scholarly journals Anterior component separation versus posterior component separation with transversus abdominus release in abdominal wall reconstruction for incisional hernia repair

QJM ◽  
2018 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
S Albalkiny ◽  
M Helmy
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Incisional Hernia Repair ◽  
Component Separation ◽  
Posterior Component Separation ◽  
Anterior Component Separation

scholarly journals EP.TH.108A Descriptive Case Series of Incisional Hernia Repair Using Dual Mesh Technique

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Chloe Theodorou ◽  
Zia Moinuddin ◽  
David Van Dellen
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Surgical Techniques ◽  
Case Series ◽  
Incisional Hernia Repair ◽  
Fistula Formation ◽  
Mesh Technique ◽  
Dual Mesh

Abstract Aims Incisional hernias are a common complication after surgery that cause significant patient morbidity. Symptomatic patients are offered repair but many surgical techniques exist, with abdominal wall reconstruction becoming preferable for large complex defects. This paper describes our experience of abdominal wall reconstruction using a dual mesh technique. Method 22 patients underwent incisional hernia repair between March 2019 and September 2020. All patients received dual mesh, placed in retrorectus or transversalis fascial/retromuscular space. Absorbable BIO-A GORE mesh was used with a polypropylene mesh above. All patients were followed up to assess for complications and recurrence. Results No patients experienced fistula formation, long-term pain or obstructive symptoms. We report one true hernia recurrence (4.5%) and one case of infected mesh (4.5%), these both await further treatment. One patient had a proven wound infection which resolved with conservative treatment. 4 patients (18.2%) experienced seromas, 3 of these resolved spontaneously, one requiring image-guided drainage. Conclusion Incisional hernia repair using combination polypropylene and bio-absorbable mesh provides a safe and effective repair with low recurrence and incidence of surgical site occurrences in the short term. Longer follow up and further studies are needed to evaluate this mesh technique to support ongoing use of absorbable meshes in complex hernia repair.

scholarly journals Combining anterior and posterior component separation for extreme cases of abdominal wall reconstruction

Hernia ◽  
2020 ◽  
Vol 24 (2) ◽  
pp. 369-379 ◽  
Author(s):  
J. Lopez-Monclus ◽  
J. Muñoz-Rodríguez ◽  
C. San Miguel ◽  
A. Robin ◽  
L. A. Blazquez ◽  
...  
Keyword(s):  
Abdominal Wall ◽  
Abdominal Wall Reconstruction ◽  
Component Separation ◽  
Posterior Component Separation ◽  
Posterior Axillary Line ◽  
The Mean ◽  
Anterior Component Separation ◽  
Midline Closure

Abstract Purpose The closure of midline in abdominal wall incisional hernias is an essential principle. In some exceptional circumstances, despite adequate component separation techniques, this midline closure cannot be achieved. This study aims to review the results of using both anterior and component separation in these exceptional cases. Methods We reviewed our experience using the combination of both anterior and posterior component separation in the attempt to close the midline. Our first step was to perform a TAR and a complete extensive dissection of the retromuscular preperitoneal plane developed laterally as far as the posterior axillary line. When the closure of midline was not possible, an external oblique release was made. A retromuscular preperitoneal reinforcement was made with the combination of an absorbable mesh and a 50 × 50 polypropylene mesh. Results Twelve patients underwent anterior and posterior component separation. The mean hernia width was 23.5 ± 5. The majority were classified as severe complex incisional hernia and had previous attempts of repair. After a mean follow-up of 27 months (range 8–45), no case of recurrence was registered. Only one patient (8.33%) presented with an asymptomatic bulging in the follow-up. European Hernia Society’s quality of life scores showed a significant improvement at 2 years postoperatively in the three domains: pain (p = 0.01), restrictions (p = 0.04) and cosmetic (p = 0.01). Conclusions The combination of posterior and anterior component separation can effectively treat massive and challenging cases of abdominal wall reconstruction in which the primary midline closure is impossible to achieve despite appropriate optimization of surgery.

scholarly journals P160 ENDOSCOPIC ANTERIOR COMPONENT SEPARATION OR OPEN TRANSVERSUS ABDOMINUS RELEASE ARE NOT ASSOCIATED WITH INCREASED WOUND MORBIDITY FOLLOWING INCISIONAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Freia Gaspar ◽  
Helle Midtgaard ◽  
Lars Nannestad Jorgensen ◽  
Kristian Kiim Jensen
Keyword(s):  
Incisional Hernia ◽  
Hernia Repair ◽  
Incisional Hernia Repair ◽  
Reoperation Rate ◽  
Hernia Recurrence ◽  
Component Separation ◽  
Transversus Abdominis ◽  
High Rate ◽  
Significant Difference ◽  
Anterior Component Separation

Abstract Aim Traditional anterior component separation during incisional hernia repair is associated with a high rate of postoperative wound morbidity. Because extensive subcutaneous dissection is avoided by endoscopic anterior component separation (eACS) or open transversus abdominis release (TAR), we hypothesized that these techniques did not increase the incidence of surgical site occurrence compared to incisional hernia repair without component separation. Material and Methods This was a retrospective cohort study of patients undergoing open, retro-rectus incisional hernia repair. Component separation during retro-rectus repair was performed using eACS or TAR. The primary outcome was 30-day incidence of postoperative surgical site occurrence. Secondary outcomes included length of stay, 30-day readmission, 30-day reoperation rate and 3-year recurrence rate. Results A total of 322 patients underwent retro-rectus repair, 168 (52%) of whom received either eACS or TAR. Addition of eACS or TAR was neither associated with surgical site occurrence, (odds ratio: 0.82, confidence interval: 0.40-1.68, P = 0.596) nor with hernia recurrence (hazard ratio 0.80, CI 0.27-2.40, P = 0.693). There was no significant difference between the groups regarding the frequencies of 30 day-readmission or 30-day reoperation. Conclusions The addition of eACS or TAR to a retro-rectus incisional hernia repair was not associated with increased wound morbidity or hernia recurrence.

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