Advertisement

Surgical Advances in the Treatment of Abdominal Wall Hernias

  • Fernando Carbonell-Tatay
  • Ángel Zorraquino González

Abstract

In the last two decades, the surgery of the abdominal wall has experienced an important development from being considered a matter of little interest for general surgeon, to having a greater presence at scientific meetings and to being increasingly prominent in the specialist training in surgery. In 1990 the plastic surgeon Oscar Ramírez published a method to repair defects in the abdominal wall that called “Component Separation Technique” thereafter general surgeons fixed his attention on the techniques of autoplastic repair of the abdominal wall that had already developed throughout the twentieth century. This interest grows with the emergence of new prosthesis and the use of laparoscopic surgery to repair eventrations since Le Blanc and Booth published in 1993. The development of techniques and materials encourages surgeons to repair large defects in the abdominal wall, using preoperative procedures to avoid complications arising from the return of viscera to a reduced abdominal cavity; it recovers the use of preoperative progressive pneumoperitoneum and the muscular expanders; it applies the use of botulinum toxin in transverse abdominal muscles. Surgery of the large eventrations, however, is not free of complications such as skin necrosis which is treated by negative pressure therapy; it is necessary to control the intra-abdominal pressure (IAP) and the development of techniques for the treatment of the open abdomen with subsequent progressive or delayed closure of the abdominal cavity. The complexity of surgical techniques and the knowledge of pre- and postoperative procedures to prevent and treat complications, in addition to the wide variety of prosthetic materials used, they justify the creation of abdominal wall surgery units in large hospitals, thus contributing to become an exciting topic for new generations.

Keywords

Abdominal wall reconstruction Separation of components Preoperative progressive pneumoperitoneum Botulinum toxin Intra-abdominal pressure Vacuum-assisted therapy Biomaterial Biofilm 

References

  1. 1.
    Ibarra HT, Nuño GC, Echeagaray HJ, Robles VE, González JJJ. Use of botulinum toxin type a before abdominal wall hernia reconstruction. World J Surg. 2009;33:2553–6.CrossRefGoogle Scholar
  2. 2.
    Byrd HS, Hobar PC. Abdominal wall expansion in congenital defects. Plast Reconstr Surg. 1989;84(2):347–52.CrossRefPubMedGoogle Scholar
  3. 3.
    Albanese AR. Eventración media xifo-umbilical gigante: método para su tratamiento. Rev Asoc Med Argent. 1951;65:376.PubMedGoogle Scholar
  4. 4.
    Ramírez OM. Inception and evolution of the component separation technique: Personal recollections. Clin Plast Surg. 2006;33:241–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Carbonell Tatay F, Bonafé Diana S, García Pastor P, Gómez Gavara C, Baquero VR. Nuevo método de operar en la eventración compleja: Separación Anatómica de Componentes con Prótesis y Nuevas Inserciones Musculares. Cir Esp. 2010;86(2):87–93.CrossRefGoogle Scholar
  6. 6.
    Carbonell AM, Cobb WS, Chen SM. Posterior components separation during retromuscular hernia repair. Hernia. 2008;12(4):359–62.CrossRefPubMedGoogle Scholar
  7. 7.
    Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012;204:709–16.CrossRefPubMedGoogle Scholar
  8. 8.
    De Beaux AC, Tulloh B. Laparoscopic ventral hernia repair. Br J Surg. 2012;99:1319–21.CrossRefPubMedGoogle Scholar
  9. 9.
    Bellón JM, Rodríguez M, García Honduvilla N, Pascual G, Buján J. Partially absorbable meshes for hernia repair offer advantages over nonabsorbable meshes. Am J Surg. 2007;194:68–74.CrossRefPubMedGoogle Scholar
  10. 10.
    Petter-Puchner AH, Dietz UA. Biological implants in abdominal wall repair. Br J Surg. 2013;100:987–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Del Pozo JL, Alonso M, Arciola CR, González R, Leiva J, Lasa I, et al. Biotechnological war against biofilms. could phages mean the end of device-related infections? Int J Artif Organs. 2007;30(9):805–12.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Fernando Carbonell-Tatay
    • 1
  • Ángel Zorraquino González
    • 2
  1. 1.Department of Abdominal Wall Surgery, Faculty of Medicine at the University of ValenciaLa Fe University HospitalValenciaSpain
  2. 2.Department of General Surgery, Abdominal Wall Surgery Unit, Faculty of Medicine at the Basque Country UniversityBasurto University HospitalBilbaoBasque Country, Spain

Personalised recommendations