Component Separation of Abdominal Wall Muscles

  • Flavio Malcher
  • Leandro Totti Cavazzola


There are several techniques of separation components for closing the midline aponeurotic muscle or a hernia defect. They always aim at reconstituting the physiology of the abdominal wall for its best function in the day-to-day activities of the patient. In this chapter, the anterior and posterior open techniques of separation of the muscular planes of the anterolateral wall of the abdomen are described, with brief technical explanations and considerations about their application.


  1. 1.
    Ramirez OM. Inception and evolution of the components separation technique: personal recollections. Clin Plast Surg. 2006;33(2):241–6.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Halvorson EG. On the origins of components separation. Plast Reconstr Surg. 2009;124(5):1545–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Pauli EM, Rosen MJ. Open ventral hernia repair with component separation. Surg Clin North Am. 2013;93(5):1111–33.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Daes J, Dennis RJ. Endoscopic subcutaneous component separation as an adjunct to abdominal wall reconstruction. Surg Endosc. 2017;31(2):872–6.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Grevious MA, Cohen M, Shah SR, Rodriguez P. Structural and functional anatomy of the abdominal wall. Clin Plast Surg. 2006;33(2):169–79.CrossRefGoogle Scholar
  6. 6.
    Harth KC, Rose J, Delaney CP, Blatnik JA, Halaweish I, Rosen MJ. Open versus endoscopic component separation: a cost comparison. Surg Endosc. 2011;25(9):2865–70.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Rosen MJ, Fatima J, Sarr MG. Repair of abdominal wall hernias with restoration of abdominal wall function. J Gastrointest Surg. 2010;14(1):175–85.CrossRefPubMedGoogle Scholar
  8. 8.
    Carbonell AM, Cobb WS, Chen SM. Posterior components separation during retromuscular hernia repair. Hernia. 2008;12(4):359–62.CrossRefPubMedGoogle Scholar
  9. 9.
    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(5):709–16.CrossRefPubMedGoogle Scholar
  10. 10.
    Gibreel W, Sarr MG, Rosen M, Novitsky Y. Technical considerations in performing posterior component separation with transverse abdominis muscle release. Hernia. 2016;20(3):449–59.CrossRefPubMedGoogle Scholar
  11. 11.
    Blatnik JA, Krpata DM, Novitsky YW. Transversus Abdominis release as an alternative component separation technique for ventral hernia repair. JAMA Surg. 2016;151(4):383–4.CrossRefPubMedGoogle Scholar
  12. 12.
    Jones CM, Winder JS, Potochny JD, Pauli EM. Posterior component separation with transversus abdominis release: technique, utility, and outcomes in complex abdominal wall reconstruction. Plast Reconstr Surg. 2016;137(2):636–46.CrossRefPubMedGoogle Scholar
  13. 13.
    Lisiecki J, Kozlow JH, Agarwal S, Ranganathan K, Terjimanian MN, Rinkinen J, Brownley RC, Enchakalody B, Wang SC, Levi B. Abdominal wall dynamics after component separation hernia repair. J Surg Res. 2015;193(1):497–503.CrossRefPubMedGoogle Scholar
  14. 14.
    Novitsky YW, Fayezizadeh M, Majumder A, Neupane R, Elliott HL, Orenstein SB. Outcomes of posterior component separation with transversus abdominis muscle release and synthetic mesh sublay reinforcement. Ann Surg. 2016;264(2):226–32.CrossRefPubMedGoogle Scholar
  15. 15.
    Parent B, Horn D, Jacobson L, Petersen RP, Hinojosa M, Yates R, Wright AS, Louie O. Wound morbidity in minimally invasive anterior component separation compared to transversus abdominis release. Plast Reconstr Surg. 2017;139(2):472–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Celebration Center for SurgeryCelebrationUSA
  2. 2.Universidade Federal do Rio Grande do Sul and Hospital de Clínicas de Porto AlegrePorto AlegreBrazil

Personalised recommendations