[New surgical technique in complex incisional hernias: Component Separation Technique (CST) with prosthesis and new muscle insertions]
Fernando Carbonell Tatay1, Santiago Bonafé Diana, Providencia García Pastor
1Unidad de Cirugía General, Sección de Cirugía de Pared Abdominal, Hospital Universitario La Fe, Valencia, España. fercarb@terra.es
Introduction:
Our goal is to show the surgical community a new technique developed by our team for treating complex and catastrophic ventral hernias: Separation of Anatomical Component (SAC) amended by Carbonell-Bonafé.
Materials And Methods:
A total of 100 patients with complex incisional hernias have been treated. The size, content and reducibility of ventral hernia (preoperative CT scan), recurrences and pre-closure techniques, height and weight, trophic skin alterations and need for preoperative pneumoperitoneum were all documented. The operation was performed following a standardised protocol; intra-abdominal pressure (IAP) was measured before, during and after the intervention. Patients were evaluated in the clinic at 15 and 30 days, monthly for 3 months, at sixth months and annually for up to 5 years.
Results:
A total of 100 consecutive patients were operated on between January 2003 and May 2008. In the immediate post-surgical period there were 12% seromas, 8% of partial-ischaemia on the edges of the wound and 1 death due to multi-organ failure. In the later period, 6% had transitional pain in bone anchorage points. They resumed their normal activities after an average of 2 months, with great improvement in their quality of life. There have been no recurrences to date.
Conclusions:
The SAC technique, as modified by our Unit, is an excellent resource in managing large ventral hernias: successfully closing with low morbidity, as well as reconstructing the biomechanics of the abdominal wall.
