Tag Archives: rTAPP

General Surgery, Print Release

PUBLISHED: Robotic-Assisted Transabdominal Preperitoneal (rTAPP) Repair for Ventral Hernias

Robotic-Assisted Transabdominal Preperitoneal (rTAPP) Repair for Ventral Hernias
Daphne Y. Lu, MD, MPH, MBA; Olivia Ziegler, MD; Saamia Shaikh, DO, JD; Jerome R. Lyn-Sue, MD, FACS
Penn State Health Milton S. Hershey Medical Center

This case describes a 58-year-old man who developed a symptomatic incisional ventral hernia following a trauma laparotomy and left nephrectomy after a motor vehicle collision. The patient presented with multiple midline hernia defects associated with bulging and discomfort. This video demonstrates a robotic transabdominal preperitoneal (rTAPP) repair with mesh. The case highlights practical strategies for managing intra-abdominal adhesions and a prior gastrostomy site, while outlining alternative operative approaches for cases in which preperitoneal flap development is technically challenging.

General Surgery, Print Release

PUBLISHED: Robotic-Assisted Laparoscopic (rTAPP) Umbilical Hernia Repair with Intra-abdominal Preperitoneal Underlay Mesh (IPUM)

Robotic-Assisted Laparoscopic (rTAPP) Umbilical Hernia Repair with Intra-abdominal Preperitoneal Underlay Mesh (IPUM)
Chloe A. Warehall, MD1; Divyansh Agarwal, MD, PhD1; Charu Paranjape, MD, FACS1,2
1Massachusetts General Hospital
2Newton-Wellesley Hospital

An umbilical hernia occurs due to weakened umbilical fascia or at the site where the involuted umbilical vessels exited. Depending on the hernia contents—preperitoneal fat, omentum, or small intestine—symptoms may include a new bulge at the umbilical site, abdominal pain, tenderness to palpation, color changes to the surrounding skin, as well as obstructive symptoms such as nausea, emesis, and constipation. Given that umbilical hernias tend to have narrow necks compared to size of the sac, incarceration and strangulation are relatively common. Elective repair of symptomatic umbilical hernias is done to minimize these risks.

Here we present the case of an 81-year-old male with a recurrent umbilical hernia who first presented secondary to obstructive symptoms caused by an incarcerated umbilical hernia. After reduction was successful, he underwent an elective robotic transabdominal (rTAPP) umbilical hernia repair with intra-abdominal preperitoneal underlay mesh (IPUM). This article and the associated video describe the pertinent history, evaluation, and operative steps of the procedure.