Background The abdominal wall can be considered comprised of two compartments: an anterior and a posterior compart- ment. The anterior compartment includes the anterior rectus sheath and the rectus muscle. The posterior compartment com- prises the posterior rectus sheath, the transversalis fascia, and the peritoneum. When a large defect in the anterior compart- ment has to be corrected, for example, a rectus diastasis or large incisional hernia, an action on the anterior compartment is necessary; therefore, an anterior component separation has to be considered. If a loss of substance is present in the posterior compartment, a trasversus abdominis release should be accomplished. Methods We propose an original anterior compartment mobilisation, by a posterior approach. Dissection of the posterior rectus sheet proceeds until the linea semilunaris is reached. Incision of the anterior rectus sheath permits a mobilisation of the anterior compartment by a posterior approach. A mesh is placed in a sublay position. If the abdominal wall presents a loss of substance of the posterior compartment, a transversus abdominis release (TAR) can be performed in the same time. Results No hernia recurrences, no wound infection, and no mesh infection have been reported. Conclusions The anterior compartment mobilization permits mobilization towards
Hernia – Springer Journals
Published: Sep 6, 2019
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