Minimally invasive component separation techniques in complex ventral abdominal hernia repair: a systematic review of the literature.

PURPOSE: Open component separation (CS) has traditionally been a popular method for management of complex abdominal wall hernias. However, it has been associated with significant wound complications. The aim of this systematic review was to examine the evidence in the literature on modern CS techniques (endoscopic and minimally invasive) for the management of such hernias.

METHODS

A systematic literature search was performed (2000 to 2013) using major electronic databases (PUBMED, EMBASE). The outcomes of interest were hernia recurrence rate and wound morbidity.

RESULTS

A total of 33 publications were retrieved. Thirteen studies involving in total 220 patients were included in this analysis. No randomised controlled trials were identified. The overall hernia recurrence and wound complication rates appear similar and in some studies superior to the results of open CS.

CONCLUSIONS

The initial results of the 2 more recent component separation techniques appear encouraging. However, better quality studies with longer follow-up are needed.