title: Laparoscopic Transversus Abdominis Release, a Novel Minimally Invasive Approach to Complex Abdominal Wall Reconstruction.
abstract: BACKGROUND
  Open abdominal wall reconstruction is used to repair complex abdominal wall hernias with contour abnormalities. We present a novel minimally invasive approach to address these types of defects, completed entirely laparoscopically.
  
  
  METHODS
  Three patients underwent laparoscopic abdominal wall reconstruction for complex hernias in August and September of 2015. Operative approach consisted of laparoscopic transversus abdominis components separation, defect closure, and wide mesh implantation in the retromuscular space.
  
  
  RESULTS
  Two males and one female with mean age and body mass index of 70 and 30.1, respectively, underwent a mean operation room time of 329 minutes. Estimated blood loss and length of stay were 91.7 cc and 4.7 days, respectively. No subcutaneous flaps were raised avoiding the need for subcutaneous drains. There were no perioperative complications. All of the subfascial drains were removed prior to patient discharge. On initial follow-up visit at 3 weeks, there was no evidence of wound complications, bulging, or hernia recurrences.
  
  
  CONCLUSIONS
  Laparoscopic abdominal wall reconstruction with transversus abdominis release is a unique and feasible approach to complex abdominal wall defects with the potential to reduce pain, facilitate recovery, and decrease length of hospital stay for patients.
authors.affiliation: Anne Arundel Medical Center, Annapolis, MD, USA ibelyansky@aahs.org.
authors.forename: Igor
authors.initials: I
authors.lastname: Belyansky
authors.affiliation: Anne Arundel Medical Center, Annapolis, MD, USA.
authors.forename: H Reza
authors.initials: HR
authors.lastname: Zahiri
authors.affiliation: Anne Arundel Medical Center, Annapolis, MD, USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Park
mesh_terms: D034861:Abdominal Wall / Q000601:surgery*; D000368:Aged; D005260:Female; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D013526:Surgical Mesh
keywords: TAR; abdominal wall reconstruction; evidence-based medicine/surgery; hernias; transversus abdominis release