Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Technical consideration for subxiphoidal incisional hernia repair.

J Conze1, A Prescher, K Kisielinski

  • 1Surgical Department and Institute for Anatomy, Rhenish Westphalian Technical University, Pauwelsstrasse 30, 52074 Aachen, Germany. jconze@ukaachen.de

Hernia : the Journal of Hernias and Abdominal Wall Surgery
|July 17, 2004
PubMed
Summary

Incisional hernia repair is challenging near the xiphoid due to anatomical limitations. Detaching the posterior rectus sheath lamina allows for adequate mesh placement in the retroxiphoidal space.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Outcomes of inguinal hernia repair in octogenarians: A propensity score-matched analysis of the Herniamed Registry.

Hernia : the journal of hernias and abdominal wall surgery·2026
Same author

Main confounders associated with the outcome of inpatient incisional hernia repair for decision making in ambulatory surgery.

Hernia : the journal of hernias and abdominal wall surgery·2026
Same author

Surgical treatment of rectus abdominis diastasis with concomitant abdominal wall hernias-perioperative outcomes of 11,658 cases from the Herniamed Registry.

Hernia : the journal of hernias and abdominal wall surgery·2025
Same author

What is the association between BMI classes and the outcome in incisional hernia repair?

Hernia : the journal of hernias and abdominal wall surgery·2025
Same author

Is there a link between Spigelian and inguinal hernias? A case series.

Hernia : the journal of hernias and abdominal wall surgery·2024
Same author

[Inguinal hernia operations-Always outpatient?]

Chirurgie (Heidelberg, Germany)·2023

Area of Science:

  • Abdominal wall reconstruction
  • Surgical anatomy
  • Hernia surgery

Background:

  • Mesh augmentation for incisional hernias requires a 5 cm overlap.
  • Osseous structures, like the xiphoid, complicate mesh placement.
  • This is particularly problematic in large proximal incisional hernias.

Purpose of the Study:

  • To investigate the retroxiphoidal space anatomy.
  • To identify methods for improving mesh overlap in challenging hernia repairs.

Main Methods:

  • Anatomical investigation of the retroxiphoidal space.
  • Analysis of fascial layers and their insertion points.

Main Results:

  • The posterior lamina of the rectus sheath inserts on the posterior xiphoid.

Related Experiment Videos

  • This lamina obstructs sufficient mesh placement.
  • Sharp dissection can detach the posterior lamina, opening the retroxiphoidal space.

    • Conclusions:

    • Detachment of the posterior rectus sheath lamina enables retroxiphoidal space access.
    • This facilitates combined retromuscular-retroxiphoid mesh augmentation.
    • A sufficient mesh underlay of at least 5 cm is achievable, adhering to sublay principles.