Abstract
Robotic hernia repair is an emerging technique born from well-established principles of both laparoscopic and open ventral hernia repair. Its growing popularity in the United States perhaps can be explained by enhanced 3D visualization, precision, and ergonomics. There are also inherent limitations of conventional laparoscopy which make it difficult operating high on the anterior abdominal wall, many of which may be overcome with the use of the robotic instrument.
There is a growing body of literature which promotes keeping mesh out of the intraperitoneal cavity secondary to bowel erosion and adhesions which may complicate subsequent abdominal operations. The robotic platform enables exploitation of the individual layers of the abdominal wall. Virtually any well-established surgical plane of the abdominal wall can be exploited and dissected for the subsequent placement of mesh in a sublay position, effectively protected from the visceral cavity by the body’s own autologous tissue. While this approach has been demonstrated with conventional laparoscopy, it remains technically challenging.
In this chapter, we introduce the robotic transabdominal preperitoneal (rTAPP) approach for hernias of the anterior abdominal wall.