Abstract

ADEFNA PEREZ, Radamés Isaac; LEAL MURSULI, Armando; IZQUIERDO LARA, Francoise T  and  RAMOS DIAZ, Nélida. The component separation technique as surgical adjuvant in suprapubic hernia repair. Rev Cubana Cir [online]. 2018, vol.57, n.2, pp.1-9. ISSN 0034-7493.

Suprapubic incisional hernia is a rare disease, generally the result of pelvic surgeries, especially those approaching the retropubic space of Retzius. To report the results of the surgical treatment of the suprapubic hernia by means of the traditional procedure of Rives-Stoppa associated to the component separation technique with polypropylene bioprosthesis as reinforcement. Three patients with large suprapubic hernias are reported. These were defined as: any defect located at a distance of no more than 5 cm from the symphysis pubis with diameter of the hernial ring over 10 cm at its major axis measured trans-operatively. Three patients, one man and two women were operated. The first, with a history of retropubic prostatectomy and the last two, with a history of gynecological surgery. In the first, the operation of Rives-Stoppa was complemented with the component separation technique and supra-aponeurotic reinforcement. For the last two, we preferred the posterior component separation in order to avoid extensive anterior dissection. The most frequent complications were seromas and, to date, no relapses have been reported. Preperitoneal repair combined with the technique of anterior or posterior component separation are valid alternatives in the repair of complex incisional hernias, such as suprapubic hernias. This allowed closure of the aponeurotic defect to cover and protect the bioprosthesis with the consequent reconstruction of the linea alba.

Keywords : suprapubic hernia; component separation; bioprosthesis.

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