Minimally invasive surgery
TAR for complex hernias
Transversus abdominis release for large or complex incisional hernias where the abdominal wall needs complex reconstruction.
Indications
- Large incisional hernia with loss of domain
- Recurrent ventral hernia after previous repair
- Defect too large for simple mesh closure
- Need for complex abdominal wall reconstruction
Steps
- Preoperative CT planning of the defect and muscle anatomy
- Dissection of the abdominal wall layers
- Release of the transversus abdominis posterior lamina
- Medialisation of the rectus muscles to close the defect
- Mesh reinforcement of the reconstruction
- Layered closure of the wound
Planning
CT imaging is essential to define the defect size, the amount of contents outside the abdominal cavity, the muscle anatomy and the reconstructive strategy.
Recovery
Recovery after TAR is gradual. Drain management, wound care, nutrition support and progressive rehabilitation are standard parts of the pathway.
