Robotic Ventral Hernia Repair

Abstract

Technologic advances in surgery are often received with equal parts enthusiasm and skepticism. Perhaps no such advancement has created as much heated debate as the introduction of the robotic platform in general surgery. The limited clinical benefit and greater expense of robotic surgery for surgeons already adept in minimally invasive techniques draws the ire of many, while the promise of increased instrument dexterity, enhanced visualization, and ergonomic advantages continue to attract new users. Robotic hernia repair has recently experienced exponential growth nationally despite the ongoing debate. The majority of robotic ventral hernia repairs (rVHR) being performed are essentially duplicating a standard laparoscopic repair, with some variations in defect closure and mesh fixation. Our group has developed a technique to duplicate an open retromuscular hernia repair as described by Rives and Stoppa robotically, fully utilizing the capabilities of the robotic platform to perform a procedure otherwise not possible with a standard laparoscopic approach. This chapter will review the currently available literature on early applications of robotics in ventral hernia repair, and focus primarily on advanced robotic abdominal wall reconstruction using the robotic retromuscular technique.