Original concepts in anatomy, abdominal-wall surgery, and component separation technique and strategy

Original concepts in anatomy, abdominal-wall surgery, and component separation technique and... 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 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Hernia Springer Journals

Original concepts in anatomy, abdominal-wall surgery, and component separation technique and strategy

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Publisher
Springer Journals
Copyright
Copyright © 2019 by Springer-Verlag France SAS, part of Springer Nature
Subject
Medicine & Public Health; Abdominal Surgery
ISSN
1265-4906
eISSN
1248-9204
DOI
10.1007/s10029-019-02030-7
Publisher site
See Article on Publisher Site

Abstract

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

Journal

HerniaSpringer Journals

Published: Sep 6, 2019

References

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