Component Separation Technique: an Effective Way of Treating Large Ventral Hernia

Punjani, Ramesh; Shaikh, Imran I; Soni, V.

doi:10.1007/s12262-015-1265-0

Cited by 16 publications

(4 citation statements)

References 6 publications

(6 reference statements)

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“…The majority of the articles, 39, originated from the USA; five were from France [11,[14][15][16][17], four from the UK [12,[18][19][20], and two from Italy [21,22], India [23,24], and Brazil [25,26]. Six manuscripts were published prior to 2000 [27][28][29][30][31][32], 20 were published between 2000 and 2009, and 51 were published from 2010 onwards.…”

Section: Resultsmentioning

confidence: 99%

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

Parker

Halligan²,

Blackburn

et al. 2018

World j. surg.

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Large ventral hernias are a significant surgical challenge. "Loss of domain" (LOD) expresses the relationship between hernia and abdominal volume, and is used to predict operative difficulty and success. This systematic review assessed whether different definitions of LOD are used in the literature. The PubMed database was searched for articles reporting large hernia repairs that explicitly described LOD. Two reviewers screened citations and extracted data from selected articles, focusing on the definitions used for LOD, study demographics, study design, and reporting surgical specialty. One hundred and seven articles were identified, 93 full-texts examined, and 77 were included in the systematic review. Sixty-seven articles were from the primary literature, and 10 articles were from the secondary literature. Twenty-eight articles (36%) gave a written definition for loss of domain. These varied and divided into six broad groupings; four described the loss of the right of domain, six described abdominal strap muscle contraction, five described the "second abdomen", five describing large irreducible hernias. Six gave miscellaneous definitions. Two articles gave multiple definitions. Twenty articles (26%) gave volumetric definitions; eight used the Tanaka method [hernia sac volume (HSV)/abdominal cavity volume] and five used the Sabbagh method [(HSV)/total peritoneal volume]. The definitions used for loss of domain were not dependent on the reporting specialty. Our systematic review revealed that multiple definitions of loss of domain are being used. These vary and are not interchangeable. Expert consensus on this matter is necessary to standardise this important concept for hernia surgeons.

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Section: Resultsmentioning

confidence: 99%

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

Parker

Halligan²,

Blackburn

et al. 2018

World j. surg.

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“…As an exception, if the length of the parietal defect is limited (supraumbilical, mesogastric, infraumbilical), the incision may be reduced, if it largely exceeds the defect [4]. If recreating the linea alba is possible after the unilateral practice of the EOA incision, contralateral anterior component release is not necessary (Fig.…”

Section: Methodsmentioning

confidence: 99%

Open Anterior Component Separation for Complex Incisional and Ventral Hernias—When and How? Case Series Analysis

Moga

Oprea

2022

Indian J Surg

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Closing the midline in patients with incisional hernias is the cornerstone for a functional reconstruction with low morbidity, low recurrence rates, and good cosmetic results, which is the ideal outcome for every hernia surgeon. However, in patients with large hernias (usually over 10 cm width) or in loss of domain cases, this goal is difficult to achieve. Anterior component separation with or without mesh reinforcement has been the procedure of choice for these patients despite its high rate of wound complications. The goal of our study is to evaluate the opportunity and necessity of the anterior component separation in patients with complex incisional or ventral hernias (defects larger than 10 cm, infected meshes). Data of patients with large incisional/ventral hernia operated using anterior component separation technique in the past 10 years were re-visited and analyzed from hospital records between January 2012 and December 2020. Demographic data (age, gender, body mass index, ASA score) and the main steps of the technique were recorded. Data were reported as mean and standard deviation. We used the anterior component separation in 66 cases, mainly for septic conditions (open abdomen, chronic and extended infections of the abdominal wall, chronic-infected meshes). For large parietal defects with aseptic local condition, we used mesh-reinforced anterior component separation (five patients). Mean age was 68.7 years. Among them, 29 patients developed wound complications (hematoma, seroma, infection). Mean hospital stay was 12.6 days. Recurrence was 18% in patients without mesh and zero in patients with mesh reinforcement after a minimum one-year follow-up. Anterior component separation is still a valid procedure in patients with large abdominal defects especially when a septic wound is to be closed. For large parietal defects, if a wide subcutaneous dissection is required, mesh-reinforced anterior component separation remains a valid alternative in abdominal wall reconstruction in certain cases (mainly aseptic conditions).

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“…In ACS techniques, the most postoperative complication is surgical site infection (SSI), wound dehiscence, seroma, hematoma, necrosis, and recurrences (18,19) .…”

Section: Complications Of Anterior Component Separation (Acs)mentioning

confidence: 99%

Contemporary Onlay Incisional Hernia Repair: Review Article

Almasri¹,

Elshewail²,

Osman³

et al. 2021

The Egyptian Journal of Hospital Medicine

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Background: Abdominal procedures, whether open or laparoscopic are often complicated with an incisional abdominal hernia (IH). Approximately 15% -20 % of all laparotomies and 1% to 5% of all laparoscopic surgeries are complicated by IHs. IH is a really bad situation for doctors and patients. Dissatisfaction, long-term malfunction, and limitations of activities and unsatisfying cosmetic appearance are just a few of the side effects that patients endure as a result of IH. For doctors; it is a challenging surgical issue associated with multiple risk factors, unclear etiology and different pathological changes, affecting different patients. Management of such a variable surgical issue necessitates a good understanding of the anatomical and physiological features of the abdominal wall by the hernia surgeon beside a wide armamentarium of surgical options to deal with complex variants to repair and restore abdominal wall integrity and function, many procedures have been utilized to repair IH and to restore abdominal wall integrity. Objective: To review the feasibility and safety of the abdominal wall component release with contemporary onlay mesh fixation procedure in the treatment of incisional abdominal hernias. Conclusion: Large incisional hernias that are difficult to close in the midline might benefit from the component separation approach. Repair of incisional hernias by abdominal wall component separation with contemporary onlay mesh fixation results in favorable outcomes and lower recurrence rates. It gives a more durable abdominal wall repair, a more physiological repair in cases of loss of domain, an affordable financial outlay, and a low incidence of complications.

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Component Separation Technique: an Effective Way of Treating Large Ventral Hernia

Cited by 16 publications

References 6 publications

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

What Exactly is Meant by “Loss of Domain” for Ventral Hernia? Systematic Review of Definitions

Open Anterior Component Separation for Complex Incisional and Ventral Hernias—When and How? Case Series Analysis

Contemporary Onlay Incisional Hernia Repair: Review Article

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