Open transversus abdominis release

Abstract

The management of most complex abdominal wall hernias remains a significant challenge and the approaches to repair them have evolved. To address these challenges, the posterior component separation using the transversus abdominis muscle release (TAR) was developed. Through cadaveric research and better understanding of the anatomy of the transversus abdominis muscle, the first TAR transversus abdominis release was performed in 2006. In the numerous studies performed since, TAR continues to show low recurrence rates, limited significant wound morbidity, rare mesh complications, and low incidence of mesh explantation. The TAR approach has now been definitively proven to be a valuable technique for abdominal wall reconstruction and can address a wide variety of defects. Moreover, a proper performed TAR has been shown to have no deleterious effects on the abdominal trunk musculature and trunk/core function. A deep understanding of the anatomy, preoperative optimization and precise surgical technique is imperative to performing a TAR and ensuring the best outcome for the patient.