Journal of Surgery Concepts & Practice ›› 2026, Vol. 31 ›› Issue (01): 23-31.doi: 10.16139/j.1007-9610.2026.01.05

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Endoscopic totally visceral sac separation for ventral hernias repair: a novel concept and its technical considera-tions

LI Binggen()   

  1. Department of General SurgeryNanfang Hospital, Southern Medical University, Guangdong Guangzhou 510515, China
  • Received:2026-01-09 Online:2026-02-25 Published:2026-04-21
  • Contact: LI Binggen E-mail:binggen_li@outlook.com

Abstract:

The abdominal wall can be treated as a whole physiological and functional entity which is composed of multiple anatomical structures and planes. Surgical approaches and technical details that required for hernic repair are diverse in different area. Indeed, the abdominal wall is confined by several anatomical boundaries which make these surgical planes separated. If one could dissect these boundaries, then separated spaces could be connected, establishing an ample retromuscular/preperitoneal space to accommodate the mesh of ventral hernia repair. The concept of totally visceral sac separation (TVS) is achieved. The TVS concept is not just an isolated technique, but the summary of diverse ventral hernia repair techniques. The article reviewed the relevant anatomy as well as surgical details used in different types of ventral hernia. Meanwhile, the article highlighted the core essence of the TVS concept, in order to facilitate better implementation of TVS techniques by hernia colleagues.

Key words: Hernia, Ventral hernias, Endoscopy/laparoscopy, Totally visceral sac separation(TVS), Retromuscular/ preperitoneal repair, Mesh

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