Combined Open Components Separation with Mesh Repair Versus Mesh Bridged Repair in Complicated Large Ventral Hernias

Elmahdy, Tamer; Mousa, Gamal; Elkhadrawy, Osama; Saber, Sherif; Elshora, Ahmed

doi:10.21608/ejsur.2025.354899.1364

Combined Open Components Separation with Mesh Repair Versus Mesh Bridged Repair in Complicated Large Ventral Hernias

Document Type : Original Article

Authors

Departments of General Surgery, Gastrointestinal and Laparoscopic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt

10.21608/ejsur.2025.354899.1364

Abstract

Background: Although Managing a major ventral hernia is a surgical struggle, which becomes increasingly more difficult
if it is complicated. Not every patient will benefit from the same ventral hernia repair strategy. So, using combined
components separation with mesh reinforcement or mesh bridged repair is important to provide tensionless repair and
avoid further complications.
Aim: Comparing combined open components separation with mesh repair versus mesh bridged repair in complicated
large ventral hernia with regard to surgical site occurrences and hernia recurrence.
Patients and Methods: This retrospective analysis was undertaken at the Department of General Surgery, Tanta
University, including 36 patients who presented with complicated large ventral hernia underwent surgical repair between
June 2018 and December 2022.
Results: The analysis included 27 women and nine men, who were followed for a median of 40 months, with a mean
age of 51.22±4.35 years. The mean preoperative BMI was 30.87±4.42kg/m2. The mean operative time was significantly
shorter in the mesh bridged group than the component separation group (102.35±27.58 vs. 145.35±12.54min). The mean
hospital stay was less in the mesh bridged group (5±0.8 vs. 7±1.2 days). Postoperative complications were encountered
in 11 cases. Recurrence occurred in two (14.2%) patients.
Conclusion: Mesh bridged repair may be the safest choice in an emergency, depending on patient stability, volume
status and degree of contamination, while the combined components separation technique with only mesh reinforcement
has superior outcomes compared with mesh bridged repair in complicated large ventral hernia as regards surgical site
occurrences, hernia recurrence and achieving functional, tensionless, strong fascial closure.

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