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.
In this case, Dr. Rockson Liu with Epic Care at Alta Bates Summit Medical Center performs a robotic eTEP retrorectus Rives-Stoppa repair of an upper midline primary ventral hernia that was partially reducible but mostly incarcerated, and greater than 6 cm in a 63-year-old female. Robotic ports were placed directly into the retrorectus space. Using the crossover technique, the retrorectus spaces were combined with a preperitoneal bridge of the peritoneum. The defects were closed robotically, and a medium-weight, macroporous polypropylene mesh was placed within the retrorectus space.
Rockson C. Liu, MD, FACS General Surgery, Epic Care, Alta Bates Summit Medical Center
In this case, Dr. Rockson Liu performs a robotic eTEP retrorectus Rives-Stoppa repair of an upper midline primary ventral hernia that was partially reducible but mostly incarcerated, and greater than 6 cm in a 63-year-old female. Robotic ports were placed directly into the retrorectus space. Using the crossover technique, the retrorectus spaces were combined with a preperitoneal bridge of the peritoneum. The defects were closed robotically, and a medium-weight, macroporous polypropylene mesh was placed within the retrorectus space.
Peter Fagenholz, MD
Assistant Professor of Surgery
Harvard Medical School
Katherine Albutt, MD
Resident Physician
Harvard Medical School
In this case, Dr. Peter Fagenholz at MGH performs a ventral incisional hernia repair on a 76-year-old female who developed a hernia following a right colectomy for colon cancer.
