The Separation of Anatomical Components in the Treatment of the Incisional Hernia with Associated Abdominal Rectus Muscle Diastasis: A Case Report

Abstract

The incisional hernia is a late occurring sequel, that may present itself in any lesion or incision on the abdominal wall, with an incidence of 10% to 15%. The coexistence of diastasis of the abdominal rectus muscles with incisional hernia of the abdominal midline, changes the muscular dynamics of the abdominal wall, and is a therapeutic challenge for any surgeon. Recent prospective studies recommend the correction of these two conditions. If only the hernial defect is corrected, without correction of the diastasis, there is great probability of hernial recurrence in the mid to long term.
The authors describe the case of a large incisional hernia, after a xiphopubic laparotomy of a 63-year-old male who also presented diastasis of the abdominal rectus muscles, and who underwent correction of both conditions by using the abdominal components separation technique, reinforced with the placement of a polypropylene prosthetic. Brief considerations are made about this technique, which allows for the closing of large defects of the midline with native tissue, and their respective results.