Original CommunicationFunctional abdominal wall reconstruction improves core physiology and quality-of-life
Section snippets
Methods
After approval by our institutional review board, patients undergoing open VHR at University Hospitals Case Medical Center, Cleveland, Ohio, by 2 surgeons (M.J.R., Y.W.N.), were recruited under a volunteer basis for prospective analysis. Thirteen adult patients (7 males; 6 females) agreed to participate. All subjects gave written informed consent to take part in this study. Baseline demographics including age, sex, body mass index, comorbidities, smoking status, number of previous abdominal
Results
A total of 13 patients met the inclusion criteria for the study and completed the dynamometric exercises successfully before and after their VHR. There were 7 males and 6 females, with a mean age of 54 ± 9 years (range, 36–69), and a mean preoperative body mass index of 31 ± 7 kg/m2 (range, 20–46). Associated comorbidities included diabetes in 1 patient and smoking history in another. Our patients had a mean ASA score of 2.5 and had undergone an average of 4 (range, 1–6) prior abdominal
Discussion
A well-established goal of modern VHR is to achieve midline reapproximation of the rectus muscles to restore native abdominal wall anatomy. When necessary, component separations are utilized to achieve medial advancement of the fascial edges to allow for closure under physiologic tension. Presumably, medialization of the rectus muscles and restoration of the linea alba improves abdominal core function, but this hypothesis has never been tested objectively. Herein we have presented a series of
References (27)
- et al.
Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction
Am J Surg
(2012) - et al.
Posterior and open anterior components separations: a comparative analysis
Am J Surg
(2012) - et al.
Design and initial implementation of HerQLes: a hernia-related quality-of-life survey to assess abdominal wall function
J Am Coll Surg
(2012) - et al.
Repair of abdominal wall hernias with restoration of abdominal wall function
J Gastrointest Surg
(2010) - et al.
Comparative radiographic analysis of changes in the abdominal wall musculature morphology after open posterior component separation or bridging laparoscopic ventral hernia repair
J Am Coll Surg
(2014) - et al.
Incisional herniation induces decreased abdominal wall compliance via oblique muscle atrophy and fibrosis
Ann Surg
(2007) - et al.
Trunk strength testing with iso-machines. Part 1: review of a decade of scientific evidence
Spine (Phila Pa 1976)
(1993) - et al.
Trunk strength testing with iso-machines. Part 2: experimental evaluation of the Cybex II Back Testing System in normal subjects and patients with chronic low back pain
Spine (Phila Pa 1976)
(1993) - et al.
Functional impairment of the abdominal wall following laparoscopic and open cholecystectomy
Surg Endosc
(2002) - et al.
Test-retest reliability of the biodex isokinetic dynamometer
J Orthop Sports Phys Ther
(1990)
Clinical uses of isokinetic measurements. Critical issues
Phys Ther
A systematic review of abdominal wall function following abdominal flaps for postmastectomy breast reconstruction
Ann Plast Surg
Quantification of functional deficits associated with rectus abdominis muscle flaps
Plast Reconstr Surg
Cited by (109)
A Scoping Review of Quality-of-Life Assessments Employed in Abdominal Wall Reconstruction
2024, Journal of Surgical ResearchAbdominal Core Health: What Is It?
2023, Surgical Clinics of North AmericaOpen Complex Abdominal Wall Reconstruction
2023, Surgical Clinics of North AmericaSecondary closure of large omphalocele using component separation technique: A pediatric case report
2022, International Journal of Surgery Case ReportsSingle institute experiences in anterior and posterior component separation technique for the large ventral hernia: A retrospective review
2022, Asian Journal of SurgeryCitation Excerpt :Considering the 2–20% risk of developing an incisional hernia after a laparotomy,2–6 the improvements in surgical and critical care, the number of ventral hernia repairs will likely increase with time. With time, the surgical community has placed a greater emphasis on anatomical restoration with a greater positive influence on the patient's quality of life.7,8 The component separation techniques are an important tool that helps reconstruct the abdominal wall in the presence of large defects or loss of domain.
Bilateral transversus abdominis release: Complex hernia repair without sacrificing quality of life
2022, American Journal of Surgery