Rhabdomyolysis: An unusual complication following endoscopic component separation hernia repair

Abstract

Separation of components technique for incisional hernia repair is increasingly utilized as a strategy for hernia repair in both the obese and those with loss of abdominal domain. Endoscopic component separation technique [ECST] is increasingly performed to minimize wound complications associated with the open procedure. We present a case of a patient who developed acute renal failure related to rhabdomyolysis following ECST. A 62-year-old morbidly obese female with BMI of 46 underwent ECST hernia repair for a large midline hernia with loss of domain. Postoperatively, she was found to be oliguric with a dark brown colored urine, elevated serum creatinine and blood urea nitrogen, and increased urine myoglobin levels. She recovered with aggressive hydration and urine alkalinization. We present this unique complication and review the literature.

Conventional versus endoscopic components separation technique: New anthropometric calculation for selection of surgical approach

“…In other studies, we found that the BMI of those who were selected for the conventional method was higher than in those selected for the endoscopic method, although there was no statistically significant difference, as in our study. In the literature review, the highest BMI among patients who underwent endoscopic CST for GVIH was 46 kg/m², as reported by Todd et al [29]. As a result, we think that obesity is not a relative contraindication in terms of endoscopic or conventional CST.…”