Masters Program Hernia Pathway: Robotic Ventral Hernia Repair

Abstract

Robotic hernia repair is an emerging laparoscopic technique born from well-established principles set by open and conventional laparoscopic technique. Inherent limitations of conventional “straight-stick” laparoscopy make operating high on the anterior abdominal wall difficult. Overcoming such difficulties with the robot’s enhanced 3D visualization, precision, and surgeon ergonomics may further the adoption of MIS technique.

The robotic platform enables exploitation of the individual layers of the abdominal wall. Virtually, any well-established surgical plane of the abdominal wall can be exploited and dissected for the subsequent placement of mesh in a preperitoneal, retromuscular, and even onlay position, effectively protected from the visceral cavity by the body’s own autologous tissue. While this approach has been demonstrated with conventional laparoscopy, it remains technically challenging (Indian J Surg 73, 403–8, 2011). These technical difficulties can be mitigated by the robotic trans-abdominal preperitoneal (rTAPP) approach for hernias of the anterior abdominal wall.