This chapter describes the robotic-assisted treatment of primary ventral umbilical and epigastric hernias. The preperitoneal approach described here allows extraperitonealization of the mesh without entering the fascial structure of the anterior abdominal wall; since concomitant (asymptomatic) hernia findings of the linea alba occur in approx. 30% of patients and wide parietalization of the peritoneum is possible, the posterior approach is superior to anterior periumbilical procedures. This chapter discusses the indications and contraindications. The focus is on the description of the surgical procedure with the left-lateral approach and with the caudal approach. In this chapter, the respective surgical steps are presented in great detail and the details of the procedure are discussed. Finally, the current results from the literature are discussed and presented in tabular form. This chapter is accompanied by two videos on the procedures described.