ArticleHernia : the journal of hernias and abdominal wall surgery2020
Combining anterior and posterior component separation for extreme cases of abdominal wall reconstruction.
Article in Hernia : the journal of hernias and abdominal wall surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Changes in the abdominal wall after anterior, posterior, and combined component separation.Hernia : the journal of hernias and abdominal wall surgery · 2022Pooled it
- Use of PERitoneal free flap (PERFF) augmentation in complex ventral hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Ex Vivo Preservation of Porcine Vascularized Composite Soft Tissue Allografts.Artificial organs · 2025Article
- Case Report: Combined posterior and anterior compartment separation in giant incisional hernia repair: balancing feasibility and postoperative complications.Frontiers in surgery · 2025Article
- How I Do It: Madrid posterior component separation in 10 steps, with special consideration of its anatomy.Langenbeck's archives of surgery · 2024Review
- Application of bridging mesh repair in giant ventral incisional hernia.Updates in surgery · 2024Article
- Hernia Correction After Liver Transplantation Using Nonvascularized Fascia.Transplantation direct · 2024Article
- Technical reason why TAR does not decrease tension in the anterior fascial layer, and this may be a blessing in disguise.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Intra-abdominal hypertension and compartment syndrome after complex hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024Review
- Long-term outcomes of Madrid approach after TAR for complex abdominal wall hernias: a single-center cohort study.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Component separation repair of incisional hernia: evolution of practice and review of long-term outcomes in a single center.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Surgical Anatomy of Transversus Abdominis Muscle for Transversus Abdominis Release: A CT-Based Study in Three Patient Groups.World journal of surgery · 2023Article
- Modified Chevrel technique for abdominal closure in critically ill patients with abdominal hypertension and limited options for closure.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- Morphological alterations of the abdominal wall after open incisional hernia repair with endoscopic anterior and open posterior component separation.Hernia : the journal of hernias and abdominal wall surgery · 2023Article
- When transversus abdominis release (TAR) is not enough during the repair of large midline incisional hernias: the double peritoneal flap to the rescue.Updates in surgery · 2022Article
Corrections and comments
- Erratum issued
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe closure of midline in abdominal wall incisional hernias is an essential principle. In some exceptional circumstances, despite adequate component separation techniques, this midline closure cannot be achieved. This study aims to review the results of using both anterior and component separation in these exceptional cases.
methodsWe reviewed our experience using the combination of both anterior and posterior component separation in the attempt to close the midline. Our first step was to perform a TAR and a complete extensive dissection of the retromuscular preperitoneal plane developed laterally as far as the posterior axillary line. When the closure of midline was not possible, an external oblique release was made. A retromuscular preperitoneal reinforcement was made with the combination of an absorbable mesh and a 50 × 50 polypropylene mesh.
resultsTwelve patients underwent anterior and posterior component separation. The mean hernia width was 23.5 ± 5. The majority were classified as severe complex incisional hernia and had previous attempts of repair. After a mean follow-up of 27 months (range 8-45), no case of recurrence was registered. Only one patient (8.33%) presented with an asymptomatic bulging in the follow-up. European Hernia Society's quality of life scores showed a significant improvement at 2 years postoperatively in the three domains: pain (p = 0.01), restrictions (p = 0.04) and cosmetic (p = 0.01).
conclusionsThe combination of posterior and anterior component separation can effectively treat massive and challenging cases of abdominal wall reconstruction in which the primary midline closure is impossible to achieve despite appropriate optimization of surgery.
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