Anterior component separation, external retrofascial approach: Is that an option?

Abstract

BACKGROUND AND AIMS: The eventration involves a highly variable surgical entity with a wide range of possible surgical techniques for its repair, without having found a “Gold Standard” technique. With these animal study, we propose a possible and useful surgical procedure for hernia repair. MATERIALS AND METHODS: We present a modified technique of the anterior component separation (ACS) based on a release of the external oblique muscle from a posterior anatomical approach, accessing the space from the retrofascial space of the anterior sheath of the rectus abdominis muscle. The technique was performed in an experimental animal model with pigs of the “Large White” breed of 20-25 kg since the pig is a good representative model of human anatomy and its abdominal wall. RESULTS: The technique was performed in an experimental animal model with pigs of the “Large White” breed. The procedure through the anterior retrofascial space of the rectus abdominal muscle was easily done, allowing the access to the inter-oblique space and facilitating the release of the external oblique muscle. CONCLUSION: Waiting for its clinical application, the ACS by its external retrofascial space approach could be an interesting surgical resource for incisional hernia repair.

Keywords

• component separation
• external oblique muscle release
• external retrofascial approach