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Cranial preperitoneal extension of the retromuscular repair in midline hernias: The Madrid Rives technique
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Cranial preperitoneal extension of the retromuscular repair in midline hernias: The Madrid Rives technique
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Journal Article
Cranial preperitoneal extension of the retromuscular repair in midline hernias: The Madrid Rives technique
2025
Overview
This is a modification of the original retromuscular approach of Rives-Stoppa-Wantz for midline hernia reconstruction. This novel approach preserves the safety and efficacy of the original one while offering two key advantages: maintaining the anatomical and functional integrity of the cranial portion of the posterior rectus sheath and enabling a wider cranial dissection, essential for achieving greater overlap in M1-M2 hernias.
Between January 2015 and September 2024, 100 patients underwent surgery (82 open, 18 laparoscopic). A total of 19 surgical site occurrences were recorded, of which 7 required procedural intervention. There were 5 cases of surgical site infection, 4 superficial and 1 deep. During a mean follow-up of 24,2 months, 3 CT-scan-confirmed recurrences and 4 cases of bulging were observed.
The MR technique enables safe and effective retromuscular-preperitoneal reconstruction of midline hernias, minimizing recurrences and improving the long-term structural integrity of the abdominal wall.
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•Modified retromuscular repair improves cranial mesh overlap in M1–M2 hernias.•Preperitoneal-prediaphragmatic plane enhances safety of epigastric dissection.•Technique preserves posterior rectus sheath and transversus abdominis insertion, improving cranial abdominal wall support.•3 % recurrence and 1 % symptomatic bulging after long-term follow-up.•Suitable for open and laparoscopic approaches in midline hernia repair.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Abdominal wall reconstruction
/ Adult
/ Aged
/ Defects
/ Female
/ Hernia
/ Hernias
/ Humans
/ Madrid posterior component separation
/ Male
/ Rives-stoppa-wants technique
/ Sheaths
/ Skull
