Ventral Hernia Repair- Preperitoneal and Underlay

The goal of any ventral hernia repair (VHR) is to ameliorate patient symptoms, repair the hernia, and minimize complications, particularly the risk for recurrence. To achieve these results, surgeons commonly use the preperitoneal space and the underlay position in the repair of ventral hernias. The general benefits of using a minimally invasive approach to these spaces include relatively low hernia recurrence rates and decreased wound infection complications compared to VHR with onlay mesh. Many surgical considerations exist when utilizing these spaces for VHR, and the surgeon may find the knowledge of the following such factors helpful in mastering the technique.