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Atlas Of Abdominal Wall Reconstruction NEW!

Large or complex abdominal wall defects are a particularly challenging surgical problem. Abdominal wall reconstruction surgery is an advanced surgical procedure that strengthens a weakened or damaged abdominal muscle and restores the normal function of the abdominal wall. It is a procedure recommended for patients with advanced hernias and requires specialized surgical expertise.

Atlas of Abdominal Wall Reconstruction

A complex hernia often occurs at the site of an earlier hernia repair and the hernia has returned. With repeated attempts at repair of hernias, the surrounding tissue can become weak or stretched and it may need to be augmented or replaced. Large hernias of the abdominal wall can result in deformity of the abdominal wall requiring a complex hernia repair. The presence of a fistula makes the repair even more complicated.

Expertise: With over 100 years of combined surgical experience, our multidisciplinary team in Charleston, S.C., has the expertise you can count on. We specialize in abdominal wall reconstruction using advanced techniques with proven results even for the most complex cases.

Leadership: Our providers hold leadership positions in prestigious societies and often asked to share their surgical expertise in trauma, minimally invasive surgery, robotic surgery and abdominal wall reconstruction. Our nationally and internationally recognized team includes a past president of the Eastern Association for the Surgery of Trauma, current president of the SC Chapter of the ACS, member of the Western Trauma Association, president of the Carolinas Chapter of the ASMBS, and co-chair of the International Committee of the ASMBS.

Figure 1. Case of reoperation at 4 months for intestinal obstruction to pelvic floor. No intra-abdominal adhesions to the abdominal wall were seen. The permanent mesh could not be discerned through the peritoneum. A layer of fibrosis between the peritoneum and the permanent mesh is observed.

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.

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