Endoscopic ACST

Novel approach to Ramirez’s original open technique to decrease skin complications.

Technique of Endoscopic Anterior Component Separation:

This can be done either as a subcutaneous technique or Sub- External oblique technique.

Subcutaneous Technique:

The Sub- External Oblique approach/Technique:

  • After Completing the Endoscopic Component Separation, the Midline is reconstituted by closing the Medial edges of Rectus Sheath: At this point decision is made as to where to place the Mesh: The Mesh can be placed either in Retro-Rectus Position or as an Onlay Mesh

    How wide a defect can be closed by this Anterior Component Separation:

    • A defect of as wide as 16cms can be closed in Umbilical region.
    • At the Xiphisternum and pubic region the defect of maximum 8 to 10cms can be closed.

    Advantages of Anterior Component Separation:

    • It can be done in open as well as Laparoscopic Repair.
    • The Component Separation can be done with open technique or Endoscopic technique.
    • The Endoscopic Technique can be combined with open ventral Hernia Repair as well as Laparoscopic Repair.
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