Anatomical Considerations and Tips for Laparoscopic and Robotic-Assisted Enhanced-View Totally Extraperitoneal Rives-Stoppa Repair for Midline Hernia

The enhanced-view totally extraperitoneal (eTEP) approach fulfills all modern principles for the repair of ventral hernias. In the hands of well-trained hernia surgeons, the approach is safe and effective and improves the patient’s quality of life, as demonstrated in more than 30 publications in the last 2 years. However, the eTEP approach is a complex operation that requires in-depth understanding of the extraperitoneal abdominal wall anatomy, including its neurovascular structures and natural boundaries. Formal training is necessary, ideally including cadaver dissection and a mentor.