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Updated: Jul 11, 2025
Use of a Rat Model to Study Ventral Abdominal Hernia Repair
Published on: October 2, 2017
Rectus to defect ratio for estimating the complexity of ventral hernia repair: Is it reliable for robotic surgery?
M Wes Love1, Sarah Davis2, Dawn Blackhurst3
1Division of Minimal Access and Bariatric Surgery, Department of Surgery, University of South Carolina School of Medicine Greenville, Prisma Health-Upstate, 701 Grove Rd. ST3, Greenville, SC, 29605, USA.
Introduction:
The rectus to defect ratio (RDR) has been previously described as a metric which enables surgeons to estimate the need to perform additional myofascial release (AMR), in addition to open Rives-Stoppa retro-muscular hernia repair. We sought to validate this measurement specifically for patients undergoing robotic totally extraperitoneal (eTEP) hernia repair.
Methods:
A retrospective chart review of 188 patients who underwent robotic ventral hernia repair via eTEP approach. RDR on preoperative CT was compared to the final operation rendered. The primary endpoint was the RDR's ability to predict the need for TAR to achieve fascial closure.
Results:
Of 188 patients, 154 were repaired with rectus myofascial release, while 34 also required TAR. There was a linear decrease in the need for TAR with increasing RDR. RDR 1-1.49 (n = 12) required TAR in 66.7 % of cases, RDR 1.5-1.99 (n = 25) in 43.8 %, RDR 2-2.49 (n = 31) in 29 %, and RDR >2.5 (n = 151) in just 5.8 % CONCLUSION: The RDR accurately predicts the need for TAR to achieve fascial closure during robotic eTEP ventral hernia repair. An RDR >2.5 portends fascial closure without TAR 94.2 % of cases.
