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Rives-Stoppa Retromuscular Repair for Incisional Hernia

Katherine Albutt, MD; Peter Fagenholz, MD
Massachusetts General Hospital

1. Introduction

2. Surgical Approach

3. Incision and Access to the Abdominal Cavity

4. Hernia Sac Dissection and Excision

5. Posterior Rectus Sheath Dissection

  1. Left Posterior Rectus Sheath Incision
  2. Development of Left Posterior Rectus Space
  3. Right Posterior Rectus Sheath Incision (Part 1)
  4. Skin Incision Extension
  5. Further Cephalad Dissection
  6. Further Lateral Dissection
  7. Right Posterior Rectus Sheath Incision (Part 2)
  8. Development of Right Posterior Rectus Space

6. Posterior Rectus Sheath Closure

7. Check for Hemostasis

8. Mesh Placement

  1. Measure Area
  2. Prepare Mesh
  3. Transfascial Sutures

9. Placement of Drains

10. Anterior Rectus Sheath Closure

11. Excise Redundant Skin

12. Closure

  1. Subcutaneous Drain Placement
  2. Close Skin

13. Post-op Remarks