Abdominoplasty Combined with the Anterior Component Separation Technique for Reconstruction of Midline Large Ventral Hernias: Functional and Aesthetic Outcome Clinical Study

Abstract

Abstract Background Large midline ventral hernias, diastasis of recti and the associated laxity and abdominal shape deformity, represent aesthetic and functional problems for the patients. So, the surgical treatment of both pathologies at the same time is highly recommended if the patient’s general condition permits. This can be achieved by a comprehensive technique incorporating abdominoplasty performed by a transverse lower abdominal incision into any of the hernia repair techniques. Objective The aim of this study is to evaluate the functional and aesthetic outcome of the combined abdominoplasty and anterior component separation technique in the management of midline ventral abdominal hernias. Patients and Methods This study is a prospective case control study that evaluates both functional and aesthetic outcome of performing abdominoplasty on patients with large midline ventral hernias. This study was conducted between December 2020 to March 2022 at the Plastic Surgery Department, Demerdash University Hospital, Cairo, Egypt. Study consisted of fifteen patients with different presentations of abdominal wall laxity and ventral hernias. Patients were evaluated regarding their age, BMI, degree of rectus diastasis, Pre-operative radiological findings, post Operative complication and hernia reoccurrence, patients’ satisfaction, and the pre-operative and post-operative umbilical measurements were compared. Results and Conclusion The current study showed that Abdomioplasty can be combined with complex hernia repair by anterior component separation technique within the same setting in high-risk patients safely with an excellent functional outcome and acceptable satisfactory aesthetic results. Although, this can be associated with an increased risk of postoperative surgical site complications such as; skin necrosis and wound infection. Patient characteristics associated with the development of complications following anterior component separation combined with abdominoplasty include obesity, previous abdominal procedures and previous pregnancies.