Endoscopic component separation technique in the repair of incisional hernia and other abdominal wall defects: analysis of an initial series

Abstract

Background: although laparoscopic incisional hernia repair has proven advantages limitations should be considered when applied to large abdominal wall defects. The endoscopic component separation (ECS) technique could achieve better results in those patients.
Objective: to evaluate a number of patients who were treated with ECS as a complement of the laparoscopic repair of large wall defects.
Methods: descriptive analysis of a prospective series of patients. Patients with abdominal wall defects that were treated laparoscopically associating ECS were included. The type and size of the abdominal wall defect, size of mesh the fixation used, surgical and ECS technique time, morbimortality and recurrence were recorded.
Results: sixteen patients were included, the average size of the defects was 12 cm in diameter and closure was accomplished in every patient. There were no intraoperative complications .There were 3 cases of post operative morbidity: one patient had abdominal pain and required more painkillers than usual, one patient without cardiac history had a cardiac event and one patient had post-operative intestinal obstruction. There were no recurrences during the follow up (18 months).
Conclusion: the ECS technique is a useful procedure as a complement in the repair of abdominal wall defects. A displacement of 6-8 cm of the rectus abdominis to the middle line is achieved,, allowing the reduction or the closure of the abdominal wall defect.