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Hernia Surgery pp 159-168 | Cite as

Open Anterior Component Separation with Perforator Preservation

  • Gregory A. DumanianEmail author
Chapter

Abstract

Repair of midline incisional hernias is a common procedure for which two related problems need to be solved. First, how can this high-tension internal closure best be achieved without the sutures cheesewiring through the fascia over time? Meshes are commonly used to distribute tension, but the optimal location of the mesh, its size, and the method of fixation are hotly debated. Equally argued is the optimal handling of the soft tissues required to place the mesh. This chapter will describe a means to reliably close a midline abdominal wall defect using a well-fixed narrow retrorectus mesh and a perforator-sparing anterior components release.

Keywords

Components release Perforator preservation Macroporous mesh Force distribution Suture tissue interface 

Supplementary material

Video 16.1

Perforator Preserving Open ACS, by Dumanian (MP4 368,919 kb)

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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Northwestern Feinberg School of MedicineNorthwestern Memorial HospitalChicagoUSA

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