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Early Results of Ventral Hernia Repair with Endoscopic Component Separation
*Lucian Panait, *Salim Abunnaja, *Sonaly Patel, *Shady Macaron, Michael S Ajemian
Saint Mary's Hospital, Waterbury, CT

Objective: A minimally invasive component separation procedure may lead to a robust abdominal wall after hernia repair, with reduced complications. We present early results of our patients undergoing this technique.
Design: Cohort study
Setting: Community hospital
Patients: Twenty-four patients (16 males, 8 females) with complex abdominal wall hernias participated in the study. Mean age was 52.9 years and average body mass index was 32. The mean number of previous abdominal operations was 3±1. The mean of previous attempts at hernia repair was 1.5±1.2.
Interventions: The patients underwent modified Reeves-Stoppa procedure for ventral hernia repair, with bilateral endoscopic component separation. All patients had the midline closed. A biological mesh was used in all cases to reinforce the midline in an underlay fashion. Drains were left in the dissection bed until the output was less than 30 ml/24 hours.
Main Outcome Measures: The postoperative complications and recurrence rates were recorded.
Results: Mean operative time was 252 minutes. Mean length of hospital stay was 5 days. Median follow-up was 10.5 months. One patient developed a midline wound seroma, which resolved with conservative treatment. Two patients had superficial midline abdominal wound infections, which were treated with a course of antibiotics and topical agents. Another patient developed a lateral abdominal wall hernia, at the side of a failed attempt at endoscopic component separation. He required a subsequent repair of this hernia. To date, no recurrence was recorded.
Conclusions: Short-term analysis of the minimally invasive component separation procedure in the treatment of ventral hernias demonstrates minimal complications and good initial outcomes. Large randomized prospective studies are necessary to demonstrate the superiority of this technique over other procedures for ventral hernia repair.

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May 5, 2014

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