Loss of Abdominal Domain

  • Victor B. Tsirline
  • Igor Belyansky
  • David A. Klima
  • B. Todd Heniford


Over two million laparotomies are performed every year in the United States. 5–20% of these cases lead to incisional hernia formation, some leading to large abdominal wall defects with loss of domain. Approximately 160,000 ventral hernia repairs are performed annually, with a recurrence rate of 5–20% in uncomplicated hernias and low-risk individuals. The success of the hernia operations diminishes with larger hernia defects, obesity, and multiple reoperations. In patients with complex abdominal hernias and loss of domain, recurrence rates of up to 67% have been reported. Such cases require particular expertise in evaluation, counseling, and multimodality treatment in order to achieve long-term success. This chapter will address some of the theoretical principles and practical considerations in the management of patients with loss of abdominal domain.


Loss of domain Abdominal hernia Ventral hernia Incisional hernia Large hernia 


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Victor B. Tsirline
    • 1
  • Igor Belyansky
    • 2
  • David A. Klima
    • 3
  • B. Todd Heniford
    • 4
  1. 1.Department of SurgeryNorthwestern Lake Forest HospitalLake ForestUSA
  2. 2.Department of General Surgery, General Surgery FacultyAnne Arundel Medical CenterAnnapolisUSA
  3. 3.Department of General SurgeryCarolinas Medical CenterCharlotteUSA
  4. 4.Department of SurgeryUniversity of North Carolina at Chapel HillCharlotteUSA

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