A Paradigm Shift in Ventral Hernia Repair. Laparoscopic Component Separation During Laparoscopic Ventral Hernia Repair.

Component separation is an important technique in the repair of ventral hernias because it allows restoration of the normal anatomic relationship of the rectus muscles while maintaining a tension-free repair. Our group has previously reported on fully laparoscopic component separation as an important tool in the repair of ventral hernias. This technique allows for protection of the skin perforators and avoids the creation of large skin flaps obligatory in open component separation. It therefore decreases the risk of infection, seroma, and hematoma. However, the laparoscopic component separation has always been done in conjunction with an open laparotomy to close the facial midline and finish the hernia repair. The necessity of opening midline abrogates the advantages of faster recovery and decreased pain associated with laparoscopic surgery.
This video shows a new completely laparoscopic technique for repair of ventral hernias using a porcine model. It details the bilateral component separation necessary to close the midline without tension. It demonstrates as well a new method of closing the midline fascia using interrupted stitches while avoiding midline laparotomy.

Session: Podium Presentation

Program Number: V017

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