P-006 OUR EXPERIENCE WITH TAR FOR COMPLEX INCISIONAL HERNIA REPAIR

Abstract

Abstract Aim Transverse abdominis muscle release (TAR) enables dissection of the preperitoneal space and the placement of large meshes. We present our experience with TAR in the treatment of complex incisional hernias (IH). Material and Methods Retrospective, descriptive study of patients operated with the TAR technique (October 2019-July 2022). Epidemiological characteristics, comorbidity, prehabilitation, type of IH, bridging, surgical time, hospital stay, morbidity, mortality and recurrence were studied. Results 69 TAR (30 females/39 males); age 64.9 years (24–85), body mass index 31 (19–49), CeDAR 35% (4–92). 66 cases (96%) treated preoperatively with Botulinum Toxin A, 31 (45%), with preoperative progressive pneumoperitoneum and 29 (42%) with both. Classification (EHS): M 52 (46%), L 7 (10%), ML 9 (13%), parastomal 1 (1%), tumour 1 (1%). 36 cases R0 (52%), R1 22 (32%), R2 4 (10%) and R3 6 (9%). Median size 17.8 cm(3–30) x13.7 cm (6–25), area 694.3 cm2. Primary fascial closure was achieved in 26 cases (38%), remaining 43 (62%) with bridging (8.7 cm (2–19)x5 cm (1–16)), postoperative area 125.6 cm2 (82% reduction). Surgical time was 242 minutes (140–450). Hospital stay 9 days (3–45). Wound-related complications 35 (50%): infection 15 (21%), seroma 17 (24%), haematoma 15 (7%), skin necrosis 1 (1%). General complications 7 (10%): 2 urinary tract infection, 1 intestinal perforation, 1 pneumonia, 1 haematoma, 1 haemorrhagic shock, 1 heart failure. Mortality 2 (3%). Recurrences 0 (0%). Conclusions TAR is a very useful and effective technique for resolving complex eventrations. It is not exempt from morbidity, therefore adequate patient selection is recommended.