What is component separation?

Although hernias can develop in a number of ways, in the case of an abdominal hernia, an organ or section of fatty tissue pushes through a separation in the abdominal muscles. As such, a component separation is recommended in cases where it is necessary to restore the function of the abdominal wall.

There’s an increase in the number of patients developing complex or large abdominal wall defects, such as large abdominal wall hernias and enterocutaneous fistulas, with the presence of bacterial contamination. These may occur due to an incisional hernia as a result of several abdominal operations, removal of the abdominal wall and abdominal wall infections. The management of complex hernias may be more challenging to repair and often presents with a much higher risk of recurrence and additional associated complications.

To manage these complex hernias, component separation is an essential technique for repairing such defects. It is largely performed when there’s insufficient muscular wall to pull back during a traditional hernia repair. Component separation involves separating layers of the abdominal wall muscle and increasing their length, bringing the right and left sides of the muscle closer to the midline to ensure adequate closure.  

What does the procedure involve?

During a component separation, certain parts of the abdominal wall are cut to allow the separate muscle sections to move. This allows muscles that have retracted to the side to be pulled together in the centre to close the defect. The sections are then joined together with sutures, which helps to restore the proper function of the abdominal muscles. In some cases, a mesh is used to reinforce the hernia repair.  You will have multiple suction drains and abdominal bracing postoperatively. You will need to keep the brace on for three to six months. You must avoid heavy lifting for three months. There will be discomfort and decreased movement for three months.