Behind the knife

Posterior sheath disruption is a feared complication of modern day hernia surgery. Though rare, this complication can have significant long term ramifications for patients because of mesh-visceral adhesions. We share a case of acute posterior sheath dehiscence, which was managed robotically. The patient did well in the postoperative setting with no significant complications and has done well in our surveillance program. This video is shared with the intent to educate surgeons on management of these rare events and review characteristic imaging findings and options for management in the acute setting.