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Robotic Transversus Abdominis Release

  • Heidi J. Miller
  • Yuri W. Novitsky
Chapter

Abstract

The transversus abdominis release (TAR) includes a wide lateral dissection, preservation of perforating nerves and vessels to the anterior abdominal wall, and medial advancement of both posterior and anterior fascial layers for re-creation of the linea alba. It reduces the risk of wound complications and reduces the risk of developing lateral hernias compared to other posterior component separation techniques. The TAR provides excellent space for mesh placement in order to reinforce the visceral sac and is applicable to many patients and many hernias. Traditionally the TAR has been an open procedure, requiring a large midline laparotomy incision and multiple-day hospital stays, but within the last few years, it has been found to be feasible, although technically difficult, to complete a TAR laparoscopically or endoscopically. The adoption and increased utilization of surgical robotics has allowed minimally invasive TAR to become much more widespread as the dissection and suturing are much less technically challenging with the EndoWrist® technology of the robot, as well as improved visualization.

Keywords

Robotic surgery Hernia Abdominal wall reconstruction Posterior component separation Ventral hernia Myofascial release Incisional hernia Retromuscular Preperitoneal 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Heidi J. Miller
    • 1
  • Yuri W. Novitsky
    • 2
  1. 1.Department of SurgeryUniversity of New MexicoAlbuquerqueUSA
  2. 2.Department of SurgeryColumbia UniversityNew YorkUSA

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