Skip to main content
SpringerLink
Log in

Robotic Ventral Hernia Repair

  • Chapter
  • First Online:
Hernia Surgery

Abstract

In this chapter we describe the repair of abdominal wall hernias utilizing the da Vinci robotic system (Intuitive Surgical, Sunnyvale, CA, USA). This emerging technology has experienced an exponential growth in its adoption for the repair of both ventral and incisional hernias. This chapter offers a detailed description of the various approaches borrowing from the well-established techniques of both open and laparoscopic hernia repair. Approaches discussed include the placement of intraperitoneal onlay mesh (IPOM) after primary defect closure, preperitoneal placement of mesh, and retromuscular placement of mesh with posterior component separation utilizing the TAR technique. Perioperative details will also be discussed including but not limited to diagnostic evaluation, patient setup, and port position.

The technique of robot-assisted laparoscopic incisional hernia repair with intracorporeal closure of the fascial defect and continuous circumferential suturing for mesh fixation is feasible and may reduce postoperative pain by eliminating transfascial sutures. The component separation techniques done robotically may decrease the incidence of surgical site infection and occurrences in this difficult group of patients. Long-term data is lacking to truly assess the benefit to the patient and therefore further evaluations and studies are required.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Jin J, Rosen MJ. Laparoscopic versus open ventral hernia repair. Surg Clin North Am. 2008;88:1083–100.

    Article  PubMed  Google Scholar 

  2. Novitsky YW, Elliott HL, Orenstein SB, et al. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012;204:709–16.

    Article  PubMed  Google Scholar 

  3. Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic repair of ventral hernias: nine years’ experience with 850 consecutive hernias. Ann Surg. 2003;238:391–9.

    PubMed  PubMed Central  Google Scholar 

  4. Perrone JM, Soper NJ, Eagon JC, et al. Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery. 2005;138:708–15.

    Article  PubMed  Google Scholar 

  5. Carbajo MA, Martin de Olmo JC, Blanco JI, et al. Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc. 1999;13:250–2.

    Article  CAS  PubMed  Google Scholar 

  6. Franklin ME, Dorman JP, Glass JL, et al. Laparoscopic ventral and incisional hernia repair. Surg Laparosc Endosc. 1998;8:294–9.

    Article  CAS  PubMed  Google Scholar 

  7. Heniford BT, Ramshaw BJ. Laparoscopic ventral hernia repair: a report of 100 consecutive cases. Surg Endosc. 2000;14:419–23.

    Article  CAS  PubMed  Google Scholar 

  8. Heniford BT, Park A, Ramshaw BJ, et al. Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg. 2000;190:645–50.

    Article  CAS  PubMed  Google Scholar 

  9. Sanders LM, Flint LM, Ferrara JJ. Initial experience with laparoscopic repair of incisional hernias. Am J Surg. 1999;177:227–31.

    Article  CAS  PubMed  Google Scholar 

  10. Ballantyne GH, Hourmont K, Wasielewski A. Telerobotic laparoscopic repair of incisional ventral hernias using intraperitoneal prosthetic mesh. JSLS. 2003;7:7–14.

    PubMed  PubMed Central  Google Scholar 

  11. Earle D, Seymour N, Fellinger E, et al. Laparoscopic versus open incisional hernia repair: a single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc. 2006;20:71–5.

    Article  CAS  PubMed  Google Scholar 

  12. Harrell AG, Novitsky YW, Peindl RD, et al. Prospective evaluation of adhesion formation and shrinkage of intraabdominal prosthetics in a rabbit model. Am Surg. 2006;72:808–13.

    PubMed  Google Scholar 

  13. McKinlay RD, Park A. Laparoscopic ventral incisional hernia repair: a more effective alternative to conventional repair of recurrent incisional hernia. J Gastrointest Surg. 2004;8:670–4.

    Article  PubMed  Google Scholar 

  14. Heniford BT, Carbonell AM, Harold K, et al. Local Injection for the Treatment of Suture Site Pain after Laparoscopic Ventral Hernia Repair. Am Surg. 2003;69:688–91.

    PubMed  Google Scholar 

  15. Lange JF, Halm JA, de Wall LL, et al. Intraperitoneal polypropylene mesh hernia repair complicates subsequent abdominal surgery. World J Surg. 2003;31(2):423–9.

    Google Scholar 

  16. Ballantyne GH. Robotic surgery, telerobotic surgery, telepresence, and telementoring: review of early clinical results. Surg Endosc. 2002;16:1389–402.

    Article  CAS  PubMed  Google Scholar 

  17. Ramirez OM, Ruas E, Dellon AL. “Components separation” method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990;86:519–26.

    Article  CAS  PubMed  Google Scholar 

  18. Rives J, Pire JC, Flament JB, et al. Treatment of large eventrations. New therapeutic Indications apropos of 322 cases. Chirurgie. 1985;111:215–25.

    CAS  PubMed  Google Scholar 

Further Reading

  • Mudge M, Hughes LE. Incisional hernia: a 10-year prospective study of incidence and attitudes. Br J Surg. 1985;72:70–1.

    Article  CAS  PubMed  Google Scholar 

  • LeBlanc KA, Heniford BT, Voeller GR. Innovations in ventral hernia repair. Contemp Surg 2006:1–8

    Google Scholar 

  • Van der Linden FT, Van Vroonhoven TJ. Long-term results after surgical correction of incisional hernia. Neth J Surg. 1988;40:127–9.

    PubMed  Google Scholar 

  • Stoppa RE. The treatment of complicated groin and incisional hernia. World J Surg. 1989;13:545–54.

    Article  CAS  PubMed  Google Scholar 

  • Laber GE, Garb JL, Alexander AI, et al. Long-term complications associated with prosthetic repair of ventral hernias. Arch Surg. 1998;133:378–82.

    Article  Google Scholar 

  • White TJ, Santos MC, Thompson JS. Factors affecting wound complications in repair of ventral hernias. Am Surg. 1998;64:276–80.

    CAS  PubMed  Google Scholar 

  • Berger D, Bientzle M, Muller A. Postoperative complications after laparoscopic incisional hernia repair. Surg Endosc. 2002;16:1720–3.

    Article  CAS  PubMed  Google Scholar 

  • Bansal VK, Misra MC, Kumar S, et al. A prospective randomized study comparing suture mesh fixation versus tacker mesh fixation for laparoscopic repair of incisional and ventral hernias. Surg Endosc. 2011;25:1431–8.

    Article  PubMed  Google Scholar 

  • Dubay DA, Wang X, Kirk S, et al. Fascial fibroblast kinetic activity is increased during abdominal wall repair compared to dermal fibroblasts. Wound Repair Regen. 2004;12:539–45.

    Article  PubMed  Google Scholar 

  • Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery: personal experience in a large community hospital. Arch Surg. 2003;138:777–84.

    Article  PubMed  Google Scholar 

  • LeBlanc KA, Booth WV. Laparoscopic repair of incisional abdominal hernias using expanded polytetrafluoroethylene: preliminary findings. Surg Laparosc Endosc. 1993;3:39–41.

    CAS  PubMed  Google Scholar 

  • Schluender S, Conrad J, Divino CM, et al. Robot-assisted laparoscopic repair of ventral hernia with intracorporeal suturing. Surg Endosc. 2003;17:1391–5.

    Article  CAS  PubMed  Google Scholar 

  • Tayar C, Karoui M, Cherqui D, et al. Robot-assisted laparoscopic mesh repair of incisional hernias with exclusive intracorporeal suturing: a pilot study. Surg Endosc. 2007;21:1786–9.

    Article  CAS  PubMed  Google Scholar 

  • LeBlanc KA. The critical technical aspects of laparoscopic repair of ventral and incisional hernias. Am Surg. 2001;67:809–12.

    CAS  PubMed  Google Scholar 

  • Sorensen LT, Hemmingsen UB, Kirkeby LT, et al. Smoking is a risk factor for incisional hernia. Arch Surg. 2005;140:119–23.

    Article  PubMed  Google Scholar 

  • Sauerland S, Walgenbach M, Habermalz B et al. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011; (3):CD007781.

    Google Scholar 

  • Forbes SS, Eskicioglu C, McLeod RS, et al. Meta-analysis of randomized controlled trials comparing open and laparoscopic ventral and incisional hernia repair with mesh. Br J Surg. 2009;96:851–8.

    Article  CAS  PubMed  Google Scholar 

  • Sajid MS, Bokhari SA, Mallick AS, et al. Laparoscopic versus open repair of incisional/ventral hernia: a meta-analysis. Am J Surg. 2009;197:64–72.

    Article  PubMed  Google Scholar 

  • Beldi G, Wagner M, Bruegger LE, et al. Mesh shrinkage and pain in laparoscopic ventral hernia repair: a randomized clinical trial comparing suture versus tack mesh fixation. Surg Endosc. 2011;25:749–55.

    Article  PubMed  Google Scholar 

  • Allison N, Tieu K, Snyder B, Pigazzi A, Wilson E. Technical feasibility of a robotic assisted ventral hernia repair. World J Surg. 2012;36(2):447–52.

    Article  PubMed  Google Scholar 

  • Bower CE, Reade CC, Kirby LW, Roth JS. Complications of laparoscopic incisional-ventral hernia repair: the experience of a single institution. Surg Endosc. 2004;18:672–5.

    Article  CAS  PubMed  Google Scholar 

  • Cadiere GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J. Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg. 2001;25:1467–77.

    CAS  PubMed  Google Scholar 

  • Corcione F, Esposito C, Cuccurullo D, Settembre A, Miranda N, Amato F, Pirozzi F, Caiazzo P. Advantages and limits of robot-assisted laparoscopic surgery: preliminary experience. Surg Endosc. 2005;19:117–9.

    Article  CAS  PubMed  Google Scholar 

  • Earle D, Seymour N, Fellinger E, Perez A. Laparoscopic versus open incisional hernia repair: a single-institution analysis of hospital resource utilization for 884 consecutive cases. Surg Endosc. 2006;20:71–5.

    Article  CAS  PubMed  Google Scholar 

  • Heniford BT, Park A, Ramshaw BJ, Voeller G. Laparoscopic ventral and incisional hernia repair in 407 patients. J Am Coll Surg. 2000;190:645–50.

    Article  CAS  PubMed  Google Scholar 

  • LeBlanc KA. Current considerations in laparoscopic incisional and ventral herniorrhaphy. JSLS. 2000;4:131–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  • LeBlanc KA. The critical technical aspects of laparoscopic repair of ventral and incisional hernias. Am Surg. 2001;67:809–12.

    CAS  PubMed  Google Scholar 

  • McKinlay RD, Park A. Laparoscopic ventral incisional hernia repair: a more effective alternative to conventional repair of recurrent incisional hernia. J Gastrointest Surg. 2004;8:670–4.

    Article  PubMed  Google Scholar 

  • Park A, Birch DW, Lovrics P. Laparoscopic and open incisional hernia repair: a comparison study. Surgery. 1998;124:816–22.

    Article  CAS  PubMed  Google Scholar 

  • Perrone JM, Soper NJ, Eagon JC, Klingensmith ME, Aft RL, Frisella MM, et al. Perioperative outcomes and complications of laparoscopic ventral hernia repair. Surgery. 2005;138:708–15.

    Article  PubMed  Google Scholar 

  • Robbins SB, Pofahl WE, Gonzalez RP. Laparoscopic ventral hernia repair reduces wound complications. Am Surg. 2001;67:896–900.

    CAS  PubMed  Google Scholar 

  • Rudmik LR, Schieman C, Dixon E, Debru E. Laparoscopic incisional hernia repair: a review of the literature. Hernia. 2006;10:110–9.

    Article  CAS  PubMed  Google Scholar 

  • Talamini MA, Chapman S, Horgan S, Melvin WS. A prospective analysis of 211 robotic-assisted surgical procedures. Surg Endosc. 2003;17:1521–4.

    Article  CAS  PubMed  Google Scholar 

  • Tani KM, Neumayer L, Reda D, Kim L, Anthony T. Repair of ventral incisional hernia: the design of a randomized trial to compare open and laparoscopic surgical techniques. Am J Surg. 2004;188:22S–9.

    Google Scholar 

  • Van’t RM, Vrijland WW, Lange JF, Hop WC, Jeekel J, Bonjer HJ. Mesh repair of incisional hernia: comparison of laparoscopic and open repair. Eur J Surg. 2002;168:684–9.

    Article  PubMed  Google Scholar 

  • Bageacu S, Blanc P, Breton C, Gonzales M, Porcheron J, Chamber M, Balique JG. Laparoscopic repair of incisional hernia: a retrospective review of 159 patients. Surg Endosc. 2002;16:345–8.

    Article  CAS  PubMed  Google Scholar 

  • Bucknall TE, Cox PJ, Ellis H. Burst abdominal and incisional hernia: a prospective study of 1129 major laparotomies. Br Med J. 1982;284:931–3.

    Article  CAS  Google Scholar 

  • Carbajo MA, de Olmo JC M, Blanco JI, de la Cuesta C, Toledano M, Martin F, et al. Laparoscopic treatment vs open surgery in the solution of major incisional and abdominal wall hernias with mesh. Surg Endosc. 1999;13:250–2.

    Article  CAS  PubMed  Google Scholar 

  • Franklin ME, Dorman JP, Glass JL, Balli JE, Gonzalez JJ. Laparoscopic ventral and incisional hernia repair. Surg Laparosc Endosc. 1998;8:294–9.

    Article  CAS  PubMed  Google Scholar 

  • Heniford BT, Ramshaw BJ. Laparoscopic ventral hernia repair: a report of 100 consecutive cases. Surg Endosc. 2000;14:419–23.

    Article  CAS  PubMed  Google Scholar 

  • Hesselink VJ, Luijendijk RW, Heide R, Jeekel J. An evaluation of risk factors in incisional hernia recurrence. Surg Gynecol Obstet. 1993;176:228–34.

    CAS  PubMed  Google Scholar 

  • Holzman MD, Purut CM, Reintgen K, Eubanks S, Pappas TN. Laparoscopic ventral and incisional hernia repair. Surg Endosc. 1997;11:32–5.

    Article  CAS  PubMed  Google Scholar 

  • Kyzer S, Alis M, Aloni Y, Charuzi I. Laparoscopic repair of postoperation ventral hernia. Surg Endosc. 1999;13:928–31.

    Article  CAS  PubMed  Google Scholar 

  • LeBlanc KA, Booth WV, Whitaker JM, Bellanger DE. Laparoscopic incisional and ventral herniorrhaphy: our initial 100 patients. Hernia. 2001;5:41–5.

    Article  CAS  PubMed  Google Scholar 

  • Luxembourger O, Regairaz C. La cure des hernies et eventrations ombilicales et sous-ombilicales sous celioscopie: a propos de 22 cas. Lyon Chir. 1997;2:130–1.

    Google Scholar 

  • Ramshaw BJ, Esartic P, Schwab J, Mason EM, Wilson RA, Duncan TD, Miller J, Lucas GW, Promes J. Comparison of laparoscopic and open ventral herniorrhaphy. Am Surg. 1999;65:827–31.

    CAS  PubMed  Google Scholar 

  • Renier JF, Bokobza B, Leturgie C, Merveille M, Selamn M, Sfihi A. Cure des eventrations soud laparoscopie par plaque intraperitoneal d’ePTFE: technique et resultants, apropos de 135 cases. J Coeliochir. 1999;32:63–7.

    Google Scholar 

  • Sanders LM, Flint LM, Ferrara JJ. Initial experience with laparoscopic repair of incisional hernias. Am J Surg. 1999;177:227–31.

    Article  CAS  PubMed  Google Scholar 

  • Thoman DS, Phillips EH. Current status of laparoscopic ventral hernia repair. Surg Endosc. 2002;16(932–942):1395.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Arrowhead Medical Center, Banner Thunderbird Medical Center, Peoria, AZ, USA

    Conrad Ballecer M.D., FACS

  2. General Surgery/Colorectal, Celebration, FL, USA

    Eduardo Parra-Davila M.D., F.A.C.S., F.A.S.C.R.S.

Authors
  1. Conrad Ballecer M.D., FACS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eduardo Parra-Davila M.D., F.A.C.S., F.A.S.C.R.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Conrad Ballecer M.D., FACS .

Editor information

Editors and Affiliations

  1. Case Comprehensive Hernia Center, University Hospitals Case Medical Center, Cleveland, Ohio, USA

    Yuri W. Novitsky

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

Robotic TAPP inguinal repair, by Ballacer (MP4 1,736,375 kb)

Robotic TAR, by Carbonell (MOV 918,251 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Ballecer, C., Parra-Davila, E. (2016). Robotic Ventral Hernia Repair. In: Novitsky, Y. (eds) Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-27470-6_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-27470-6_26

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27468-3

  • Online ISBN: 978-3-319-27470-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation