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Ventral Hernia Repair - robotic pre-peritoneal approach

Robotic hernia defect closure

Ventral hernias (including umbilical hernias and incisional hernias) are one of the most common forms of hernia that require surgical repair.  There are many different techniques to repair these hernias.  One technique that I would like to introduce to readers of this blog is the "robotic pre-peritoneal approach".


In this technique, the inner layer of the abdominal wall is partially separated from the abdominal wall itself.  By separating that inner layer, a "pocket" is developed for the placement of a reinforcing mesh.  This is where the robot is helpful.  That inner layer of the abdominal wall, called peritoneum, is quite delicate.  The DaVinci Xi surgical robot allows me to handle this delicate tissue and to be the only hernia surgeon providing this type of hernia repair in North Alabama or the Tennessee Valley. 


By placing the mesh in the "preperitoneal pocket," it is protected from touching the intestines, and therefore adhesions to the intestines will not form.  In contrast, the most common ventral hernia repair in the United States uses a mesh inside of the abdominal cavity, and formation of adhesions to the mesh is expected.


The preperitoneal approach to ventral hernia repair is an exciting new option in the world of hernia surgery.  Surgeons who have adopted this technique hope to reduce complications that arise from adhesions while also providing an excellent hernia repair.


Please use this link to watch a short video of one of the latest techniques in hernia repair.

rTAPP ventral hernia repair

Dr. Ray Sheppard Jr. Dr. Sheppard has been practicing general surgery for over two decades. He is a leader in robotic and advanced laparoscopic surgery. He has special interests in gallbladder surgery, hernia surgery, and breast cancer surgery. He also perform surgery to remove masses and skin cancers as well as to implant vascular access devices.

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