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19.03.2020 | Original Article

Abdominal Wall Reconstruction (AWR): Initial Experience from an Indian Centre

Indian Journal of Surgery
J. B. Agrawal, Aparna Hegde, P. D. Rekha
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Posterior component separation through transverse abdominis muscle release (TAR) is a relatively new surgical technique and gaining popularity for complex large ventral hernia repair. This is a single centre, retrospective study involving ventral hernia cases managed by abdominal wall reconstruction during 2017–18. Patient demographics, body mass index (BMI), comorbidities, type of surgery, mesh size, complications, pain score, length of stay, and recurrence were recorded from the medical records and analysed statistically as mean, standard deviation, median, range, and percentile as applicable. The study included 14 cases presenting with incisional ventral hernia. Mean BMI of the study population was 28 ± 5.26 kg/m2 and mean age was 60.28 ± 9.68 years. Three different types of mesh were used for reinforcing the abdominal layers separated during the surgery. The average hospital stay was 4.71 ± 1.43 days and median follow-up was 12 months. There were no major complications reported post surgery; however, surgical site infection was reported in 4 (28.57%) patients. One patient (male, 60 years, BMI 34.5 kg/m2, M2, M3 hernia and defect size of 18 × 20 cm), reported a minor bulge after 2 years of surgery. Transverse abdominis muscle release surgical technique is giving satisfactory results and can be safely adopted as an alternate to existing techniques for treating large, incisional midline ventral hernia in Indian population.

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