Lateral single-port laparoscopic repair of primary ventral hernias via the plane posterior to the posterior rectus sheath

PURPOSE: Laparoscopic ventral hernia repair is widely practiced; however, the use of a lateral single-port approach to access the plane posterior to the posterior rectus sheath for primary ventral hernias is scarcely reported. This study explores this novel surgical plane and the relevant approach as an alternative for ventral hernia repair. METHODS: During August 2025-February 2026, total extraperitoneal repair was performed in seven patients with primary ventral hernias using a lateral single-port approach in the plane posterior to the posterior rectus sheath. RESULTS: All procedures were completed using the lateral single-port approach in the target plane. No conversions to open repair, intraperitoneal onlay mesh, or standard extended totally extraperitoneal techniques were required. There were no perioperative complications or early recurrences. CONCLUSION: Repair of primary ventral hernias via the plane posterior to the posterior rectus sheath using a lateral single-port approach is a safe and feasible technique, albeit warranting a selective application by experienced surgeons.