Introduction Few techniques in surgery have evolved more over the course of the last two decades than those related to hernia and abdominal wall reconstructions. Advances in technology, coupled with a better understanding of the abdominal wall anatomy, have resulted…
Introduction The field of abdominal wall reconstruction has been rapidly evolving, particularly in recent years, with the popularization of several novel minimally invasive extraperitoneal approaches. Enhanced-view totally extraperitoneal (eTEP) access in combination with retromuscular repair has expanded what is feasible…
Indications For ventral hernias of the midline between 2 and 5 cm in width, I prefer to perform a robotic retrorectus repair with a 15-cm wide mesh. I use a technique with a single dock lateral transabdominal approach. This technique…
Preoperative considerations It is critical to have a thorough understanding of the layers of the abdominal wall. The preperitoneal space can be surgically dissected from the overlying layers of the abdominal wall from the diaphragm to the myopectineal orifice and…
Indications All patients with incisional hernias are candidates for hernia repair with mesh. The eligibility for a minimally invasive hernia repair depends largely on the hernia width. In our practice, a hernia width of up to 7 cm measured preoperatively…
Background Inguinal hernia is a common pathology, occurring in approximately 27% of men and 3% of women throughout their lives. Worldwide, operative repair of inguinal hernia is performed an estimated 20 million times annually. With the widespread adoption of tension-free,…
There has always been a need to perform an inguinal hernia repair without mesh, i.e., tissue repair. These repairs are typically performed in an open, anterior fashion and include techniques as described by Shouldice, Bassini, and McVay. The open preperitoneal…
Introduction Inguinal hernia is the most common of all primary abdominal wall hernias. Surgical repair of these constitutes 80% of all hernia operations. Over 800,000 inguinal hernias are repaired annually in the United States. Definitive treatment is surgical and can…
Indications The principles of hernia repair management are based on the patient’s symptoms, along with the characteristics of the hernia, including the size and location of the hernia defect(s), and the presence of bowel, infection, among other factors. Patients presenting…
A comprehensive understanding of abdominal wall anatomy is critical for the successful repair of hernias. Such anatomical understanding is generally considered to be practically applied in the operative theater but is perhaps most appropriately utilized in the preoperative evaluation of…