Laparoscopic Retrorectus Hernia Repair - Ventral Hernia Surgery - Umbilical Hernia Surgery
Laparoscopic retrorectus hernia repair or Laparoscopic Rives Stopa / Trans-abdominal retrorectus mesh (TARM) repair for umbilical hernia/ ventral hernia/ incisional hernia is a surgery for the skilled laparoscopic surgeon as the dissection as well as suturing is predominantly with the camera upside down. Watch as Dr. Rajvilas Narkhede, Alexis hospital, Nagpur demonstrates this difficult procedure in one of his surgeries.
If you all recall, we have already shown a video on the intraperitoneal onlay (IPOM) mesh placement. If you have missed it, kindly find it here - Ventral Hernia repair - Minimally invasive step by step IPOM repair technique - EDUSURG CLINICS - https://youtu.be/pedscalm21A
This is the second video showing a different technique for transabdominal retro muscular repair of ventral/ incisional hernia. This is in fact the retro rectus plane of mesh placement in a ventral hernia. If you wish to revise the planes of mesh placement in ventral hernia surgery, do have a look at our video on Ventral hernia surgery - Planes for mesh placement - Terminology demystified - https://youtu.be/LmvScRycSWo
The retro-rectus mesh placement requires the creation of a peritoneal flap which is developed all way around the sac followed by excision of the sac and closure of the defect from within. After this, the mesh is placed and few transfascial fixation sutures are taken. After suture fixation of the mesh, the peritoneal flap is closed and then, port sites are closed in layers.
This procedure is more cost-effective when compared to Intraperitoneal onlay repair as you can use a prolene mesh in the retro rectus plane. We hope the video will help you in understanding the retro rectus ventral hernia repair technique. Feel free to leave your opinions and experiences in the comments section so as to share your techniques.
The video will definitely help all students in understanding the plane of mesh placement, the steps of this tricky surgery as well as in performing the procedure appropriately. As we have always said, there is no single way of performing surgery. This is Dr. Rajvilas's technique so, let us have a look at his surgery now.