Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Mar 27:5:24.
doi: 10.3389/fsurg.2018.00024. eCollection 2018.

What Do We Know About Component Separation Techniques for Abdominal Wall Hernia Repair?

Hubert Scheuerlein  1 , Andreas Thiessen  1 , Christine Schug-Pass  2 , Ferdinand Köckerling  2
Affiliations

What Do We Know About Component Separation Techniques for Abdominal Wall Hernia Repair?

Hubert Scheuerlein et al. Front Surg. .

Abstract

Introduction: The component separation technique (CST) was introduced to abdominal wall reconstruction to treat large, complex hernias. It is very difficult to compare the published findings because of the vast number of technical modifications to CST as well as the heterogeneity of the patient population operated on with this technique.

Material and methods: The main focus of the literature search conducted up to August 2017 in Medline and PubMed was on publications reporting comparative findings as well as on systematic reviews in order to formulate statements regarding the various CSTs.

Results: CST without mesh should no longer be performed because of too high recurrence rates. Open anterior CST has too high a surgical site occurrence rate and henceforth should only be conducted as endoscopic and perforator sparing anterior CST. Open posterior CST and posterior CST with transversus abdominis release (TAR) produce better results than open anterior CST. To date, no significant differences have been found between endoscopic anterior, perforator sparing anterior CST and posterior CST with transversus abdominis release. Robot-assisted posterior CST with TAR is the latest, very promising alternative. The systematic use of biologic meshes cannot be recommended for CST.

Conclusion: CST should always be performed with mesh as endoscopic or perforator sparing anterior or posterior CST. Robot-assisted posterior CST with TAR is the latest development.

Keywords: component separation technique; endoscopic component separation technique; perforator sparing component separation technique; robotic transversus abdominis release; transversus abdominis release.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Schematic drawing of endoscopic component separation technique (A) and transversus abdominis release (B).
See this image and copyright information in PMC

References

    1. Switzer NJ, Dykstra MA, Gill RS, Lim S, Lester E, de Gara C, et al. Endoscopic versus open component separation: systematic review and meta-analysis. Surg Endosc (2015) 29(4):787–95. 10.1007/s00464-014-3741-1 - DOI - PubMed
    1. Albanese AR. [Gigantic median xipho-umbilical eventration; method for treatment]. Rev Asoc Med Argent (1951) 65(709-710):376–8. - PubMed
    1. Albanese AR. [Liberating incisions in the treatment of large supraumbilical eventrations]. Prensa Med Argent (1966) 53(38):2222–7. - PubMed
    1. Ramirez OM, Ruas E, Dellon AL. "Components separation" method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg (1990) 86(3):519–26. - PubMed
    1. Ramirez OM. Abdominoplasty and abdominal wall rehabilitation: a comprehensive approach plastic and reconstructive. Surgery (2000) 105:425–35. - PubMed

LinkOut - more resources