Since the introduction of laparoscopic ventral hernia repair in the early 1990s , the benefits of the procedure—decreased postoperative pain, faster recovery with less wound, and overall complication rates, while maintaining recurrence rates equal or less to those of open ventral hernia repair—have led to its widespread adoption. Laparoscopy, however, has its own limitations. The lack of articulation limits the degrees of motion of laparoscopic instruments, and visualization is also limited to two dimensions. As a result, technically demanding maneuvers such as intracorporeal closure of hernia defect or minimally invasive myofascial release have not been widely adopted. This can compromise the outcome of the repair, leading to increased mesh bulging, hernia recurrences, seroma formation, and patient dissatisfaction . Additionally, the tackers and transabdominal sutures used to secure the mesh have been implicated in the occurrence of increased pain and postoperative adhesions.
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