MEDLINE Journals

    Minimally invasive component separation with inlay bioprosthetic mesh (MICSIB) for complex abdominal wall reconstruction.

    Butler CE, Campbell KT 
    Plast Reconstr Surg 2011 Sep; 128(3) :698-709.

    Ventral hernia repair can be challenging, particularly in patients with serious comorbidity. Minimally invasive component separation with inlay bioprosthetic mesh (MICSIB) uses tunnel incisions for external oblique aponeurosis release. It preserves both the rectus abdominis myocutaneous perforator vessels that supply the overlying skin and the connection between the subcutaneous fat and anterior rectus sheath, thereby reducing subcutaneous dead space and potentially improving overlying skin flap vascularity. Inlay bioprosthetic mesh reinforces the musculofascial repair. This study evaluated surgical outcomes of the technique used to repair challenging ventral hernias in cancer patients.Data from all patients who underwent minimally invasive component separation with inlay bioprosthetic mesh abdominal wall reconstruction from 2007 to 2010 were analyzed. Surgical outcomes assessed included wound complications, hernia recurrence, and repair-site bulge/laxity.Thirty-eight cancer patients (mean age, 63.3 years) considered at high risk for wound healing complications and hernia recurrence were included: 80 percent had preexisting medical comorbidities, 42 percent had infected or contaminated defects, and 26 percent had previous ventral hernia repairs. Despite the mean fascial defect size of 494 ± 229 cm2, only seven patients required a bridged repair. During a mean follow-up of 12.4 months, three patients (8 percent) required operative interventions, and nonoperative complications occurred in eight (21 percent). None developed a postoperative laxity/bulge; one (3 percent) had a hernia recurrence requiring operative repair.Minimally invasive component separation with inlay bioprosthetic mesh yields acceptable early outcomes in complex patients, likely because it reduces subcutaneous dead space, preserves the vascularity of overlying skin, and reinforces the musculofascial repair with mesh.Therapeutic, IV.

    Abdominal Neoplasms
    Abdominal Wall
    Aged, 80 and over
    Body Mass Index
    Follow-Up Studies
    Hernia, Ventral
    Middle Aged
    Postoperative Complications
    Surgical Mesh
    Surgical Procedures, Minimally Invasive
    Wound Healing


    Pub Type(s)
    Journal Article Research Support, N.I.H., Extramural
    PubMed ID


    Content Manager
    Related Content

    Minimally invasive component separation results in fewer wound-healing complications than open component separation for large ventral hernia repairs.

    Discussion: Minimally invasive component separation with inlay bioprosthetic mesh (MCSIB) for complex abdominal wall reconstruction.

    Laparoscopic component separation in the single-stage treatment of infected abdominal wall prosthetic removal.

    Outcomes of complex abdominal herniorrhaphy: experience with 106 cases.

    Current options in the management of complex abdominal wall defects.

    Bovine versus porcine acellular dermal matrix for complex abdominal wall reconstruction.

    Safety and outcome of use of nonabsorbable mesh for repair of fascial defects in the presence of open bowel.

    A 5-year clinical experience with single-staged repairs of infected and contaminated abdominal wall defects utilizing biologic mesh.