In order to repair multiple hernias of the abdominal wall, for example midline hernias and hernias related to colostomy or ileostomy procedures a large exposure is needed to properly perform a repair. Often the previous multiple incisions can be incorporated and included into one wound to obviate or prevent complications from wound breakdown.
Further, massive hernias of the abdominal wall may require multiple stages to repair. When repairing hernias, stable soft tissue coverage is important. In patients who have developed a loss of domain because of prior open wounds, a component separation may be employed to recruit more tissue to facilitate closure. Occasionally, in large tumors of the abdominal wall, the plastic and reconstructive surgeon will use the tensor fascia lata muscle from the thigh to close the wound.
The tensor fascia lata is harvested and exposed and then rotated towards the abdomen. The upper border of the abdominal fascia can be closed and the inferior portion can be closed as an underlay with the tensor fascia lata.