Deepithelialization of a complex ventral hernia for completely extraperitoneal Rives-Stoppa herniorrhaphy

Peritoneal incisions made during abdominal surgery are associated with numerous postoperative complications. Laparoscopic procedures are extraperitoneal, but they do not always provide adequate exposure of the defect nor room for manipulation. We suggest a de-epithelialization approach prior to mesh placement for the repair of large ventral hernias as a means of achieving a completely extraperitoneal ventral herniorrhaphy.