Journal Review in Hernia Surgery: Quantitative Tension on the Abdominal Wall in Posterior Components Separation With Transversus Abdominis Release

Behind The Knife: The Surgery Podcast

Medicine, Health & Fitness, Education, Science

4.8 • 1.4K Ratings

🗓️ 16 May 2024

⏱️ 22 minutes

🔗️ Recording | iTunes | RSS

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Summary

How is each release of the TAR contributing to the final tension on the anterior and posterior fascia? Join Drs. Michael Rosen, Benjamin T. Miller, Sara Maskal, and Ryan C. Ellis as they discuss their group’s recent cohort study of tensiometry in 100 TARs.

Hosts:
- Michael Rosen, Cleveland Clinic
- Benjamin T. Miller, Cleveland Clinic
- Sara Maskal, Cleveland Clinic
- Ryan C. Ellis, Cleveland Clinic, @ryanellismd

Learning objectives:
- Review the steps of a TAR
- Understand the changes in tension on the anterior and posterior fascia with each step of the TAR
- Think about the application this data has to similar operations

References:

Miller BT, Ellis RC, Petro CC, Krpata DM, Prabhu AS, Beffa LRA, Huang LC, Tu C, Rosen MJ. Quantitative Tension on the Abdominal Wall in Posterior Components Separation With Transversus Abdominis Release. JAMA Surg. 2023 Dec 1;158(12):1321-1326. doi: 10.1001/jamasurg.2023.4847. PMID: 37792324; PMCID: PMC10551814. https://pubmed.ncbi.nlm.nih.gov/37792324/

Miller BT, Ellis RC, Walsh RM, Joyce D, Simon R, Almassi N, Lee B, DeBernardo R, Steele S, Haywood S, Beffa L, Tu C, Rosen MJ. Physiologic tension of the abdominal wall. Surg Endosc. 2023 Dec;37(12):9347-9350. doi: 10.1007/s00464-023-10346-w. Epub 2023 Aug 28. PMID: 37640951. https://pubmed.ncbi.nlm.nih.gov/37640951/

Ramirez OM, Ruas E, Dellon AL. "Components separation" method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990 Sep;86(3):519-26. doi: 10.1097/00006534-199009000-00023. PMID: 2143588. https://pubmed.ncbi.nlm.nih.gov/2143588/

Hope WW, Williams ZF, Rawles JW 3rd, Hooks WB 3rd, Clancy TV, Eckhauser FE. Rationale and Technique for Measuring Abdominal Wall Tension in Hernia Repair. Am Surg. 2018 Sep 1;84(9):1446-1449. PMID: 30268173. https://pubmed.ncbi.nlm.nih.gov/30268173/

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Transcript

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0:00.0	Behind the surgery podcast relevant and engaging content designed to help you dominate the day.
0:13.0	Hello and
0:15.0	and welcome to behind the knife.
0:17.0	This is the hernia team at the Cleveland Hello and
0:22.8	welcome to Behind the Knife. This is the hernia team at the Cleveland Clinic.
0:25.3	I'm Ryan Ellis here with my but Rosen, Benjamin Miller, and Sarah Maskell.
0:28.7	Today we're excited to talk about a recent publication in the field of
0:31.6	abdominal wall reconstruction entitled
0:33.5	quantitative tension on the abdominal wall and posterior component separation with
0:37.2	transverseus abdominous release which was published in Jama surgery in October of
0:41.2	2023.
0:41.8	Prospective cohort study of abdominal wall tensiometry and 100 patients undergoing posterior
0:47.8	component separation with a transverse this abdominous release, which we're going to refer
0:52.4	to as a tar going forward.
0:54.3	The primary study outcome was a percentage change in tension on the anterior and posterior
0:59.1	fascia associated with each step of the posterior component separation with tar.
1:05.0	Because most of the audience probably doesn't know what a tensiometer is.
1:08.0	Can one of you please explain what it is and how it's used for the listeners?
1:12.0	Tensiometry is just sort of... what it is and how it's used for the listeners.
1:13.0	Tensiometry is just sort of a fancy way to describe
1:16.8	measuring the tension on something in this case the abdominal wall
1:20.0	and the tensiometer is based on a scale used to weigh things.
	...

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