Endoscopic subcutaneous component separation as an adjunct to abdominal wall reconstruction

Area of Science:

• Abdominal Wall Reconstruction
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Achieving proper defect closure in abdominal wall reconstruction (AWR) is crucial for optimal cosmetic and functional outcomes.
• Minimizing morbidity is a key goal in AWR procedures.
• Endoscopic subcutaneous anterior component separation (ACS) is a technique adjunct to laparoscopic AWR.

Purpose of the Study:

• To present long-term clinical and imaging follow-up results of endoscopic subcutaneous ACS.
• To evaluate the safety, efficacy, and reliability of this technique in AWR.

Main Methods:

• Prospective data collection over 3 years (2012-2015) on patients undergoing AWR with endoscopic ACS.
• Inclusion criteria focused on specific defect sizes and patient conditions.
• Clinical follow-up at 3, 6, 12 months, then annually; CT scanning at 3 months, 1 year, then annually.

Main Results:

• Twenty patients underwent endoscopic ACS as an adjunct to AWR (17 laparoscopic, 2 open, 1 hybrid).
• Up to 38 months follow-up (mean 21 months) showed no ventral hernia recurrences or de novo hernias at the ACS site.
• Excellent cosmetic results and patient satisfaction were reported, with low morbidity (hematoma, seroma, transient neuralgia).

Conclusions:

• Endoscopic subcutaneous ACS is a safe and effective technique for selected patients undergoing AWR.
• The technique reliably facilitates primary defect closure, improving outcomes.
• This method is reproducible and contributes to successful abdominal wall reconstruction.