## 4 Discussion  
In this case series, we present a new technique of epitaxial repair as a new way to successfully repair hernias and defects of the anterior abdominal wall using minimally invasive surgery. Most of the published literature to date has focused on adult surgery. Both plication-based methods and hernia repair techniques are used for adult DRA repair. Based on the current literature, no clear distinction can be made regarding the recurrence rates, postoperative complications or patient-reported outcomes. Linea alba plication can be performed using open surgery or laparoscopic techniques. Both approaches use mesh reinforcement. Open surgery allows for the repair of complex abdominal hernias as well as extended abdominoplasty, including resection of skin laxity. Plication can be performed on either the posterior or the anterior rectus fascia, as well as on the widened linea alba. Open surgery can be associated with very large wound areas, postoperative seroma, poor wound healing and in the worst cases, mesh infection [18; 19]. In contrast, laparoscopic approaches do not have these disadvantages. [PERSON] et al. [20] described the use of the \"Venetian Blinds\" technique a in laparoscopic repair of diastasis recti, a technique in which they place interrupted sutures than run in and out of the widened linea alba several times, causing the midline to fold like a \"Venetian blind\" as the sutures are tied. Thie minimal-invasive procedure provided a solid repair and reduced the incidence seroma without any recurrence of diastasis recti. This technique is also used for the treatment of ventral hernia repair in combination with botulinum toxin injections 4-6 weeks prior to surgery [21]. However, both studies used mesh reinforcement. [PERSON] [22] described a laparoscopic mesh-free approach in a single case study. Hernia-based techniques for DRAM repair are often modifications of the original Chevrel or Rives-Stoppa techniques. The modified Chevrel technique preserves the musculoskeletal continuity of the ventral abdominal wall by not opening the abdominal cavity or posterior rectus fascia. Instead, the anterior rectus fascia is incised and overturned to form a wider posterior rectus fascia. The widened midline is not incised [23]. In the meshless modification of the Rives-Stoppa repair, the hernia sac is excised and the posterior rectus fascia is sutured using an overlapping technique. The anterior rectus fascia is then closed [24]. Both methods are open techniques and have seroma as a major complication. However, there are also promising recently developed hybrid minimally invasive techniques used for combined repair of DRA and small midline hernias. They offer similar advantages to the laparoscopic technique: less wound infection and pain, shorter hospital stays, good cosmetic results and rapid postoperative recovery. In addition, there is no need to enter the abdominal cavity, which eliminates the risk of adhesions and subsequent obstructive ileus, as well as the risk of organ perforation. Secondly, despite the small access, a good overview can be achieved. Thirdly, the risk of a postoperative incisional hernia is reduced because the hernia repair is not performed through a damaged linea alba. [PERSON] et al. [25] presented the endoscopic-assisted linea alba reconstruction (ELAR) plus mesh augmentation technique. This technique consists of an endoscopic extraperitoneal myofascial release followed by a shoelace repair of the rectus sheath and the insertion of an onlay mesh. [PERSON] et al. [26] described a similar technique, the mini- or less open sublay technique (e)MILOS. The technique consists of an extraperitoneal mesh repair of a ventral hernia (umbilical, epigastric or incisional). A 5 cm skin incision is made to correct the hernia and then the retro-muscular space is dissected endoscopically to place a mesh to stabilize the entire ventral abdominal wall. [PERSON] et al. [27] described a similar minimally invasive technique, the totally endoscopic midline plication.