Abstract
Transversus abdominis release has become a popular technique for complex ventral hernias. It has shown to be an effective technique in large hernias, recurrent hernias, and boundary hernias. However, some hernias are so large and wide that even TAR does not give an approximation of anterior and posterior rectus sheath to reconstruct the midline. In these situations, certain bailout options such as bridging repair are needed. The incidence of bridging repair ranges from 0% to 19% in cases where TAR is performed. However, the bridged TAR has drawbacks. A recent study with 96 patients of TAR with bridged repair for large complex ventral hernias observed a composite recurrence of 46%, 10% SSI, 2% mesh exposure, 5% partial mesh excision, and 16% surgical site occurrences requiring procedural intervention (SSOPI). This is in our opinion is a useful addition to the armamentarium of procedures for large ventral hernias.
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References
Pauli EM, Wang J, Petro CC, Juza RM, Novitsky YW, Rosen MJ. Posterior component separation with transversus abdominis release successfully addresses recurrent ventral hernias following anterior component separation. Hernia. 2015;19:285–91.
Petro CC, Como JJ, Yee S, Prabhu AS, Novitsky YW, Rosen MJ. Posterior component separation and transversus abdominis muscle release for complex incisional hernia repair in patients with a history of an open abdomen. J Trauma Acute Care Surg. 2015;78:422–9.
Sanford DE, Doyle MB, Chapman WC, Blatnik JA. Transversus abdominus muscle release with mesh reinforcement is safe and effective for repairing incisional hernias in liver transplant patients. HPB. 2018;20:S808–9.
Petro CC, Orenstein SB, Criss CN, Sanchez EQ, Rosen MJ, Woodside KJ, et al. Transversus abdominis muscle release for repair of complex incisional hernias in kidney transplant recipients. Am J Surg. 2015;210:334–9.
Moores N, Conway H, Donato D, Gociman B, Pannucci CJ, Agarwal J. Is release of the posterior lamella enough? A cadaveric exploration of posterior component separation techniques. Am J Surg. 2019;218:533–6.
Baig SJ, Afaque MY, Priya P. Combination of transversus abdominis release and peritoneal flap hernioplasty for large midline ventral hernias: a case series. Indian J Surg. 2022; https://doi.org/10.1007/s12262-021-03279-y.
Alkhatib H, Tastaldi L, Krpata DM, Petro CC, Fafaj A, Rosenblatt S, Rosen MJ, Prabhu AS. Outcomes of transversus abdominis release (TAR) with permanent synthetic retromuscular reinforcement for bridged repairs in massive ventral hernias: a retrospective review. Hernia. 2020;24(2):341–52. https://doi.org/10.1007/s10029-019-02046-z.
Malik A, MacDonald ADH, De Beaux AC, Tulloh BR. The peritoneal fap hernioplasty for repair of large ventral and incisional hernias. Hernia. 2014;18:39–45.
Petersson P, Montgomery A, Petersson U. Modifed peritoneal fap hernioplasty versus retromuscular technique for incisional hernia repair: a retrospective cohort study. Scand J Surg. 2020;109:279–88. https://doi.org/10.1177/1457496919863943.
Nielsen MF, de Beaux A, Tulloh B. Peritoneal fap hernioplasty for reconstruction of large ventral hernias: long-term outcome in 251 patients. World J Surg. 2019;43:2157–63. https://doi.org/10.1007/s00268-019-05011-0.
Yeste JP, Riquelme-Gaona J. When transversus abdominis release (TAR) is not enough during the repair of large midline incisional hernias: the double peritoneal flap to the rescue. Updates Surg. 2022; https://doi.org/10.1007/s13304-022-01278-6.
Warren JA, Love M, Cobb WS, Befa LR, Couto FJ, Hancock BH, Morrow D, Ewing JA, Carbonell AM. Factors affecting salvage rate of infected prosthetic mesh. Am J Surg. 2020;220(3):751–6. https://doi.org/10.1016/j.amjsurg.2020.01.028.
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Baig, S.J., Afaque, M.Y. (2022). TAR Plus (TAR plus Peritoneal Flap Hernioplasty) for Large Midline Ventral Hernias. In: Baig, S.J., Bhandarkar, D., Priya, P. (eds) Newer Concepts and Procedures in Hernia Surgery - An Atlas. Springer, Singapore. https://doi.org/10.1007/978-981-19-5248-7_19
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DOI: https://doi.org/10.1007/978-981-19-5248-7_19
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