Robotic Transversus Abdominis Release (rTAR) For Ventral Hernia Repairs

Robotic transversus abdominis release (roboTAR) is an established minimally invasive surgical technique that follows the principles set forth by Rives and Stoppa. Novitsky et al. first described the open transversus abdominis release (TAR), which extends the concept of the retromuscular operation of Rives to include Stoppa’s concept of the giant prosthetic reinforcement of the visceral sac (GPRVS) (Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ. Am J Surg. 204:709–716, 2012). Therefore, the principles of TAR allow for the reconstitution of the linea alba for large defects, as well as allow for the creation of a large extraperitoneal space for mesh placement, which may reinforce the entire visceral sac. General benefits of minimally invasive surgery can be expected and include decreased wound morbidity and postoperative pain, shorter hospitalization, and earlier return to work and or resumption of the normal activities of daily living. In this chapter, we will discuss the history and overview of roboTAR, preoperative considerations, relevant anatomy, and technical approaches to perform this procedure, as well as postoperative outcomes and pitfalls to avoid.