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Surgical Innovation
April 2016

Transversus Abdominis Release as an Alternative Component Separation Technique for Ventral Hernia Repair

Author Affiliations
  • 1Section of Minimally Invasive Surgery, Department of Surgery, Washington University School of Medicine, St Louis, Missouri
  • 2Division of General Surgery, Department of Surgery, University Hospitals Case Medical Center, Cleveland, Ohio
JAMA Surg. 2016;151(4):383-384. doi:10.1001/jamasurg.2015.3611

The use of myofascial advancement flaps, or component separation technique, dates back more than 25 years. The most commonly mentioned approach is that of Ramirez et al1 from 1990 in which the external abdominal oblique (EO) musculature is divided as a method of providing midline abdominal muscle advancement of up to 10 cm bilaterally. Although effective in rectus muscle medialization, anterior component separation technique requires creation of large, often morbid, lipocutaneous flaps. The Rives-Stoppa retromuscular reconstruction is effective, but it is not applicable for larger defects. Transversus abdominis release (TAR) is the most recent technique to address limitations of traditional reconstructive options.

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