Transversus abdominis muscle release for repair of complex incisional hernias in kidney transplant recipients

Clayton C. Petro, Sean Orenstein, Cory N. Criss, Edmund Q. Sanchez, Michael J. Rosen, Kenneth J. Woodside, Yuri W. Novitsky

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background Incisional hernias in kidney transplant recipients (KTRs) can be complex because of adjacent bony structures, proximity of the allograft/transplant ureter, and context of immunosuppression. We hypothesized that our novel posterior component separation with transversus abdominis muscle release (TAR) and retromuscular mesh reinforcement offers a safe and durable repair. Methods KTRs with incisional hernias repaired using the aforementioned technique were identified within our prospective database (2007 to 2013) and analyzed. Results Eleven patients were identified (median age 49 years, body mass index 32). The median hernia size was 30 cm2 (range 88 to 1,040 cm2) and 8 of the 11 patients were recurrent. Intraoperative morbidity consisted of one transplant ureter injury repaired primarily over a stent. Postoperative morbidity consisted of 2 superficial surgical site infections that resolved and 1 readmission for a blood transfusion. There were no instances of mesh infection, explantation, graft loss, or graft dysfunction. With a median follow-up of 12 months (range 3 to 69), 1 (9%) lateral recurrence has been documented. Conclusions For complex incisional hernias in KTRs, TAR is associated with low perioperative morbidity and durable repair.

Original languageEnglish (US)
Pages (from-to)334-339
Number of pages6
JournalAmerican Journal of Surgery
Volume210
Issue number2
DOIs
StatePublished - Aug 1 2015
Externally publishedYes

Fingerprint

Abdominal Muscles
Transplants
Kidney
Muscles
Ureter
Morbidity
Surgical Wound Infection
Hernia
Blood Transfusion
Immunosuppression
Stents
Allografts
Body Mass Index
Databases
Recurrence
Incisional Hernia
Transplant Recipients
Wounds and Injuries
Infection

Keywords

  • Abdominal wall reconstruction
  • Flank hernia
  • Kidney transplant
  • Posterior component separation
  • Transversus abdominis release
  • Ventral hernia

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Transversus abdominis muscle release for repair of complex incisional hernias in kidney transplant recipients. / Petro, Clayton C.; Orenstein, Sean; Criss, Cory N.; Sanchez, Edmund Q.; Rosen, Michael J.; Woodside, Kenneth J.; Novitsky, Yuri W.

In: American Journal of Surgery, Vol. 210, No. 2, 01.08.2015, p. 334-339.

Research output: Contribution to journalArticle

Petro, Clayton C. ; Orenstein, Sean ; Criss, Cory N. ; Sanchez, Edmund Q. ; Rosen, Michael J. ; Woodside, Kenneth J. ; Novitsky, Yuri W. / Transversus abdominis muscle release for repair of complex incisional hernias in kidney transplant recipients. In: American Journal of Surgery. 2015 ; Vol. 210, No. 2. pp. 334-339.
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