Abstract

Research Article

Mesh-reinforced Anterior Component Separation for Repair of Large Ventral Hernia: Ten-year Experience in Multiple Centers

Sardar Rezaul Islam*, Shah Alam Sarkar, Debabrata Paul, Shah Poran, Mushfiqur Rahman, Adiba Chowdhury and Bithika Sarkar

Published: 12 August, 2025 | Volume 9 - Issue 2 | Pages: 033-037

Background: Repair of a large ventral hernia is a challenge for surgeons. Component Separation Technique (CST) is a novel technique for closure of the midline with live tissues without undue tension. This can further be reinforced by a prosthesis. We wanted to see the outcome of mesh-reinforced open Anterior Component Separation (ACS) for large complex ventral hernia repair. We aimed to see the duration of surgery, hospital stay, Surgical Site Occurrence (SSO), and recurrence within the first year after surgery.
Materials and methods: We analyzed data of patients operated from January 2014 to January 2024 for a period of 10 years in three centers. There were 13 patients with divarication of recti without any previous surgery. Rest 44 patients had either incisional hernia or port site hernia. All patients had defect sizes more than 8 cm. Open bilateral anterior component separations were done to achieve midline closure. Medium-pore soft Prolene mesh was used to reinforce the midline closure by an on-lay technique. Patients were followed up to 1 year after surgery to assess efficacy and complications of the procedure.
Results: The average operating time was 73 ± 12 min. Hospital stay was 3 to 7 days, mean was 5.3 days. Surgical site occurrence was 14%. These include seroma formation, major wound infection, and abscess formation. There was no flap necrosis nor mesh removal. There was no recurrence within one year of follow-up after surgery. 
Conclusion: Open mesh Anterior Component Separation (mACS) is an easy and effective way of treating large and complex ventral hernia. Operating time is substantially less than posterior component separation. Reinforcement with mesh reduces recurrence.

Read Full Article HTML DOI: 10.29328/journal.ascr.1001089 Cite this Article Read Full Article PDF

Keywords:

Large ventral hernia; Hernioplasty; Anterior component separation and Onlay mesh technique

References

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