Anterior component separation with sublay polypropylene mesh placement: An ideal way to deal with large ventral abdominal hernias.

Abstract

Objectives: To study the effectiveness of open anterior component separation technique for repair of large incisional abdominal hernias. To study the effect of addition of polypropylene mesh with open anterior CST in sublay position. Study Design: Experimental study. Setting: Department of Surgery, DHQ Hospital Rawalpindi. Period: January 2016 to November 2016. Material & Methods: Patients (n=19) were admitted through OPD electively by purposive non- probability sampling in accordance with the inclusion/exclusion criteria. patients were operated under general anaesthesia. Anterior CST was done by standard Ramirez technique. Polypropylene mesh was placed in sublay (retrorectus) position. Data obtained was analysed by SPSS-20 software to calculate SSI and Recurrence rate. Results: A total of 19 (n=19) patients were included in the study and operated upon.There were 61% males with average age of 42 years and 39% females of average31 years.Average defect size was 10.11 cm with SD  of 1.899 cm. Recurrence rate was 5.26%. SSI rate was 10.50%. Patients were followed up for one year for Recurrence of hernia. Conclusion: Anterior component separation is an effective technique for repair of otherwise inoperable large ventral abdominal hernias especially when combined with polypropylene mesh in sublay position. Addition of mesh in sublay position with CST signifantly reduces both recurrence and SSI rate.