A surgical procedure guide describing robotic diastasis repair using the Inan Inverting Plication Stitch (IIPS) was released in collaboration with Intuitive Surgical as part of the da Vinci surgical procedure guide series.
The document presents a structured description of the operative strategy used for robotic abdominal wall reconstruction and restoration of the linea alba through a suprapubic eTEP approach.
The Inan Inverting Plication (IIP) is a robotic reconstructive technique for rectus diastasis repair, designed to restore the anatomical continuity of the linea alba during robotic abdominal wall reconstruction.
This educational material contributes to the dissemination of advanced techniques in robotic hernia surgery and abdominal wall reconstruction.
Further information about hernia surgery and abdominal wall reconstruction is available here:
https://genevasurgery.com/diastasis-recti/
The Inan Inverting Plication Technique
The Inan Inverting Plication describes a posteriorly inverted plication of the anterior rectus sheath performed robotically within the retrorectus space.
The objective is to restore physiological midline tension while enabling placement of a large retrorectus mesh reinforcement, supporting durable abdominal wall reconstruction.
The plication follows a small-stitch philosophy, incorporating the decussating fibres of the anterior and posterior rectus sheaths in order to achieve a stable anatomical reconstruction of the linea alba.
This configuration produces a posteriorly inverted midline ridge reminiscent of traditional open repair techniques while preserving the advantages of minimally invasive robotic surgery.
Suprapubic eTEP Approach
The procedure guide details a bottom-up suprapubic eTEP approach, providing wide retrorectus dissection and excellent visualisation of the entire linea alba.
Precise Anatomical Dissection
The robotic platform enables meticulous dissection of the retrorectus space and controlled identification of anatomical planes.
Controlled Midline Reconstruction
The approach facilitates precise restoration of the linea alba and placement of a large extraperitoneal mesh reinforcement.
Through this strategy, robotic diastasis repair achieves functional reconstruction of the abdominal wall while minimising tissue trauma.
Technique Highlight
Inan Inverting Plication (IIP)
Robotic reconstructive technique designed for rectus diastasis repair and abdominal wall reconstruction.
Key principles include:
small-stitch plication of the anterior rectus sheath
posterior inversion of the midline
reinforcement with large retrorectus mesh
This approach allows anatomical reconstruction of the linea alba while preserving the advantages of robotic minimally invasive surgery.
Educational Surgical Material
The procedure guide was developed within the Intuitive Surgical educational platform, supporting surgeons performing advanced robotic abdominal wall surgery.
It accompanies a procedural video demonstrating the key steps of the suprapubic eTEP repair and the Inan Inverting Plication technique.
The surgical concepts described in the guide reflect clinical experience developed in specialised practices such as Geneva Surgery in Geneva, where robotic techniques are applied in hernia surgery and abdominal wall reconstruction.
Further information on robotic abdominal wall surgery in Geneva is available here:
https://genevasurgery.com/hernia-abdominal-wall/
