A major advance in abdominal wall reconstruction.
A technique with minimally invasive component separation with inlay bioprosthetic mesh, subcutaneous tunnels allowing access to the external oblique aponeurosis.
Use can prevent hernia recurrence in many patients.
Minimally invasive approach to component separation that reduces complications and potentially improves functional outcomes.
Component separation used for abdominal wall reconstructions in ventral hernia repair or other surgeries requiring resection along the midline of the rectus abdominis complex.
Allows the surgeon to close musculofascial defects without excessive tension and without a distant transposition flap.
With an open procedure the amount of dead space created and the need to transect the blood vessels that supply the overlying fat and skin can lead to seromas, infections, and wound-healing complications.
The minimally invasive component separation with inlay bioprosthetic mesh (MICSIB), preserves the rectus abdominis perforator vessels and maintains the connection between the subcutaneous fat and the anterior rectus sheath.
Allows complete primary fascial closure with bioprosthetic mesh used as an underlay reinforcement.
Reduces the muscular tension that can accompany the closure of the rectus abdominis muscle by separating the rectus abdominis muscle from the topmost of the three layers of oblique muscles to the left and right of the rectus abdominis.
Skin flaps are created on each side of the semilunar line, which is just lateral to the rectus abdominis muscle, and the external oblique aponeurosis is released from the costal margin to near the pubis.
Releasing and separation of the internal and external oblique muscles enables the advance of the rectus complex toward the midline, thus reducing the size of the defect.
If the defect is narrow enough, a primary musculofascial closure reinforced with an inlay of synthetic or bioprosthetic mesh can be achieved.
With residual large defects mesh is used as a bridge between the musculofascial edges.
Open component separation fully separates the rectus abdominis muscle from the overlying skin, MICSIB uses narrow tunnels to access the external oblique aponeurosis and thus decreases the damage to rectus abdominis perforator vessels.
In a comparison of open vs minimally invasive surgical techniques for complex ventral hernia repairs with open component separation: Significantly more patients who had undergone open component separation had wound-healing complications and skin dehiscences compared with those who had undergone MICSIB (Butler C et al).