Endolaparoscopic retromuscular repair of smaller midline ventral hernias—too much for too little?

Excerpt

The evolution of the retromuscular space as a preferred location for hernia repair of the abdominal wall has been long and eventful. The retromuscular hernia repair was initially described by Rene Stoppa for repair of bilateral inguinal hernias. Stoppa technique involved placement of a large sheet of polyester mesh in the preperitoneal or retrofascial space allowing for the intraabdominal pressure to secure the mesh between the peritoneum and abdominal wall [1]. The Open Rives-Stoppa retromuscular repair was developed by Drs. Jean Rives and Rene Stoppa in 1960′s and later popularized by Dr. George Wantz [2]. Rives applied these priniciples for Ventral hernia repairs by placing the mesh in a similar retromuscular plane but above the arcuate line (posterior to the rectus muscle and anterior to the posterior rectus sheath) [3]. The retromuscular, prefascial location of mesh and Stoppa concept of giant prosthetic reinforcement of visceral sac were the principles for repair of inguinal hernias with minimal access surgery in Totally Extraperitoneal (TEP) and Transabdominal Preperitoneal (TAPP) techniques [4]. …