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Endoscopic transversus abdominis release in the treatment of midline incisional hernias: a prospective single-center observational study on 100 patients

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Abstract

Background

For W2-3 incisional hernias of the midline, a component separation is often needed to achieve closure of the fascia during repair with a mesh. Posterior component separation has been initially performed via open surgical approach, but more recently interest in minimally invasive reconstruction has grown. The aim of this work is to describe the technical aspects of endoscopic hernia repair with posterior component separation and to assess its feasibility in midline incisional hernias, based on the analysis of the results.

Methods

We prospectively evaluated and analyzed patients with midline incisional hernias who underwent endoscopic posterior component separation by transversus abdominis release (TAR).

Results

A group of 100 patients was operated between April 2017 and September 2021. The median follow-up was 27 ± 13.5 months, mean age 59 ± 10.2 years, ASA 2.5 ± 0.7; 94% of patients had comorbidity. There were 7 (7%) complications observed in the early postoperative period—retromuscular hematoma (1), infection of the retromuscular space (4), and thrombophlebitis of superficial veins (2). In 4 (4%) patients, late complications were observed—persistent seroma (3) and chronic pain (1). There were no hernia recurrences in the follow-up period.

Conclusion

The use of TAR endoscopic separation can reduce the number of unfavorable surgical site events, compared to the published data on a similar open surgery, while maintaining a low recurrence rate.

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Authors and Affiliations

  1. Voskresensk City Hospital No 2, 2A Grazhdanskaya Str., Voskresensk, Moscow Region, 140203, Russia

    V. Burdakov & A. Zverev

  2. Department of Experimental and Clinical Surgery of Biomedical Faculty, Chair, Pirogov Russian Research Scientific Medical University, 1 Ostrovityanova Str., Moscow, 117997, Russia

    N. Matveev

Authors
  1. V. Burdakov
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  2. A. Zverev
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  3. N. Matveev
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Corresponding author

Correspondence to V. Burdakov.

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Conflict of interest

Vladislav Burdakov declares no conflicts of interest in the manuscript. Andrew Zverev declares no conflicts of interest in the manuscript. Nikolay Matveev declares no conflicts of interest in the manuscript. There are no conflicts of interest and nothing to disclose.

Ethical approval

The study was approved by ethics committee of Pirogov Russian Research Scientific Medical University.

Human and animal rights

All procedures within the study “Endoscopic Transversus Abdominis Release in The Treatment of Midline Incisional Hernias” involving human participants were approved by the Local Ethics Committee of Voskresensk City Hospital №2 and were in accordance with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Burdakov, V., Zverev, A. & Matveev, N. Endoscopic transversus abdominis release in the treatment of midline incisional hernias: a prospective single-center observational study on 100 patients. Hernia 26, 1381–1387 (2022). https://doi.org/10.1007/s10029-022-02641-7

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  • DOI: https://doi.org/10.1007/s10029-022-02641-7

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