Morbid obesity is traditionally considered a modifiable risk factors for patients who desires abdominal wall reconstruction and ventral hernia repair. Much of the morbidity is associated with skin and soft tissue complications. Minimally invasive approaches to repair can reduce the short term morbidity following repair and my provide a durable solution to patients who are significant limited by symptomatic hernias. This video reviews a robotic retrorectus repair in a patient presenting with chronic abdominal pain and a BMI of 42.