• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Ventral Incisional Hernia Repair with Extraperitoneal Mesh Placement, Bilateral Posterior Rectus Release, and Unilateral Transversus Abdominis Release, via Single Dock Robotic Approach

Ventral Incisional Hernia Repair with Extraperitoneal Mesh Placement, Bilateral Posterior Rectus Release, and Unilateral Transversus Abdominis Release, via Single Dock Robotic Approach

Adam J Blau, MD. Albany Medical Center

Introduction: Complex ventral incisional hernia repair (VIHR) continues to be performed via an open and laparoscopic approach. However, new robotic approaches allow for the primary closure of a fascial defect, with restoration of the abdominal wall in the midline, and with extraperitoneal mesh placement.

Single dock robotic VIHR with components separation is a safe and reproducible operation. While there is limited data on this approach, we hypothesize that relative to an open or laparoscopic approach, this approach affords similar recurrence rates, decreased seroma formation rates, and decreased rates of surgical site infections.

Case: We present here the case of a 42-year-old obese female (BMI 45), who presented electively with a symptomatic ventral incisional hernia. We offered her a single dock robotic VIHR using the Si Davinci System, with bilateral posterior rectus release, unilateral transversus abdominis release (TAR), and placement of mesh in the retrorectus space.

After docking the robot, a lysis of adhesions is performed, and the Swiss cheese-like hernia defect is visualized. The hernia sac is first excised. Next, the posterior rectus fascia contralateral to the camera port is incised. The lateral aspect of this rectus muscle is identified, and a TAR is performed on this side. Then, the posterior rectus fascia ipsilateral to the camera port is incised. Upon completion of these releases, enough length is created in order to restore the abdominal wall in the midline. The anterior rectus fascia along with the rectus muscles are approximated in the midline with a simple running number 1 Stratafix suture. Then, a piece of ProGrip mesh is cut to size, placed in the retrorectus space, and centered over the midline. The posterior rectus sheath along with the peritoneum is closed using a simple running suture.

Discussion: This approach provides many benefits. The patient now has restoration of her midline abdominal wall, with an extraperitoneal piece of mesh that is not in contact with the abdominal viscera. Furthermore, the hernia sac is easily excised, and large tissue flaps are avoided, likely decreasing the rates of seroma formation and surgical site infections, respectively. Finally, we have avoided both double docking of the robot and having the need to place additional ports. Future studies using this approach will help to prove these benefits.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79165

Program Number: V171

Presentation Session: Video Loop

Presentation Type: VideoLoop

102

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals