ArticleHernia : the journal of hernias and abdominal wall surgery2023
Pathways of the preperitoneal plane: from the "fatty triangle" in Rives to the "fatty trident" in extended retromuscular abdominal wall reconstruction. A tribute to Prof. Schumpelick.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Optimizing robotic approach to ventral hernia repair: an updated systematic review and meta-analysis between preperitoneal versus retromuscular repair.Journal of robotic surgery · 2025Pooled it
- Short-term outcomes of minimally invasive techniques in posterior component separation for ventral hernia repair: a systematic review and meta-analysis.Hernia : the journal of hernias and abdominal wall surgery · 2024Pooled it
- Enhanced view/extended totally extraperitoneal plasty (eTEP) Rives-Stoppa repair versus open Rives-Stoppa repair: a single-center retrospective propensity score-matched cohort study.Surgical endoscopy · 2026Article
- Standardization of the latero-medial preperitoneal/pretransversalis dissection in PeTEP ventral hernia repair: single-center outcomes.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Lateral single-port laparoscopic repair of primary ventral hernias via the plane posterior to the posterior rectus sheath : The world journal of hernia and abdominal wall surgery.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Predictive factors for transversus abdominis release in laparoscopic enhanced-view totally extraperitoneal repair of midline ventral and incisional hernias.Surgical endoscopy · 2026Article
- Essential Anatomy for the Abdominal Wall Surgeon: Expert Consensus of Anatomical Concepts and Operative Steps for Posterior Component Separation.World journal of surgery · 2025Article
- Cranial approach for preperitoneal/pretransversalis enhanced-view totally extraperitoneal (PeTEP) hernia repair: a novel technique description and early outcomes.Surgical endoscopy · 2025Observational
- Case Report: Robotic PeTEP for Totally Extraperitoneal Repair of Incisional Hernia.Journal of abdominal wall surgery : JAWS · 2025Article
- Totally Extraperitoneal Approach With Preperitoneal Repair for the Treatment of Midline Hernia Defects: A Case Series and Single-Center Experience.Journal of abdominal wall surgery : JAWS · 2025Article
- How I Do It: Madrid posterior component separation in 10 steps, with special consideration of its anatomy.Langenbeck's archives of surgery · 2024Review
- The Madrid Posterior Component Separation: An Anatomical Approach for Effective Reconstruction of Complex Midline Hernias.Journal of abdominal wall surgery : JAWS · 2024Article
- Pre-peritoneal Fat as a Guide to Extended View Total Extraperitoneal (eTEP) Repair for Inguinal Hernia.Cureus · 2024Article
- [Incisional hernia: open abdominal wall reconstruction. Current state of the technique and results].Chirurgie (Heidelberg, Germany) · 2024Review
- EIT Ambivium, Linea Semilunaris, and Fulcrum Abdominalis.Journal of abdominal wall surgery : JAWS · 2023Review
- Incisions in Hepatobiliopancreatic Surgery: Surgical Anatomy and its Influence to Open and Close the Abdomen.Journal of abdominal wall surgery : JAWS · 2023Review
- Reverse TAR may be added when necessary in open preperitoneal repair of lateral incisional hernias: a retrospective multicentric cohort study.Surgical endoscopy · 2022Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeExtended retromuscular dissection performed for abdominal wall reconstruction in complex abdominal wall repair has progressively exposed the anatomy between the peritoneal layer and abdominal wall muscles. This study aimed to assess the morphology and distribution of preperitoneal fat in a cadaveric model and its influence in retromuscular preperitoneal dissections.
methodsThirty frozen cadaver torsos were dissected by posterior component separation. The shape of the preperitoneal fat was identified, and the dimensions and more significant distances were calculated.
resultsThe results showed that the preperitoneal fat resembles a trident, exists along the midline under the linea alba, and expands in the epigastric area into a rhomboid shape. The fatty triangle was found to be a part of this rhomboid. Caudally, the midline preperitoneal fat widened under the arcuate line to reach the Retzius space. Laterally, the Bogros space communicated the root of the trident with the paracolic gutters, Toldt's fascia, and pararenal fats, forming the lateral prong of the trident. The peritoneum not covered by the preperitoneal fatty trident was easy to break. Three pathways could be tracked following the distribution of this fat that facilitated the dissection of the preperitoneal space to prepare the landing zone of the meshes in hernia repair.
conclusionThe concept of preperitoneal fatty trident may be of practical assistance to perform various hernia procedures, from the simple ventral hernia repair to the more complex preperitoneal ventral repair or posterior component separation techniques. The consistency of this layer allows us to follow three specific pathways to find our plane between the peritoneum and muscle layers to extend the preperitoneal dissection.
Indexed as
Identifiers
35426573What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.