Outcomes of transversus abdominis release (TAR) with permanent synthetic retromuscular reinforcement for bridged repairs in massive ventral hernias: a retrospective review

The aim of the study was to investigate the effect of different methods of anterior abdominal wall separation on the increasion of the abdominal cavity volume (ACV) for the prevention of compartment sindrome. The effect of Novitsky posterior separation (Transversus Abdominis Release – TAR), Ramirez anterior separation and Ramirez anterior separation with the mobilization of posterior wall rectus sheath (R+MPRS) on increase ACV was studied. The study was conducted on autopsy materials of 30 non-fixed corpses. In the first part of investigation the results of Novitsky operation have been studied (n=10), in the second part – of Ramirez operation (n=10) and in the third part – R+MPRS (n=10). The ACV have been determined before and after surgery and the degree of it’s increasion after each operation have been counted. In Ramiraz's separation the average of ACV before the operation was 3.2±0.2 L, after the operation – 4.06±0.2 L with an average increasion in volume of 27.8±2.6%. In Novitsky operation the average of ACV before the operation was 3.1±0.1 L, after the operation – 3.9±0.1 L, with an average increasion of 24.2±1.7%. In Ramiraz + MPRS the average of ACV before the operation was 3.1±0.08 L, after the operation – 4.7±0.22 L with an average increasion of 49.8±4.6%. The study revealed different effects of the three types seperation of the abdominal wall on increasion the ACV. The operation of Ramiraz+ MPRS has the greatest effect on the increasion the ACV (49.8±4.6). The results were successfully used in the choice of the type of operation in 8 patients with large ventral hernias.

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Outcomes of posterior component separation with transversus abdominis release (TAR) in large and other complex ventral hernias: a single-surgeon experience

Hernia ◽

10.1007/s10029-021-02520-7 ◽

2021 ◽

Author(s):

G. Chatzimavroudis ◽

G. Kotoreni ◽

I. Kostakis ◽

N. Voloudakis ◽

E. Christoforidis ◽

...

Keyword(s):

Component Separation ◽

Transversus Abdominis ◽

Transversus Abdominis Release ◽

Posterior Component Separation ◽

Surgeon Experience ◽

Ventral Hernias

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Endoscopic transversus abdominis release separation in the treatment of patients with midline incisional hernias

Vestnik of Russian military medical Academy ◽

10.17816/brmma50539 ◽

2020 ◽

Vol 22 (3) ◽

pp. 82-87

Author(s):

V. A. Burdakov ◽

A. A. Zverev ◽

S. A. Makarov ◽

V. V. Strizheletsky ◽

G. M. Rutenburg ◽

...

Keyword(s):

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Early Postoperative Period ◽

Hernia Recurrence ◽

Transversus Abdominis ◽

Transversus Abdominis Release ◽

Totally Extraperitoneal ◽

Transabdominal Preperitoneal ◽

Simultaneous Operations ◽

Ventral Hernias

Abstract. The issues of reconstruction of the anterior abdominal wall in patients with median postoperative ventral hernias remain relevant for many years. The paradigm of their treatment is gradually shifting towards functional minimally invasive reconstructions of the anterior abdominal wall. The indications and technical aspects of endoscopic posterior separation surgery are considered. The analysis of 70 transversus abdominis release was carried out. The average age of patients with postoperative ventral hernias was 61,210 years. The median follow-up was 14,28,2 months and the anaesthesia risk was 2,80,5. The mean hernia width was 151,773,7 cm2 and the implant size was 832,9243,3 cm2. In the early postoperative period complications were observed in 7 (10%) patients, including the one with retromuscular hematoma, four with retromuscular space infection and two with superficial vein thrombophlebitis. Late complications were observed in 6 (8,7%) patients, there were persistent seroma (3) and chronic pain (3). No hernia recurrence was detected during this period. Thus, the use of endoscopic abdominal wall separation reduces the risk of local complications compared to similar open surgery. At the same time, there is a low level of hernia recurrence and a satisfactory quality of life. In total there were 70 (100%) transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release operations performed, among them 14 (77,8%) were bilateral transversus abdominis release and 32 (61,5%) were unilateral transversus abdominis release 4 (22,2%) and 20 (38,4%) respectively were transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal 10 (14,3%) operations with combined access were performed: 3 (16,7%) and 7 (1,5%) respectively transabdominal preperitoneal plastic transversus abdominis release and endoscopic totally extraperitoneal transversus abdominis release. In 13 (18,6%) cases simultaneous operations occurred, including 7 (10%) laparoscopic cholecystectomy and 6 (8,6%) endoscopic inguinal hernioplasty.

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