Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
Hernia
Published in: Hernia 1/2013

01-02-2013 | Original Article

Closure of midline contaminated and recurrent incisional hernias with components separation technique reinforced with plication of the rectus muscles

Authors: A. Espinosa-de-los-Monteros, I. Domínguez, D. Zamora-Valdés, T. Castillo, O. F. Fernández-Díaz, H. A. Luna-Torres

Published in: Hernia | Issue 1/2013

Login to get access

Abstract

Purpose

Midline incisional hernia reconstruction by defect closure and reinforcement with either prosthetic or biologic materials has shown to significantly decrease recurrence rates even for complex cases. The purpose of this study is to evaluate outcomes regarding large incisional hernia reconstruction with components separation technique using rectus muscle plication as a reinforcement method.

Methods

Thirteen patients having large midline incisional hernias and either history of abdominal wall contamination or recurrence in the presence of mesh were treated between January 2007 and December 2011 with closure using components separation technique reinforced by rectus muscle plication.

Results

Average hernia square was 222 cm2, and mean follow-up was 24 months. Complications occurred in 6 patients with a mean time to resolution of 59 days. One recurrence was present.

Conclusions

When use of mesh or biologic materials is not desired, rectus muscle plication is a feasible tool as a reinforcement method after large hernia closure with components separation.
Literature
1.
Breuing K, Butler CE, Ferzoco S et al (2010) Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery 148:544–558PubMedCrossRef
2.
Espinosa-de-los-Monteros A, de-la-Torre JI, Ahumada LA et al (2006) Reconstruction of the abdominal wall for incisional hernia repair. Am J Surg 191:173–177PubMedCrossRef
3.
Acevedo FA, Lombardi SJ, León SJ et al (2009) Eventraciones: reconstitución plástica de la línea alba mediante doble sutura invaginante isotensional (DSII). Rev Chilena Cirugia 61:339–344
4.
Luijendijk RW, Hop WC, van den Tol MP et al (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398PubMedCrossRef
5.
Burger JW, Luijendijk RW, Hop WC et al (2004) Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg 240:578–583PubMed
6.
Ramirez OM, Ruas E, Dellon AL (1990) “Components separation” method for closure of abdominal-wall defects: an anatomical and clinical study. Plast Reconstr Surg 86:519–526PubMedCrossRef
7.
Shestak KC, Edington HJ, Johnson RR (2000) The separation of anatomic components technique for the reconstruction of massive midline abdominal wall defects: anatomy, surgical technique, applications and limitations revisited. Plast Reconstr Surg 105:731–738PubMedCrossRef
8.
Lowe JB III, Lowe JB, Baty JD et al (2003) Risks associated with “components separation” for closure of complex abdominal wall defects. Plast Reconstr Surg 111:1276–1283PubMedCrossRef
9.
De Vries Reilingh TS, van Goor H, Rosman C et al (2003) “Components separation technique” for the repair of large abdominal wall hernias. J Am Coll Surg 196:32–37PubMedCrossRef
10.
Girotto JA, Chiaramonte M, Menon NG et al (2003) Recalcitrant abdominal wall hernias: long-term superiority of autologous tissue repair. Plast Reconstr Surg 112:106–114PubMedCrossRef
11.
Nguyen V, Shestak KC (2006) Separation of anatomic components method of abdominal wall reconstruction: clinical outcome analysis and an update of surgical modifications using the technique. Clin Plast Surg 33:247–257PubMedCrossRef
12.
Abulezz T (2008) Repair of recurrent midline abdominal wall dehiscence using the components separation technique. J Plast Aesthet Reconstr Surg 61:997–999CrossRef
13.
Shabatian H, Lee DJ, Abbas MA (2008) Components separation: a solution to complex abdominal wall defects. Am Surg 74:912–916PubMed
14.
Wind J, van Koperen PJ, Slors JF et al (2009) Single-stage closure of enterocutaneous fistula and stomas in the presence of large abdominal wall defects using the components separation technique. Am J Surg 197:24–29PubMedCrossRef
15.
Ko JH, Wang EC, Salvay DM et al (2009) Abdominal wall reconstruction: lessons learned from 200 “components separation” procedures. Arch Surg 144:1047–1055PubMedCrossRef
16.
DiCocco JM, Magnotti LJ, Emmett KP et al (2010) Long-term follow-up of abdominal wall reconstruction after planned ventral hernia: a 15-year experience. J Am Coll Surg 210:686–695PubMedCrossRef
17.
Mazzochi M, Dessy LA, Ranno R et al (2011) “Component separation” technique and panniculectomy for repair of incisional hernia. Am J Surg 201:776–783CrossRef
18.
Moore M, Bax T, MacFarlane M et al (2008) Outcomes of the fascial component separation technique with synthetic mesh reinforcement for repair of complex ventral incisional hernias in the morbidly obese. Am J Surg 195:575–579PubMedCrossRef
19.
Davison SP, Parikh PM, Jacobson JM et al (2009) A “buttressed mesh” technique for fascial closure in complex abdominal wall reconstruction. Ann Plast Surg 62:284–289PubMedCrossRef
20.
Carbonell-Tatay F, Bonafé-Diana S, García-Pastor P et al (2009) New surgical technique in complex incisional hernias: component separation technique (CST) with prosthesis and new muscle insertions. Cir Esp 86:87–93PubMedCrossRef
21.
Cox TC, Pearl JP, Ritter EM (2010) Rives-Stoppa incisional hernia repair combined with laparoscopic separation of abdominal wall components: a novel approach to complex abdominal wall closure. Hernia 14:561–567PubMedCrossRef
22.
Borud LJ, Grunwaldt L, Janz B et al (2007) Components separation combined with abdominal wall plication for repair of large abdominal wall hernias following bariatric surgery. Plast Reconstr Surg 119:1792–1798PubMedCrossRef
23.
Yousif NJ, Lifchez SD, Nguyen HH (2004) Transverse rectus sheath plication in abdominoplasty. Plast Reconstr Surg 114:778–784PubMedCrossRef
24.
Sozer SO, Agullo FJ (2006) Triple plication in miniabdominoplasty. Aesthetic Plast Surg 30:263–268PubMedCrossRef
25.
Toranto IR (1990) The relief of low back pain with the WARP abdominoplasty: a preliminary report. Plast Reconstr Surg 85:545–555PubMedCrossRef
26.
Oneal RM, Mulka JP, Shapiro P et al (2011) Wide abdominal rectus plication abdominoplasty dor the treatment of chronic intractable low back pain. Plast Reconstr Surg 127:225–231PubMedCrossRef
27.
Tadiparthi S, Shokrollahi K, Doyle GS et al (2012) Rectus sheath plication in abdominoplasty: assessment of its longevity and a review of the literature. J Plast Reconstr Aesthet Surg 65:328–332PubMedCrossRef
28.
Hawn MT, Gray SH, Snyder CW et al (2011) Predictors of mesh explantation after incisional hernia repair. Am J Surg 202:28–33PubMedCrossRef
29.
Bröker M, Verdaasdonk E, Kasrten T (2011) Components separation technique combined with a double-mesh repair for large midline incisional hernia repair. World J Surg 35:2399–2402PubMedCrossRef
30.
Yegiyants S, Tam M, Lee DJ et al. (2011) Outcome of components separation for contaminated complex abdominal wall defects. Hernia 2012; 16:41–45
31.
White TJ, Santos MC, Thompson JS (1998) Factors affecting wound complications in repair of ventral hernias. Am Surg 64:276–280PubMed
32.
Moreno-Egea A, Carrillo-Alcaraz A, Aguayo-Albasini JL (2012) Is the outcome of laparoscopic incisional hernia repair affected by defect size?: a prospective study. Am J Surg 203:87–94PubMedCrossRef
33.
Raftopoulos I, Courcoulas AP (2007) Outcome of laparoscopic ventral hernia repair in morbidly obese patients with a body mass index exceeding 35 kg/m2. Surg Endosc 21:2293–2297PubMedCrossRef
Metadata
Title
Closure of midline contaminated and recurrent incisional hernias with components separation technique reinforced with plication of the rectus muscles
Authors
A. Espinosa-de-los-Monteros
I. Domínguez
D. Zamora-Valdés
T. Castillo
O. F. Fernández-Díaz
H. A. Luna-Torres
Publication date
01-02-2013
Publisher
Springer-Verlag
Published in
Hernia / Issue 1/2013
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI
https://doi.org/10.1007/s10029-012-1012-4

Other articles of this Issue 1/2013

Hernia 1/2013 Go to the issue

Editorial

Hernia surgery and contamination: biological mesh and nothing else?

Original Article

Components separation technique utilizing an intraperitoneal biologic and an onlay lightweight polypropylene mesh: “a sandwich technique”

Original Article

Open inguinal hernia repair with the use of polyglycolic acid/trimethylene carbonate absorbable mesh: a critical update of the long-term results

Review

Internal hernias through the falciform ligament: a case series and comprehensive literature review of an increasingly common pathology

Comment

Venous aneurysms of saphena magna: is this really a rare disease?

Review

Abdominal wall bulging after thoracic surgery, an underdiagnosed wound complication