ABDOMINAL WALL RECONTRUCTION UTILIZING POSTERIOR COMPONENT SEPARATION TRANSVERSUS ABDOMINIS MUSSCLE RELEASE IN CASE OF HUGE INCISIONAL HERNIA

Resume. Introduction. Postoperative ventral hernia is a fairly common postoperative complication that occurs in patients who have undergone laparotomy. Depending on various factors, such as age, obesity, contamination of the surgical field, and the number of previous surgical interventions, the probability of this complication varies from 5 % to 31 %. A large ventral hernia is a challenge for the surgeon when reconstructing the abdominal wall, due to difficulties in closing the defect. Each case requires an individual approach for choosing a surgical technique. In the surgical treatment of giant ventral hernias, a mesh implant should always be used, and its retromuscular placement has a number of advantages when combined with the component separation technique. Objective. To present a clinical case of reconstruction of the anterior abdominal wall using the posterior component separation technique in the TAR (Transversus abdominis muscle release) technique. Materials and methods. The basis of this study was the anamnesis data, objective data, visualization data of the state of the abdominal wall according to the performed preoperative computer tomography of the abdominal organs, intraoperative photofixation of the surgical intervention and postoperative computer tomography in the second year after the surgical intervention. Results. Analyzing the data of the objective examination, comparing the data of the preoperative and postoperative computer tomography of the abdominal cavity and abdominal wall, there are clear signs of successful reconstruction of the abdominal wall, the return of the muscles to their previous anatomical position, and complete elimination of the preoperative hernia defect. Conclusion. According to the results of this clinical case: Reconstruction of the abdominal wall by the method of posterior component separation in case of large ventral hernias allows to achieve full anatomical restoration of the muscles of the abdominal wall to their previous position, to eliminate large hernia defects and to use large mesh implants in the retromuscular position, avoiding their direct contact with the organs of the abdominal cavity. The results of the computed tomography performed for the second postoperative year and their comparison with the preoperative study confirms the reliability and stability of the obtained result.