Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair

Bittner, James G.; Alrefai, Sameer; Vy, Michelle; Mabe, Micah; Prado, Paul A. R. Del; Clingempeel, Natasha L.

doi:10.1007/s00464-017-5729-0

Cited by 121 publications

(62 citation statements)

References 21 publications

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“…Recently, there has been an emergence of literature about minimally invasive approaches to PCS/TAR 19–22. PCS/TAR has traditionally been performed as an open procedure, but robotic TAR is a novel, minimally invasive technique that combines the benefits of the RSW approach with bilateral TAR with the well-established benefits of minimally invasive surgery.…”

Section: Discussionmentioning

confidence: 99%

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Use of posterior component separation and transversus abdominis release in trauma and emergency general surgery patients: a case report and review of the literature

Como

Gunter

Díaz³

et al. 2019

Trauma Surg Acute Care Open

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Posterior component separation with transversus abdominis release and implantation of synthetic mesh in the retromuscular space is a durable type of repair for many large incisional hernias with recurrence rates consistently less than 10%. The purported advantage of biologic prostheses in contaminated fields has recently been challenged, and the concern for placing synthetic mesh in contaminated fields may be overstated. There are almost no data specifically addressing the use of this type of repair for chronic incisional hernias in trauma and emergency general surgery patients, so research is needed on this patient population. In this review, a case of a trauma patient receiving posterior component separation with transversus abdominis release and implantation of synthetic mesh for a chronic incisional hernia resulting from a gunshot wound to the abdomen is presented, the technique is explained, and relevant literature is reviewed.

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Section: Discussionmentioning

confidence: 99%

“…Bittner and colleagues performed a retrospective review of patients who underwent open TAR or robotic TAR from January 2015 to August 2016 20. Of 102 patients, 76 underwent open TAR and 26 had robotic TAR.…”

Section: Discussionmentioning

confidence: 99%

Use of posterior component separation and transversus abdominis release in trauma and emergency general surgery patients: a case report and review of the literature

Como

Gunter

Díaz³

et al. 2019

Trauma Surg Acute Care Open

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“…Robotic repair resulted in significantly shorter LOS compared to OVHR [39]. [40]. Operative time was significantly longer for rRVHR/rTAR in each of these studies.…”

Section: Recommendaɵons: Rrvhr / Rtar / Etepmentioning

confidence: 72%

Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)): Part B

et al. 2019

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In 2014 the International Endohernia Society (IEHS) published the first international “Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias”. Guidelines reflect the currently best available evidence in diagnostics and therapy and give recommendations to help surgeons to standardize their techniques and to improve their results. However, science is a dynamic field which is continuously developing. Therefore, guidelines require regular updates to keep pace with the evolving literature.MethodsFor the development of the original guidelines all relevant literature published up to year 2012 was analyzed using the ranking of the Oxford Centre for Evidence-Based-Medicine. For the present update all of the previous authors were asked to evaluate the literature published during the recent years from 2012 to 2017 and revise their statements and recommendations given in the initial guidelines accordingly. In two Consensus Conferences (October 2017 Beijing, March 2018 Cologne) the updates were presented, discussed, and confirmed. To avoid redundancy, only new statements or recommendations are included in this paper. Therefore, for full understanding both of the guidelines, the original and the current, must be read. In addition, the new developments in repair of abdominal wall hernias like surgical techniques within the abdominal wall, release operations (transversus muscle release, component separation), Botox application, and robot-assisted repair methods were included.ResultsDue to an increase of the number of patients and further development of surgical techniques, repair of primary and secondary abdominal wall hernias attracts increasing interests of many surgeons. Whereas up to three decades ago hernia-related publications did not exceed 20 per year, currently this number is about 10-fold higher. Recent years are characterized by the advent of new techniques—minimal invasive techniques using robotics and laparoscopy, totally extraperitoneal repairs, novel myofascial release techniques for optimal closure of large defects, and Botox for relaxing the abdominal wall. Furthermore, a concomitant rectus diastasis was recognized as a significant risk factor for recurrence. Despite still insufficient evidence with respect to these new techniques it seemed to us necessary to include them in the update to stimulate surgeons to do research in these fields.ConclusionGuidelines are recommendations based on best available evidence intended to help the surgeon to improve the quality of his daily work. However, science is a continuously evolving process, and as such guidelines should be updated about every 3 years. For a comprehensive reference, however, it is suggested to read both the initially guidelines published in 2014 together with the update. Moreover, the presented update includes also techniques which were not known 3 years before.

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“…Bittner et al ( 36 ) compared 76 open posterior CST with TAR and 26 robot-assisted posterior CST with TAR. Patients were comparable regarding age, gender, body mass index, and the presence of comorbidities.…”

Section: Robotic Posterior Cst With Transversus Abdominis Release (Tamentioning

confidence: 99%

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

et al. 2018

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IntroductionThe 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 MethodsThe 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.ResultsCST 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.ConclusionCST 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.

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Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair

Cited by 121 publications

References 21 publications

Use of posterior component separation and transversus abdominis release in trauma and emergency general surgery patients: a case report and review of the literature

Use of posterior component separation and transversus abdominis release in trauma and emergency general surgery patients: a case report and review of the literature

Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)): Part B

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

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