Robot-assisted laparoscopic repair of ventral hernia with intracorporeal suturing

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Abstract
Background: This study presents a novel technique for laparoscopic ventral hernia repair using the da Vinci Robot and intracorporeal suturing. Thus, it offers an alternative to transabdominal sutures and tackers. Methods: A ventral hernia model was created in six pigs. The mesh was fixed to the circumference of the fascia using interrupted sutures. The outer border of the mesh was then fixed to the posterior fascia using running sutures. Results: There were no complications. The depth and location of the interrupted and running sutures were confirmed postmortem. Conclusions: The transabdominal sutures and tackers used in laparoscopic ventral hernia repair can be the focus for postoperative pain and adhesions. As an alternative, the da Vinci Robot can be used to facilitate intracorporeal suturing of the mesh directly to the fascial edge and to secure the circumference of the mesh to the posterior fascia. The preliminary results are promising and represent a safe method that can be implemented in humans.