Abstract

Abstract Aim The application of component separation techniques for the repair of large and other complex ventral hernias, has been a landmark in their successful management. The aim of this study is to present our experience with the posterior component separation with transversus abdominis release (TAR) in patients with these very demanding ventral hernias. Material & Methods A retrospective analysis of prospectively collected data of all patients who underwent elective ventral hernia repair with TAR technique between January 2016 and May 2021 was performed. Selection of the type of inserted mesh was based on the risk of developing surgical site infection (SSI) and other surgical site occurrences (SSOs). Preoperative, intraoperative, and postoperative data were analyzed. Results A total of 167 patients with large and other complex ventral hernias were included in the final analysis. More than 80% of patients had one or more comorbidities. Of all patients, 156 (93.4%) had a history of previous abdominal surgery, 42 (25.1%) had a history of SSI and 11 (6.6%) had active fistulas, of which nine involved previous implanted meshes. Postoperatively, SSOs were presented in 12 patients (7.2%), including three cases of SSI. Neither mesh infection occurred, nor mesh excision required. With a mean follow-up of 3 years, only one recurrence has been observed. Conclusions With a wound complication rate of less than 8% and a recurrence rate of less than 1%, our results show that TAR is a reliable, safe and effective technique for the repair of large and other complex ventral hernias.

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