Endoscopic Component Separation



UW Health surgeons at UW Hospital and Clinics in Madison, Wisconsin, perform a minimally invasive surgery called endoscopic component separation in order to reconstruct the abdominal wall. The abdominal wall may require reconstruction to prevent recurrence of an incisional hernia (a hernia that develops at the site of a former surgical incision).


The Procedure


This minimally invasive approach allows the surgeon to separate the layers of the abdominal wall which provides much more mobility for each of these layers. This is critical as it facilitates closure of the hernia defects in a manner that reduces tension on the closure. This increases the likelihood that the hernia repair will be durable over time.


Once in the operating room, patients are placed under general anesthesia. There are typically three small incisions made in the lateral abdominal wall. A laparoscope is placed into one of the incisions and laparoscopic scissors are used to identify the external oblique fascia (abdominal tissue enclosing the ribs). The surgeon is then able to separate the external oblique fascia from the ribs all the way down toward the lower abdomen. This technique is favorable because it reestablishes the natural function of abdominal muscles, might not require placement of synthetic mesh (which is beneficial to patients who have experienced former complications and infection from surgical mesh) and has superior cosmetic results.


The Difference of Minimally Invasive


There are numerous benefits to having this procedure performed endoscopically rather than with the traditional open method:

  • Faster recovery
  • Less pain post-operatively
  • Fewer post-operative complications
  • Cosmetic appeal
  • Smaller incisions are more ideal for already weakened abdominal tissue. Large incisions can further weaken the abdominal tissue, increasing the risk of recurrence.