Posterior component separation and transversus abdominis muscle release for complex incisional hernia repair in patients with a history of an open abdomen

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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Long-term outcomes and quality of life assessment after posterior component separation with transversus abdominis muscle release (TAR)

Surgical Endoscopy ◽

10.1007/s00464-021-08402-4 ◽

2021 ◽

Author(s):

E. E. Sadava ◽

M. E. Peña ◽

C. Bras Harriott ◽

M. A. Casas ◽

F. Schlottmann ◽

...

Keyword(s):

Quality Of Life ◽

Component Separation ◽

Transversus Abdominis ◽

Life Assessment ◽

Long Term Outcomes ◽

Quality Of Life Assessment ◽

Posterior Component Separation ◽

Transversus Abdominis Muscle

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OV10 LAPAROSCOPIC-GUIDED TRANSVERSUS ABDOMINIS PLANE (TAP) BLOCK IN HERNIA SURGERY - HOW WE DO IT

British Journal of Surgery ◽

10.1093/bjs/znab396.061 ◽

2021 ◽

Vol 108 (Supplement_8) ◽

Author(s):

Mário Rui Gonçalves ◽

Conceição Antunes ◽

Mariana Capinha ◽

Ana Rita Arantes ◽

Paulo Almeida ◽

...

Keyword(s):

Incisional Hernia ◽

Hernia Repair ◽

Ventral Hernia ◽

Incisional Hernia Repair ◽

Transversus Abdominis ◽

Direct Visualization ◽

Tap Block ◽

Transversus Abdominis Plane ◽

Hernia Surgery ◽

Surgical Department

Abstract Aim “COVID has been a great challenge for Hospitals around the world. At our surgical department a new protocol of TAP block was designed and implemented in our laparoscopic incisional ventral hernia repairs, to allow these patients to be operated in ambulatory regime, without compromising pain control and the outcomes. In this video we aim to present the technique for the Laparoscopic-guided TAP Block during a Laparoscopic IPOM Plus ventral hernia repair.” Material and Methods “We implemented this protocol in July 2020 and since then, we performed 18 TAP block in laparoscopic incisional hernia repairs, laparoscopic guided by the Surgeon or ultrasound-guided by the Anesthesiologist. In this case, the video reports to a Laparoscopic IPOM Plus incisional hernia repair performed on a 54-year-old patient, male, with obesity, arterial hypertension and dyslipidemia. He had a 6 centimeter incisional hernia post-colorectal surgery in 2013.” Results “As detailed in the video, we show all the steps to perform a TAP block under laparoscopic direct visualization” Conclusions “TAP block can be performed by the Surgeon, with direct visualization at the beginning of the laparoscopic procedure.”

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