Indications
It may be indicated for
- Rectus diastasis
- Umbilical hernias
- Epigastric hernias
- Multiple midline defects
- Lateral defects
small incisions below the underwear line
How the procedure is performed
- ICreating the preperitoneal space
Through small minimally invasive access sites, a space is created between the abdominal wall and the peritoneum. This allows the surgeon to work outside the abdominal cavity, avoiding direct contact with the bowel loops.
- IIReconstructing the midline
The midline is corrected by plication of the abdominal wall, bringing the rectus muscles back towards the centre. When associated hernias are present, the defects are repaired in the same operation.
Midline reconstruction by plication. - IIIPlacing the mesh
The mesh is placed in the preperitoneal plane, between the peritoneum and the posterior fascia. In this way the mesh is separated from the bowel by a natural anatomical layer.
Robotic peTEP: preperitoneal mesh placement. The mesh in the preperitoneal plane, separated from the bowel.
Why the preperitoneal plane matters
- 01mesh outside the abdominal cavity
- 02no direct contact with the bowel loops
- 03a wide reinforcement surface can be used
- 04reconstruction of the midline
- 05simultaneous treatment of diastasis and associated hernias
Laparoscopy or robotics
peTEP can be performed using:
Robotics is particularly helpful for:
- deep dissections
- midline suturing
- more extensive reconstructions
- managing complex anatomy
The anatomical principle stays the same: creating and using the preperitoneal plane to carry out the reconstruction and place the mesh outside the abdominal cavity.
Learn moreRobotic abdominal wall surgeryPlastic surgery
Possible combination with plastic surgery
Where indicated, functional reconstruction can be combined with aesthetic remodelling of the abdominal wall performed by the plastic surgery team.
This can be particularly useful when diastasis is accompanied by:
- 01excess skin
- 02marked tissue laxity
- 03marked changes in the abdominal profile
Reconstructing the midline also helps restore the waistline.
Learn moreAesthetic remodelling of the abdominal wallTiming and hospital stay
- About 2h
Duration of surgery · one night in hospital
- After 2h
Early mobilisation
- After 24h
Discharge
Post-operative recovery
immediate
- Straight awayImmediate return to daily activities
- End of rehabilitationGradual return to physical activity, at the end of the rehabilitation programme
Frequently asked questions
Is the mesh placed inside the abdomen?
No. In peTEP the mesh is placed in the preperitoneal plane, outside the abdominal cavity and separated from the bowel.
Can peTEP also correct diastasis?
Yes. In selected patients it allows the midline to be corrected by plication while treating any associated hernias at the same time.
What is the main difference compared with eTEP?
In eTEP the main working plane is retromuscular; in peTEP it is preperitoneal. They are two different anatomical strategies, chosen according to the type of defect and the patient's abdominal wall.
Can it be performed robotically?
Yes. peTEP can be performed either laparoscopically or robotically.
How long is the hospital stay?
Usually one night, although it depends on the extent of the procedure and individual recovery.
Not every diastasis needs the same reconstruction
peTEP is one of the techniques that make it possible to reconstruct the midline and keep the mesh outside the abdominal cavity. The choice depends on anatomy, type of defect, associated hernias, tissue quality and the patient's goals.