no consensus on the optimal method of ventral hernia repair, and the choice of techniques is typically dictated by a combination of patient factors and surgeon expertise. Component separation techniques allow medial advancement of the rectus abdominis muscle to create a midline tension-free fascial closure.
In this case, we describe a posterior component separation with retrorectus mesh placement, also known as a Rives-Stoppa retromuscular repair. With low morbidity and mortality, this technique provides a durable repair with low rates of recurrence and surgical site infection while providing dynamic muscle support and physiologic tension, preventing eventration, and allowing incorporation of mesh into the existing abdominal wall.
Robotic-Assisted Laparoscopic (rTAPP) Bilateral Inguinal Hernia Repair
David Lourié, MD, FACS, FASMBS
Huntington Memorial Hospital
There are over 1 million hernia repairs performed annually in the US, and robotics is revolutionizing the adoption of minimally-invasive hernia repairs. From 2015 to 2018, robotic laparoscopic hernia repairs have explosively grown from less than 2% to 20% of all hernia repairs performed in the US.
Hernia repairs are among the most basic procedures for general surgeons, and there is substantial enthusiasm on the part of surgeons regarding the rapid changes in techniques as well as the best methods of teaching them. Surgical training programs may find it difficult to maintain training for their residents and fellows in the face of rapidly evolving technology. Here, Dr. Lourié presents the case of a 28-year-old male with bilateral inguinal hernias that were repaired using a robotic-assisted laparoscopic approach.
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