title: Repair of Large Abdominal Wall Defects Using Total Anterior Aponeurotic Flap: Anatomical Feasibility Study and Comparison with Ramirez's Technique.
abstract: In this cadaveric study, we explored the feasibility of a maximal mobilization of the superficial abdominal fascia, in a continuous flap, to achieve a tension-free covering of midline defects. The aponeurosis of the external oblique muscle was incised along the anterior axillary line and then detached up to the anterior rectus sheath. The latter was opened between the external and the internal oblique aponeurosis while keeping the continuity with the external oblique fascia. The obtained flap was solid and uninterrupted. The width gain reached 15 ± 3 cm on each sides, providing tissue advancement 60% longer than Ramirez's technique (n = 8). The described technique allows large covering with respect to the anatomical planes. Further clinical tests should evaluate the validity of such concept in the repair of giant and asymmetrical hernias.
authors.affiliation: Visceral Surgery Division, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; and Faculty of Medicine, Department of Cellular Physiology and Metabolism, Anatomy Sector, University of Geneva, Geneva, Switzerland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Staszewicz
authors.affiliation: Visceral Surgery Division, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; and Faculty of Medicine, Department of Cellular Physiology and Metabolism, Anatomy Sector, University of Geneva, Geneva, Switzerland.
authors.forename: Michela
authors.initials: M
authors.lastname: Assalino
authors.affiliation: Visceral Surgery Division, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; and Faculty of Medicine, Department of Cellular Physiology and Metabolism, Anatomy Sector, University of Geneva, Geneva, Switzerland.
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.affiliation: Visceral Surgery Division, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; and Faculty of Medicine, Department of Cellular Physiology and Metabolism, Anatomy Sector, University of Geneva, Geneva, Switzerland.
authors.forename: Jean H D
authors.initials: JH
authors.lastname: Fasel
authors.affiliation: Visceral Surgery Division, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; and Faculty of Medicine, Department of Cellular Physiology and Metabolism, Anatomy Sector, University of Geneva, Geneva, Switzerland.
authors.forename: Bojan V
authors.initials: BV
authors.lastname: Stimec
authors.affiliation: Visceral Surgery Division, University Hospitals of Geneva and Faculty of Medicine, Geneva, Switzerland; and Faculty of Medicine, Department of Cellular Physiology and Metabolism, Anatomy Sector, University of Geneva, Geneva, Switzerland.
authors.forename: Mickael
authors.initials: M
authors.lastname: Tobalem