Minimally Invasive Component Separation in the Repair of Large Abdominal Wall Defects

Chapter

Abstract

The minimally invasive component separation technique is a feasible and reproducible procedure that restores the abdominal midline in many large defects, helping to promote physiological abdominal reconstruction. It is of special use when dealing with a contaminated setting as it can lead to abdominal midline closure without applying prosthetic material. If complete midline restoration is not possible, component separation helps reduce the abdominal wall defect, decreasing the amount of prosthetic material necessary for a bridge repair, respecting as much as possible the physiology and kinetics of the abdominal wall. The minimally invasive component separation technique has many advantages over classic open techniques, avoiding large skin flaps and consequent problems related to wound healing. More studies are needed to compare different minimally invasive techniques regarding advancement of myofascial flaps and respective costs. In this chapter, we describe and illustrate in detail the video-assisted component separation technique and discuss special settings for its use, such as in the primary closure of the difficult open abdomen. Finally, it is fundamental to keep in mind that the minimally invasive component separation technique is only one helpful part in the puzzle involving large and complex abdominal wall defects. Proper planning and attention to details are important for successful achievement of closure.

Keywords

Minimally invasive • component separation • massive hernias • loss of domain • video-assisted • planned ventral hernia 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of Surgery: Colo-Rectal and Abdominal Wall SurgeryHospital Pedro Hispano - Rua Dr. Eduardo TorresSenhora da Hora, Sra da HoraPortugal
  2. 2.Department of AnatomyICBAS - University of PortoPortoPortugal
  3. 3.Department of Surgery, Upper Gastrointestinal and Abdominal Wall SurgeryHospital Pedro HispanoSra da HoraPortugal
  4. 4.Department of Medicine - University of PortoPraça de Gomes TeixeiraPortoPortugal

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