[New surgical technique in complex incisional hernias: Component Separation Technique (CST) with prosthesis and new muscle insertions].
BACKGROUND
Our goal is to show the surgical community a new technique developed by our team for treating complex and catastrophic ventral hernias: Separation of Anatomical Component (SAC) amended by Carbonell-Bonafé.


METHODS
A total of 100 patients with complex incisional hernias have been treated. The size, content and reducibility of ventral hernia (preoperative CT scan), recurrences and pre-closure techniques, height and weight, trophic skin alterations and need for preoperative pneumoperitoneum were all documented. The operation was performed following a standardised protocol; intra-abdominal pressure (IAP) was measured before, during and after the intervention. Patients were evaluated in the clinic at 15 and 30 days, monthly for 3 months, at sixth months and annually for up to 5 years.


RESULTS
A total of 100 consecutive patients were operated on between January 2003 and May 2008. In the immediate post-surgical period there were 12% seromas, 8% of partial-ischaemia on the edges of the wound and 1 death due to multi-organ failure. In the later period, 6% had transitional pain in bone anchorage points. They resumed their normal activities after an average of 2 months, with great improvement in their quality of life. There have been no recurrences to date.


CONCLUSIONS
The SAC technique, as modified by our Unit, is an excellent resource in managing large ventral hernias: successfully closing with low morbidity, as well as reconstructing the biomechanics of the abdominal wall.
Carbonell Tatay
Fernando
F
Unidad de Cirugía General, Sección de Cirugía de Pared Abdominal, Hospital Universitario La Fe, Valencia, España. fercarb@terra.es
Bonafé Diana
Santiago
S
García Pastor
Providencia
P
Gómez I Gavara
Concepción
C
Baquero Valdelomar
Ricardo
R
D034861:Abdominal Wall / Q000601:surgery*; D006555:Hernia, Ventral / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000601:surgery*; D011446:Prospective Studies