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Siegal et al. Plast Aesthet Res 2019;6:25 Plastic and
DOI: 10.20517/2347-9264.2019.35 Aesthetic Research

Review Open Access

Posterior component separation/transversus
abdominis release

Steve R. Siegal, Eric M. Pauli

Division of Minimally Invasive and Bariatric Surgery, Penn State Health, Department of Surgery, Hershey, PA 17033, USA.

Correspondence to: Dr. Steve R. Siegal, Division of Minimally Invasive and Bariatric Surgery, Penn State Health, Department of
Surgery, Hershey, PA 17033, USA. E-mail: ssiegal@pennstatehealth.psu.edu
How to cite this article: Siegal SR, Pauli EM. Posterior component separation/transversus abdominis release. Plast Aesthet Res
2019;6:25. http://dx.doi.org/10.20517/2347-9264.2019.35

Received: 4 Oct 2019 First Decision: 23 Oct 2019 Revised: 30 Oct 2019 Accepted: 19 Nov 2019 Published: 29 Nov 2019

Science Editor: Alexander F. Mericli Copy Editor: Cai-Hong Wang Production Editor: Tian Zhang

Abstract

The Rives-Stoppa technique for ventral hernia repair is commonly utilized due to well-proven outcomes with low overall
morbidity. However, this approach is limited by the amount of myofascial advancement and sublay space available for
a wide mesh overlap. Thus, anterior component separation was developed to allow further myofascial advancement.
Some limitations were noted, which led to the subsequent study, utilization, and refinement of the posterior component
separation (PCS) technique. PCS continues to demonstrate low hernia recurrence, surgical site occurrences, and
improvement in rectus muscle function. Continued adoption of this technique has expanded to minimally invasive approaches
for hernia repair. This paper is a comprehensive review of the evolution of PCS, technique, and outcomes.

Keywords: Posterior component separation, transversus abdominis release, ventral hernia repair

INTRODUCTION
The major tenants of herniorrhaphy and abdominal wall reconstruction are reduction of the hernia,
defect closure, and strengthening the repair with mesh reinforcement. While small ventral defects lend
themselves to various techniques of herniorrhaphy, larger, recurrent, and more complex hernias require
[1]
more nuanced approaches. Stoppa et al. published his original technique of preperitoneal repair of
recurrent bilateral inguinal hernias with polyester mesh in 1973. This was shortly followed by a colleague,
[2]
Rives et al. , who described incisional hernia repair with mesh placed behind the rectus muscle to protect

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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