Anterior Component Separation Techniques

Complex abdominal wall reconstruction may be accomplished utilizing anterior component separation techniques. These techniques involve both division of the posterior rectus sheath and the external oblique aponeurosis to facilitate advancement of the rectus abdominis muscle along with the internal oblique and transversus abdominis muscle. Significant advancement of the abdominal wall may be obtained resulting in closure of defects spanning nearly 20 cm in width. While traditional techniques involved the creation of undermining skin flaps with resultant wound morbidity, evolutionary techniques including the perforator preserving technique and endoscopic component separation technique allow for similar abdominal advancement while minimizing wound complications.