Extended Total Extraperitoneal Rives-Stoppa Repair: A New Effective Frontier for Ventral Hernia Repair

With the advent of the laparoscopy revolution, even ventral herniae have come within its ambit. However, some issues like high costs of materials, post-operative pain at mesh fixation sites, compromised functionality of the abdominal wall, etc., have stunted the initial enthusiasm over the early laparoscopic bridging repairs like the intraperitoneal onlay meshplasty. These, though relatively easy to perform, were plagued with the above-mentioned limitations. As surgical techniques evolved, a relatively new laparoscopic/robotic procedure rose in eminence for ventral hernia. Paradoxically, this was based on principles of the relevant anatomical space creation, propounded by its two founding fathers, in the mid-1960s, i.e., almost 60 years ago! Thus, these principles took more than half a century to realize their full potential and thereby, provide a novel minimally invasive repair of ventral hernia, which seems to satisfactorily address the limitations of the early bridging repairs. We, herein, present the case of a 46-year-old male who underwent this novel repair for umbilical hernia in our department.