Endoscopically assisted “components separation technique” for the repair of complicated ventral hernias

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Abstract
Repair of large incisional hernias and abdominal wall defects by primary closure is often impossible or leads to reherniation rates of up to 46%. 1 George C.D. Ellis H. The results of incisional hernia a twelve-year review. Ann R Coll Surg Engl. 1986; 68 : 185 PubMed Google Scholar The use of prosthetic material reduces the risk of reherniation but carries the risk of infection and other complications such as erosion of the skin or viscera. 2 Luijendijk R.W. Hop W.C. van den Tol M.P. et al. Comparison of suture closure and mesh repair for incisional hernia. N Engl J Med. 2000; 343 : 392-398 Crossref PubMed Scopus (1231) Google Scholar , 3 Bleichrodt R.P. Simmermacher R.K.J. VanderLei B. et al. Expanded polytetrafluoroethylene patch versus polypropylene mesh for the repair of contaminated defects of the abdominal wall. Surg Gynecol Obstet. 1993; 76 : 18-24 Google Scholar , 4 Simmermacher R.K.J. Bleichrodt R.P. Schakenraad J.M. Biomaterials for abdominal wall reconstruction. A review. Cells Mater. 1992; 2 : 281-290 Google Scholar , 5 Voyles C.R. Richardson J.D. Bland K.I. et al. Emergency abdominal wall reconstruction with polypropylene mesh. Short term benefits versus long term complications. Ann Surg. 1981; 194 : 219-223 Crossref PubMed Scopus (276) Google Scholar In addition, the use of prosthetic material in a contaminated environment is contraindicated, because the risk of infection and the recurrence rate are unacceptably high. 3 Bleichrodt R.P. Simmermacher R.K.J. VanderLei B. et al. Expanded polytetrafluoroethylene patch versus polypropylene mesh for the repair of contaminated defects of the abdominal wall. Surg Gynecol Obstet. 1993; 76 : 18-24 Google Scholar