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, John J.; Gunter, Oliver L.; Díaz, José Luis Rodríguez; Ho, Vanessa P.; Miller, Preston R.

doi:10.1136/tsaco-2018-000268

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…John J. Como et al 13 also recommends use of mesh in sublay position (Retromuscular) similar to this study but he uses posterior CST contrary to present study. Micheal J. Rosen 14 in his research work also supported the use of mesh in sublay position with maximum overlap for repair of abdominal hernias.…”

Section: Discussionsupporting

confidence: 52%

Anterior component separation with sublay polypropylene mesh placement: An ideal way to deal with large ventral abdominal hernias.

Rashid

2021

TPMJ

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Objectives: To study the effectiveness of open anterior component separation technique for repair of large incisional abdominal hernias. To study the effect of addition of polypropylene mesh with open anterior CST in sublay position. Study Design: Experimental study. Setting: Department of Surgery, DHQ Hospital Rawalpindi. Period: January 2016 to November 2016. Material & Methods: Patients (n=19) were admitted through OPD electively by purposive non- probability sampling in accordance with the inclusion/exclusion criteria. patients were operated under general anaesthesia. Anterior CST was done by standard Ramirez technique. Polypropylene mesh was placed in sublay (retrorectus) position. Data obtained was analysed by SPSS-20 software to calculate SSI and Recurrence rate. Results: A total of 19 (n=19) patients were included in the study and operated upon.There were 61% males with average age of 42 years and 39% females of average31 years.Average defect size was 10.11 cm with SD of 1.899 cm. Recurrence rate was 5.26%. SSI rate was 10.50%. Patients were followed up for one year for Recurrence of hernia. Conclusion: Anterior component separation is an effective technique for repair of otherwise inoperable large ventral abdominal hernias especially when combined with polypropylene mesh in sublay position. Addition of mesh in sublay position with CST signifantly reduces both recurrence and SSI rate.

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Section: Discussionsupporting

confidence: 52%

Anterior component separation with sublay polypropylene mesh placement: An ideal way to deal with large ventral abdominal hernias.

Rashid

2021

TPMJ

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“…The theory behind TAR is that by dividing this muscle, circumferential tension will be released, providing significant medial advancement of the rectus muscle and its enveloping sheaths, thus allowing re-approximation of the anterior rectus sheath in the midline. TAR affords 8 cm to 12 cm advancement per side in most patients [9]. In a cadaveric model, posterior sheath advancement of over 11 cm was obtained, at the end of the TAR, allowing for restoration of the visceral sac.…”

Section: Discussionmentioning

confidence: 99%

Surgical anatomy of transversus abdominis muscle for transversus abdominis release

Shanthi,

Sam,

Jacob

et al. 2024

Anat Cell Biol

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Transversus abdominis release (TAR) is a myofascial release technique which helps in surgical repair of large ventral abdominal wall defects. In this procedure, the medial margin of muscular part of transversus abdominis (TA) is of great importance. Hence, the authors sought to describe the extent of medial margin of TA muscle. The surgical steps of TAR were performed in 10 formalin-fixed cadavers and distance between medial margin of TA muscle, lateral margin of rectus abdominis, to linea alba at five anatomical levels were documented respectively. The distance between the inferior epigastric vessels and the medial border of TA muscle was also noted. The TA muscle was within the posterior rectus sheath in all cadavers, at the xiphisternum (R, 61.6 mm; L, 58.9 mm), and at midway between xiphisternum and umbilicus (R, 25.4 mm; L, 27.1 mm). The TA muscle exited the posterior rectus sheath between this point and the umbilicus. The mean incongruity at the next three levels were -24.6 mm, -24.9 mm, and -22.9 mm respectively on the right and -21.4 mm, -19.9 mm, and -18.9 mm respectively on the left. The mean distance between the medial border of TA and inferior epigastric vessels was 18.9 mm on the right and 17.2 mm on the left. The muscular part of TA was incorporated within the posterior rectus sheath above the umbilicus, and it completely exited the rectus sheath at the umbilicus. This is contrary to the traditional understanding of posterior rectus sheath formation.

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Abdominal Wall Reconstruction in the Elderly During the Acute Phase: Principles and Techniques

Gogna

Choi

Latifi

2021

Emergency General Surgery in Geriatrics

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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

Cited by 3 publications

References 19 publications

Anterior component separation with sublay polypropylene mesh placement: An ideal way to deal with large ventral abdominal hernias.

Anterior component separation with sublay polypropylene mesh placement: An ideal way to deal with large ventral abdominal hernias.

Surgical anatomy of transversus abdominis muscle for transversus abdominis release

Abdominal Wall Reconstruction in the Elderly During the Acute Phase: Principles and Techniques

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