Transversus Abdominis Muscle Release (TAR) for Posterior Component Separation during Major Abdominal Wall Reconstructions

Abstract

entral hernia repair is one of the most common operations performed today, yet when complex and huge it presents a true challenge for surgical team. Large hernia is an important complication of abdominal surgery with an incidence of 10–23 %, especially incisional type after midline laparotomy increasing up to 38 % in specific risk groups. Large hernia can lead to pain, discomfort and cosmetic complaints, resulting in a decreased quality of life. Moreover, large, complex hernia can cause incarceration and strangulation of abdominal contents, requiring emergency surgery, with associated morbidity and mortality. Mid line laparotomy is associated with highest incidence of developing incisional hernia and sometimes huge being true challenge for the surgeons to perform functional restoration of abdominal wall with autologous tissue repair that’s followed by mesh reinforcement. For these reasons the component separation techniques have gained popularity among general surgeons in the management of giant abdominal hernia. TAR technique is an important modification of posterior component separation. With the multitude of operative approaches and variability amongst patients and hernias, defining a single, ideal operative approach is challenging and possibly unrealistic for ventral hernia repair.