Transversus Abdominis Release for Abdominal Wall Reconstruction: Early Experience with a Novel Technique

Joshua S. Winder, Brittany J. Behar, Ryan M. Juza, John Potochny, Eric Pauli

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background Ventral hernias are common sequelae of abdominal surgery. Recently, transversus abdominis release has emerged as a viable option for large or recurrent ventral hernias. Our objective was to determine the outcomes of posterior component separation via transversus abdominis release for the treatment of abdominal wall hernias in the first series of patients at one institution. Methods We performed a retrospective review of a prospectively maintained database of open ventral hernia repair patients to identify patients who underwent posterior component separation via transversus abdominis release at one institution from 2012 to 2015. Patients who were at least 1 year out from surgery were included. Patient demographic characteristics, operative details, perioperative and postoperative complications, and recurrences were analyzed. Postoperative imaging was reviewed for evidence of morbidity or recurrence. Results Thirty-seven patients met inclusion criteria; 23 (62.2%) of these patients were female, with a mean age of 57.5 ± 11 years and median BMI of 32.1 kg/m2 (range 23.6 to 44.0 kg/m2). All patients underwent repair with mesh (81.1% polypropylene, 5.4% porcine dermal matrix, and 13.5% biologic/permanent synthetic hybrid). Median defect size was 392 cm2 (range 250 to 2,700 cm2) and median mesh area was 930 cm2 (range 600 to 3,600 cm2). Approximately 24% (9 of 37) of patients experienced a postoperative complication; ileus was the most common (4 patients). Surgical site events requiring intervention (ie drainage and antibiotics) developed in 2 patients. Median follow-up period was 21 months (range 12 to 42 months), during which one recurrence was identified (2.7%). Conclusions Posterior component separation via transversus abdominis release is a safe and effective method of ventral herniorrhaphy with favorable rates of wound morbidity and recurrence.

Original languageEnglish (US)
Pages (from-to)271-278
Number of pages8
JournalJournal of the American College of Surgeons
Volume223
Issue number2
DOIs
StatePublished - Aug 1 2016

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Abdominal Muscles
Abdominal Wall
Ventral Hernia
Recurrence
Herniorrhaphy
Abdominal Hernia
Morbidity
Ileus
Polypropylenes
Biological Products
Drainage
Swine
Demography
Databases

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

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title = "Transversus Abdominis Release for Abdominal Wall Reconstruction: Early Experience with a Novel Technique",
abstract = "Background Ventral hernias are common sequelae of abdominal surgery. Recently, transversus abdominis release has emerged as a viable option for large or recurrent ventral hernias. Our objective was to determine the outcomes of posterior component separation via transversus abdominis release for the treatment of abdominal wall hernias in the first series of patients at one institution. Methods We performed a retrospective review of a prospectively maintained database of open ventral hernia repair patients to identify patients who underwent posterior component separation via transversus abdominis release at one institution from 2012 to 2015. Patients who were at least 1 year out from surgery were included. Patient demographic characteristics, operative details, perioperative and postoperative complications, and recurrences were analyzed. Postoperative imaging was reviewed for evidence of morbidity or recurrence. Results Thirty-seven patients met inclusion criteria; 23 (62.2{\%}) of these patients were female, with a mean age of 57.5 ± 11 years and median BMI of 32.1 kg/m2 (range 23.6 to 44.0 kg/m2). All patients underwent repair with mesh (81.1{\%} polypropylene, 5.4{\%} porcine dermal matrix, and 13.5{\%} biologic/permanent synthetic hybrid). Median defect size was 392 cm2 (range 250 to 2,700 cm2) and median mesh area was 930 cm2 (range 600 to 3,600 cm2). Approximately 24{\%} (9 of 37) of patients experienced a postoperative complication; ileus was the most common (4 patients). Surgical site events requiring intervention (ie drainage and antibiotics) developed in 2 patients. Median follow-up period was 21 months (range 12 to 42 months), during which one recurrence was identified (2.7{\%}). Conclusions Posterior component separation via transversus abdominis release is a safe and effective method of ventral herniorrhaphy with favorable rates of wound morbidity and recurrence.",
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Transversus Abdominis Release for Abdominal Wall Reconstruction : Early Experience with a Novel Technique. / Winder, Joshua S.; Behar, Brittany J.; Juza, Ryan M.; Potochny, John; Pauli, Eric.

In: Journal of the American College of Surgeons, Vol. 223, No. 2, 01.08.2016, p. 271-278.

Research output: Contribution to journalArticle

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AU - Winder, Joshua S.

AU - Behar, Brittany J.

AU - Juza, Ryan M.

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N2 - Background Ventral hernias are common sequelae of abdominal surgery. Recently, transversus abdominis release has emerged as a viable option for large or recurrent ventral hernias. Our objective was to determine the outcomes of posterior component separation via transversus abdominis release for the treatment of abdominal wall hernias in the first series of patients at one institution. Methods We performed a retrospective review of a prospectively maintained database of open ventral hernia repair patients to identify patients who underwent posterior component separation via transversus abdominis release at one institution from 2012 to 2015. Patients who were at least 1 year out from surgery were included. Patient demographic characteristics, operative details, perioperative and postoperative complications, and recurrences were analyzed. Postoperative imaging was reviewed for evidence of morbidity or recurrence. Results Thirty-seven patients met inclusion criteria; 23 (62.2%) of these patients were female, with a mean age of 57.5 ± 11 years and median BMI of 32.1 kg/m2 (range 23.6 to 44.0 kg/m2). All patients underwent repair with mesh (81.1% polypropylene, 5.4% porcine dermal matrix, and 13.5% biologic/permanent synthetic hybrid). Median defect size was 392 cm2 (range 250 to 2,700 cm2) and median mesh area was 930 cm2 (range 600 to 3,600 cm2). Approximately 24% (9 of 37) of patients experienced a postoperative complication; ileus was the most common (4 patients). Surgical site events requiring intervention (ie drainage and antibiotics) developed in 2 patients. Median follow-up period was 21 months (range 12 to 42 months), during which one recurrence was identified (2.7%). Conclusions Posterior component separation via transversus abdominis release is a safe and effective method of ventral herniorrhaphy with favorable rates of wound morbidity and recurrence.

AB - Background Ventral hernias are common sequelae of abdominal surgery. Recently, transversus abdominis release has emerged as a viable option for large or recurrent ventral hernias. Our objective was to determine the outcomes of posterior component separation via transversus abdominis release for the treatment of abdominal wall hernias in the first series of patients at one institution. Methods We performed a retrospective review of a prospectively maintained database of open ventral hernia repair patients to identify patients who underwent posterior component separation via transversus abdominis release at one institution from 2012 to 2015. Patients who were at least 1 year out from surgery were included. Patient demographic characteristics, operative details, perioperative and postoperative complications, and recurrences were analyzed. Postoperative imaging was reviewed for evidence of morbidity or recurrence. Results Thirty-seven patients met inclusion criteria; 23 (62.2%) of these patients were female, with a mean age of 57.5 ± 11 years and median BMI of 32.1 kg/m2 (range 23.6 to 44.0 kg/m2). All patients underwent repair with mesh (81.1% polypropylene, 5.4% porcine dermal matrix, and 13.5% biologic/permanent synthetic hybrid). Median defect size was 392 cm2 (range 250 to 2,700 cm2) and median mesh area was 930 cm2 (range 600 to 3,600 cm2). Approximately 24% (9 of 37) of patients experienced a postoperative complication; ileus was the most common (4 patients). Surgical site events requiring intervention (ie drainage and antibiotics) developed in 2 patients. Median follow-up period was 21 months (range 12 to 42 months), during which one recurrence was identified (2.7%). Conclusions Posterior component separation via transversus abdominis release is a safe and effective method of ventral herniorrhaphy with favorable rates of wound morbidity and recurrence.

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