Anterior Component Separation Technique Is Efficient Enough in Loss of Domain Hernia Treatment

2020 ◽  
Vol 82 (5) ◽  
pp. 879-885
Author(s):  
Salih Tosun ◽  
Nesrin Gunduz
Keyword(s):  
Component Separation ◽  
Separation Technique ◽  
Loss Of Domain ◽  
Component Separation Technique ◽  
Anterior Component Separation

scholarly journals Postoperative outcome of a giant incisional hernia resolved by anterior component separation technique

2018 ◽  
Vol 13 (4) ◽  
pp. 286-288
Author(s):  
Bogdan Socea ◽  
◽  
Camelia Diaconu ◽  
Ovidiu Gabriel Bratu ◽  
Tiberiu Paul Neagu ◽  
...  
Keyword(s):  
Incisional Hernia ◽  
Postoperative Outcome ◽  
Component Separation ◽  
Separation Technique ◽  
Component Separation Technique ◽  
Anterior Component Separation

scholarly journals Is the Anterior component separation technique sufficient for ventral hernia?

2020 ◽  
Vol 4 (3) ◽  
pp. 82-84
Author(s):  
Dr. Ajay A Gujar ◽  
Dr. Attman P Velani ◽  
Dr. Amrita A Gujar ◽  
Dr. Aashay Dharia
Keyword(s):  
Ventral Hernia ◽  
Component Separation ◽  
Separation Technique ◽  
Component Separation Technique ◽  
Anterior Component Separation

scholarly journals OPTIMIZATION OF THE CHOICE OF LAPAROSCOPIC AND OPEN ALLOPLASTICS IN CASE OF INCISIONAL VENTRAL HERNIAS

2021 ◽  
Vol 20 (2) ◽  
Author(s):  
Ya.P. Feleshtynsky ◽  
O.M. Lerchuk ◽  
V.V. Smishchuk
Keyword(s):  
Postoperative Pain ◽  
Abdominal Wall ◽  
Rectus Abdominis ◽  
Component Separation ◽  
Separation Technique ◽  
Chronic Postoperative Pain ◽  
Postoperative Wound ◽  
Component Separation Technique ◽  
Sublay Technique ◽  
Anterior Component Separation

The aim of the work – to increase the effectiveness of surgical treatment of incisionalventral hernias (IVH) by optimizing the choice of laparoscopic and open allohernioplasty.Material and methods. The analysis of surgical treatment of 508 patients with IVH from2009 to 2020 was conducted. According to the Europenian Herniology Association(EGA) classification (Ghent, Belgium, 2008) IVH was distributed as follows: MW1-2R0 was diagnosed in 217 (42,7%), MW3R0 – in 291 (57,3%) patients. Diastasis of therectus abdominis muscles up to 5 cm was present in 217 (42,7%) patients, diastasis5-10 cm – in 127 (25%), diastasis greater than 10 cm – in 164 (32.3%) patients.Depending on the size of the hernia and the width of diastasis of the rectus abdominis,patients were divided into 3 groups.In group I, laparoscopic allohernioplasty was performed in 109 (21,5%) patients withsmall and medium-sized IVH with diastasis of up to 5 cm, in particular the developedlaparoscopic preperitoneal in 63 patiens and laparoscopuc retromuscular alloplastiesin 46 patients. The comparison group IIa consisted of 108 (15,1%) patients whounderwent open retromuscular allohernioplasty.In group II, 64 (12,6%) patients with large IVH and diastasis of the rectus abdominis5-10 cm underwent open allohernioplasty by «sublay» technique. The comparison groupIIa consisted of 63 (12,4%) patients who were performed the open method «onlay».In group III, in 82 (16,1%) patients with giant IVH and diastasis more than 10 cm ananterior component separation technique of the abdominal wall in combination withalloplasty with intra-abdominal placement of a mesh implant with anti-adhesive coatingwas performed according to the developed method. Comparison group IIIa consistedof 82 (16,1%) patients who underwent anterior component separation technique of theabdominal wall in combination with alloplasty «onlay».Results. For small and medium-sized IVH and diastasis of the rectus abdominis musclesup to 5 cm, laparoscopic allohernioplasty with preperitoneal and retromuscularplacement of a mesh implant and elimination of diastasis is optimal in comparisonwith open retromuscular allohernioplasty, contributes to a significant decrease in theincidence of seroma from 35,2% to 3,7 %, postoperative wound suppuration – from6,5% to 0%, inflammatory infiltrate – from 4,6% to 0%, chronic postoperative pain –from 6,4% to 2,6%, hernia recurrence – from 6,4% up to 0%.The optimal method of allohernioplasty for large IVH and diastasis of the rectusabdominis muscles from 5 to 10 cm is the open «sublay» technique in comparison withthe open «onlay» technique, reduces the incidence of seroma from 23,8% to 6,3%,postoperative wound suppuration – from 4,8% to 1,6%, chronic postoperative pain –from 4,8% to 1,6%, hernia recurrence – from 7,9% to 3,1%.In case of gigantic IVH, contracture of the rectus abdominis muscles and diastasisof more than 10 cm the anterior component separation technique of the anatomicalcomponents of the abdominal wall in combination with intra-abdominal alloplasty isoptimal in comparison with the use of an anterior component separation techniqueof an abdominal wall combined with «onlay» significant improvement in treatmentoutcomes, namely, reduction of seroma frequency from 25,6% to 7,3%, postoperativewound suppuration – from 4,9% to 2,4%, postoperative wound infiltrate – from 13,4%to 2,4 %, chronic postoperative pain – from 8,1% to 1,6%, recurrence of IVH – from6,5% to 1,6%.Conclusion. Optimization of the choice of laparoscopic and open allohernioplastyenables to increase significantly ventral hernias and to decrease the quantity of thepost-operative complications.

Transversalis fascia scoring: a new adjunct to anterior component separation technique

2017 ◽  
Vol 41 (3) ◽  
pp. 329-334
Author(s):  
Inzhili K. Ismail ◽  
Carol E. Soteropulos ◽  
Alice C. Huang ◽  
Kristen M. Rezak ◽  
Ashit Patel
Keyword(s):  
Component Separation ◽  
Separation Technique ◽  
Transversalis Fascia ◽  
Component Separation Technique ◽  
Anterior Component Separation

scholarly journals Prospective study of midline abdominal incisional hernia repair by component separation technique augmented with prosthetic mesh

2020 ◽  
Vol 7 (10) ◽  
pp. 3273
Author(s):  
Ravi Saroha ◽  
Shivani B. Paruthy ◽  
Sunil Singh
Keyword(s):  
Abdominal Wall ◽  
Tertiary Care ◽  
Component Separation ◽  
Separation Technique ◽  
Close Monitoring ◽  
Care Hospital ◽  
Early Recovery ◽  
Component Separation Technique ◽  
Early Return ◽  
Mesh Augmentation

Background: In our tertiary care hospital, we receive a large number of acute abdomen cases. Raised intra-abdominal pressure (IAP) makes laparostomy mandatory initially and abdominal wall approximation cannot be completed due to compromised state in most cases. Large incisional hernias were seen on complete healing and this study was done to see the feasibility of component separation technique (CST) with mesh augmentation.Methods: 30 patients were subjected to CST with mesh augmentation. Preoperative defect size mapping, Pre- and post-operative monitoring of IAP were done. Pain scoring by visual analogue scale (VAS), early and late complications was noted. Patients were followed up for 60 months.Results: CST with mesh augmentation was found to be feasible with 96.77% success rate as no recurrence was noted in follow up. Preoperative average Basal metabolic index was 26.09. Size of defect varied from 17-20×9-16 cm2 (length X width). Seroma seen in 50% of patients was managed without any intervention. Skin necrosis in 6.6% and wound dehiscence in 3.33%, managed with minimal debridement & local wound care respectively. Respiratory compromise and hematoma were not seen and no patient required any active ICU care. Average length of hospital stay was 5.22 days. Close monitoring of IAP in immediate post-operative period was found to be significant.Conclusion: Physical acceptance of stable abdominal wall gives a psychological boost to patients with early recovery in form of ambulation and early return to work.

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