Comparison of Outcomes of Open and Minimally-Invasive Component Separation Techniques

PURPOSE

Recently, there have been several investigations comparing the outcomes of open and minimally invasive component separation techniques.  It has been suggested that minimally invasive component separation techniques reduce wound complications over open techniques presumably through the preservation of abdominal wall perforators supplying the skin and subcutaneous tissue. 

METHODS/MATERIALS

A retrospective review of patients undergoing open (open CS) or minimally invasive component separation (MICS) technique between October 2008 and February 2011 was performed.  Multiple patient-related variables were compared including age, gender, BMI, wound classification, maximum transverse defect width, and previous ventral hernia repairs.  Outcome variables were also evaluated and included hernia recurrence, and wound complications.

EXPERIENCE/SUMMARY OF RESULTS

Twenty consecutive patient that underwent open CS repair and twenty consecutive patients that underwent MICS repair were identified.  The average age was 45.6 in the patients undergoing open CS repair, and 44.5 in the patients undergoing MICS repair.  The average BMI was 31.4 kg/m² in patients undergoing open CS repair and 29.3 kg/m² in patients undergoing MICS repair.  The average transverse defect width was 12.1 cm for the open CS group and 10.7 cm in the MICS group.  The open CS group had an average of 1.9 previous ventral hernia repairs, whereas the MICS group had an average of 1.7 prior repairs.  The recurrence rate was 5% (1 patient) for the open CS group, whereas the MICS repair group had no recurrences.  Wound complications were observed in 45% (9 patients) of the open CS technique patients and in 10% (2 patients) of the MICS technique patients.  The mean follow-up of all patients was 16 months (range, 12-34 months).

CONCLUSIONS

In our experience, the subset of patients in which an open CS was performed demonstrated similar patient demographics as patients in which MICS repair was performed.  The rate of recurrence was similar at short-term follow-up; however the rate of wound complications was significantly higher in the open CS repair group.