Combined Open Components Separation with Mesh Repair Versus Mesh Bridged Repair in Complicated Large Ventral Hernias | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 3, July 2025, Pages 1060-1069 PDF (884.84 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2025.354899.1364 | ||
| Authors | ||
| Tamer Elmahdy; Gamal Mousa; Osama Elkhadrawy; Sherif Saber; Ahmed Elshora* | ||
| Departments of General Surgery, Gastrointestinal and Laparoscopic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt | ||
| Abstract | ||
| Background: Although Managing a major ventral hernia is a surgical struggle, which becomes increasingly more difficult if it is complicated. Not every patient will benefit from the same ventral hernia repair strategy. So, using combined components separation with mesh reinforcement or mesh bridged repair is important to provide tensionless repair and avoid further complications. Aim: Comparing combined open components separation with mesh repair versus mesh bridged repair in complicated large ventral hernia with regard to surgical site occurrences and hernia recurrence. Patients and Methods: This retrospective analysis was undertaken at the Department of General Surgery, Tanta University, including 36 patients who presented with complicated large ventral hernia underwent surgical repair between June 2018 and December 2022. Results: The analysis included 27 women and nine men, who were followed for a median of 40 months, with a mean age of 51.22±4.35 years. The mean preoperative BMI was 30.87±4.42kg/m2. The mean operative time was significantly shorter in the mesh bridged group than the component separation group (102.35±27.58 vs. 145.35±12.54min). The mean hospital stay was less in the mesh bridged group (5±0.8 vs. 7±1.2 days). Postoperative complications were encountered in 11 cases. Recurrence occurred in two (14.2%) patients. Conclusion: Mesh bridged repair may be the safest choice in an emergency, depending on patient stability, volume status and degree of contamination, while the combined components separation technique with only mesh reinforcement has superior outcomes compared with mesh bridged repair in complicated large ventral hernia as regards surgical site occurrences, hernia recurrence and achieving functional, tensionless, strong fascial closure. | ||
| Keywords | ||
| Components separation; Mesh bridged; Ventral hernia | ||
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