“Component separation” technique and panniculectomy for repair of incisional hernia

• Published in: The American journal of surgery Vol. 201; no. 6; pp. 776 - 783
• Main Authors: Mazzocchi, Marco, M.D., Ph.D, Dessy, Luca Andrea, M.D., Ph.D, Ranno, Raul, M.D., Ph.D, Carlesimo, Bruno, M.D, Rubino, Corrado, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2011; Elsevier; Elsevier Limited
• Subjects: Abdomen; Abdominal Wall - surgery; Aged; Biological and medical sciences; Classification; Clinical appearance of the abdomen; Complications; Defects; Fascia; Female; Follow-Up Studies; Gastrointestinal surgery; General aspects; Hazards; Hernia; Hernia, Ventral - surgery; Hernias; Humans; Incisional hernia; Integration; Intensive care; Intravesical pressure; Lipectomy - methods; Male; Medical sciences; Middle Aged; Panniculectomy; Patient Satisfaction; Patients; Pressure; Prospective Studies; Prostheses; Separation; Stomach, duodenum, intestine, rectum, anus; Surgeons; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Mesh; Suture Techniques; Treatment Outcome; Wound Healing; “Components separation” technique; Clinical appearance of the abdomen; Panniculectomy; Intravesical pressure; “Components separation” technique; Incisional hernia; Separation; Bariatric surgery; Abdomen; Hernia; Medicine; Lipectomy; Components separation technique; Technique; Repair
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2010.04.013

Abstract Background Primary incisional hernia repair is rarely successful, with recurrence rates ranging from 18% to 62%. We describe the integration of “components separation” herniorrhaphy with panniculectomy. Methods Twenty-two patients were treated. Standard panniculectomies and component separation were performed. Intravesical pressure was measured preoperatively, intraoperatively, and postoperatively. Measurement variations were compared using the Wilcoxon test. Complications or hernia recurrence were evaluated. The clinical appearance of the abdomen was subjectively evaluated by patients. Results Secure abdominal defect closure with midline approximation of the fascia was achieved in all patients. No major early complications occurred. Hernia recurred in 1 patient (4.5%). Intra-abdominal pressure increased in all the patients in our series but remained well below the danger level. Fifteen patients were fully satisfied with the appearance of their abdomen, whereas 7 were satisfied. Conclusions Abdominal component separation provides a reliable autologous reconstructive option. Hernia repair combined with abdominoplasty provides functional and esthetic benefits.