TRANSVERSUS ABDOMINIS RELEASE: A CASE REPORT
Journal
Medicus
Date Issued
2020-08
Author(s)
Aleksandar Mitevski
Ilija Milev
Nikola Trokovski
Petar Markov
Abstract
Introduction: Patients with large abdominal wall defects experience significant deformity, pain and decreased
energy due to a loss of normal abdominal wall mechanics, severely impacting their quality of life.Reconstructive
techniques for complex ventral hernia repair are numerous but most of them are unable to achieve the goals of
hernioplasty. Posterior component separation with transverses abdominis muscle release (TAR) is a novel approach
that offers a solution for complex ventral hernias.
Case: A 59 year old patient was admitted to our hospital for treatment of clinically and radiologically verified
incisional hernia with 20% loss of domain characteristics, acquired after cesarean section and hysterectomy.
Discussion/Conclusion: Typical reconstructive techniques may struggle to reestablish abdominal domain and to
create a lasting repair. Posterior component separation with transversus abdominis release is a novel technique
that offers a durable solution to a variety of complex ventral hernias.The lack of sufficient tissue requires the
insertion of prosthetic material or transposition of autologous material to bridge the fascial gap.Retromuscular
or sublay hernia repair with mesh has proven to be a durable technique for ventral hernia defects, and completely
avoids subcutaneous flap elevation.
TAR allows for significant posterior rectus fascia advancement, wide lateral dissection, preservation of the
neurovascular supply, avoids subcutaneous tissue undermining and provides a large space for mesh sublay which
allowsfor bilaminarin growth of the mesh.
energy due to a loss of normal abdominal wall mechanics, severely impacting their quality of life.Reconstructive
techniques for complex ventral hernia repair are numerous but most of them are unable to achieve the goals of
hernioplasty. Posterior component separation with transverses abdominis muscle release (TAR) is a novel approach
that offers a solution for complex ventral hernias.
Case: A 59 year old patient was admitted to our hospital for treatment of clinically and radiologically verified
incisional hernia with 20% loss of domain characteristics, acquired after cesarean section and hysterectomy.
Discussion/Conclusion: Typical reconstructive techniques may struggle to reestablish abdominal domain and to
create a lasting repair. Posterior component separation with transversus abdominis release is a novel technique
that offers a durable solution to a variety of complex ventral hernias.The lack of sufficient tissue requires the
insertion of prosthetic material or transposition of autologous material to bridge the fascial gap.Retromuscular
or sublay hernia repair with mesh has proven to be a durable technique for ventral hernia defects, and completely
avoids subcutaneous flap elevation.
TAR allows for significant posterior rectus fascia advancement, wide lateral dissection, preservation of the
neurovascular supply, avoids subcutaneous tissue undermining and provides a large space for mesh sublay which
allowsfor bilaminarin growth of the mesh.
File(s)![Thumbnail Image]()
Loading...
Name
medicus-gusht-2020 select.pdf
Size
215.99 KB
Format
Adobe PDF
Checksum
(MD5):262e637fea3f0512e0b782d0c33e9a34