Danni Lu*, Andrew Bates and Aurora Pryor
Department of Gastroenterological Surgery, Stony Brook University School of Medicine, USAFulltext PDF
The component separation technique can be used for the management of large or complex midline abdominal wall defects resulting from infection, trauma, or complications of multiple abdominal surgeries. This technique was first described in 1990 as a surgical procedure that would release tension from the circumference of the abdominal wall while restoring function and stability of the abdominal wall muscles. The general technique involves the separation of abdominal muscle layers followed by disconnection of the muscle unit from the fascial sheath envelope and bilateral expansion, allowing for equilibration of pulling forces and centralization of the midline. A supplemental mesh may be used to reinforce the repair, and may help to reduce short-term recurrence rates. Currently, there are two approaches that are used - anterior and posterior - involving the isolation and division of the external abdominal oblique or transversus abdominis muscles, respectively. While the component separation technique yields promising results in restoring abdominal support following large wall defects, further study is required to adequately understand the risks of this procedure. This case report study presents an acute case of severe herniation following the failure of the abdominal wall following a posterior component separation.
Lu D, Bates A, Pryor A. A Case of Severe Herniation Following a Posterior Component Separation. Clin Surg. 2018; 3: 1875.