Open Ventral/Incisional Hernia Repair and Abdominal Wall Reconstruction

Peter J. Lydon, MD, FACS

Very large, complex, and recurrent incisional hernias sometimes require a more advanced abdominal wall repair designed to return the midline musculature back together. These are more complex and advanced repairs requiring “mobilization” of abdominal wall muscles and the repairs utilize synthetic or biologic mesh to help support the repairs. There are 3 main types of Abdominal Wall Reconstructions:

Anterior Component Separation

This repair separates the superficial lateral muscles of the abdominal wall in order to allow closure of the midline musculature. Mesh is used to supplement the repair for strength. Typically, a 2 to 5 day hospital stay is required for recovery and return to daily activity can be 2 to 4 weeks on average.

Retro-Rectus Hernia Repair (Rives-Stoppa Repair)

This repair mobilizes tissue planes behind the mid abdominal rectus muscles and places mesh in this space to allow for closure of the midline without tension. This type of repair is more appropriate for the medium midline Ventral/Incisional hernias with defects under 6 cm. Typically, a 2 to 4 day hospital stay is required for recovery and return to daily activities can be 2 to 4 weeks on average.

Transversus Abdominus Release (TAR)

This is a similar repair to the Retro-Rectus repair but is more complex repair involving release of the lateral and deeper transversus abdominus muscle to allow closure of midline defects up to about 10 to 14 cm. The post operative recovery is similar to the Anterior Component Separation procedure and requires a 2 to 5 day hospital stay and return to daily activities in 2 to 4 weeks on average.

Dr. Lydon can make a recommendation as to what type of repair is best for your hernia after an office consultation.