Components separation technique and laparoscopic approach

A review of two evolving strategies for ventral hernia repair

Rodrigo Gonzalez, Robert D. Rehnke, Archana Ramaswamy, C. Daniel Smith, John M. Clarke, Bruce Ramshaw

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

When faced with large ventral hernias, surgeons frequently must choose between higher incidence of recurrence after primary repair and higher incidence of wound complications after repair with mesh. The aim of this study is to compare early outcomes between laparoscopic repair (LR) and components separation technique (CST), two evolving strategies for the management of large ventral hernias. We reviewed 42 consecutive patients who underwent CST and 45 consecutive patients who underwent LR of ventral hernia defects of at least 12 cm2. Demographics, hernia characteristics, and short-term outcomes were compared between groups. Patients in the LR group were younger (53 ± 2 vs 68 ± 2 years, P < 0.0001), had greater body mass index (34 ± 2 vs 29 ± 1 kg/m2, P = 0.02), and had larger hernia defects (318 ± 49 vs 101 ± 16 cm2, P < 0.0001) than patients in the CST group. The LR resulted in shorter length of hospital stay (4.9 ± 0.9 vs 9.6 ± 1.8 days, P < 0.0001), lower incidence of ileus (7% vs 48%, P < 0.0001), and lower incidence of wound complications (2% vs 33%, P < 0.001) than the CST. Both techniques resulted in similar operative times, transfusion requirements, and mortality. Recurrences occurred in 7 per cent of patients at mean follow-up of 16 months in the CST group and O per cent at mean follow-up of 9 months after LR. The LR may have a short-term advantage over the CST in terms of incidence of ileus, wound complications, and hospital stay. Because of their unique advantage over traditional hernia repairs, both techniques may play a significant role in the future treatment of large ventral hernias. Adequate training will be essential for the safe and effective implementation of these techniques within the surgical community.

Original languageEnglish (US)
Pages (from-to)598-605
Number of pages8
JournalAmerican Surgeon
Volume71
Issue number7
StatePublished - Dec 1 2005
Externally publishedYes

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Ventral Hernia
Herniorrhaphy
Incidence
Length of Stay
Ileus
Hernia
Wounds and Injuries
Recurrence
Operative Time
Body Mass Index
Demography
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Components separation technique and laparoscopic approach : A review of two evolving strategies for ventral hernia repair. / Gonzalez, Rodrigo; Rehnke, Robert D.; Ramaswamy, Archana; Smith, C. Daniel; Clarke, John M.; Ramshaw, Bruce.

In: American Surgeon, Vol. 71, No. 7, 01.12.2005, p. 598-605.

Research output: Contribution to journalArticle

Gonzalez, R, Rehnke, RD, Ramaswamy, A, Smith, CD, Clarke, JM & Ramshaw, B 2005, 'Components separation technique and laparoscopic approach: A review of two evolving strategies for ventral hernia repair', American Surgeon, vol. 71, no. 7, pp. 598-605.
Gonzalez, Rodrigo ; Rehnke, Robert D. ; Ramaswamy, Archana ; Smith, C. Daniel ; Clarke, John M. ; Ramshaw, Bruce. / Components separation technique and laparoscopic approach : A review of two evolving strategies for ventral hernia repair. In: American Surgeon. 2005 ; Vol. 71, No. 7. pp. 598-605.
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