Bilateral transversus abdominis release: Complex hernia repair without sacrificing quality of life
Adrienne N Christopher1, Cody Fowler2, Viren Patel2
1Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA; Department of Surgery, Thomas Jefferson University, Philadelphia, PA, USA.
Background:
Transversus Abdominis Release (TAR) during ventral hernia repair (VHR) allows for further lateral dissection by dividing the transversus abdominis muscles (TAM). The implications of division of the TAM on clinical and patient-reported outcomes has not be extensively studied.
Methods:
Adult patients undergoing retrorectus (RR) VHR with biosynthetic mesh with or without bilateral TAR were retrospectively identified. Post-operative and patient-reported outcomes (PROs) were collected.
Results:
Of 50 patients, 24 underwent TAR and 26 had RR repair alone. Median defect sizes were 449 cm2 and 208 cm2, respectively (p < 0.001). Rates of SSO and SSI were similar (p > 0.05). One TAR patient (4.2%) and four RR patients (15.4%) recurred (p = 0.26), with median follow up of 24 and 38 months. PROs improved significantly in both groups (p < 0.05).
Conclusion:
Despite more complex abdominal wall reconstruction on larger defects, TAR has minimal major adverse events, low recurrence rates, and does not negatively affect PROs.
