Skip to main content
SpringerLink
Log in

The Transversus Abdominis Muscle Release (TAR) Procedure

  • Chapter
  • First Online:
The Art of Hernia Surgery

Abstract

The retromuscular repair described by Rives and Stoppa can frequently meet the goals of a hernia repair. Nevertheless, retrorectus-only repair offers restricted myofascial medial advancement and a limited area for mesh placement, which are critical in complex ventral hernias. During recent years, transversus abdominis muscle release (TAR) has gained popularity because it facilitates medial myofascial advancement without creation of large skin flaps or damage to the neurovascular supply of the rectus abdominis muscle and retromuscular reinforcement of the visceral sac.

This chapter describes the anatomical basis, indications, and technical and postoperative aspects of the TAR procedure.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 229.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 299.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rives J, Pire JC, Flament JB, Convers G. Treatment of large eventrations (apropos of 133 cases). Minerva Chir. 1977;32:749–56.

    PubMed  CAS  Google Scholar 

  2. Stoppa R, Louis D, Henry X, Verhaeghe P. Postoperative eventrations. Apropos of a series of 247 surgically treated patients. Chirurgie. 1985;111:303–5.

    PubMed  CAS  Google Scholar 

  3. Iqbal CW, Pham TH, Joseph A, Mai J, Thompson GB, Sarr MG. Long-term outcome of 254 complex incisional hernia repairs using the modified Rives-Stoppa technique. World J Surg. 2007;31:2398–404.

    Article  PubMed  Google Scholar 

  4. Carbonell AM. Rives-stoppa retromuscular repair. In: Novitsky YW, editor. Hernia surgery—current principles. Switzerland: Springer; 2016. p. 107–15.

    Google Scholar 

  5. Novitsky YW, Elliott HL, Orenstein SB, Rosen MJ. Transversus abdominis muscle release: a novel approach to posterior component separation during complex abdominal wall reconstruction. Am J Surg. 2012;204:709–16.

    Article  PubMed  Google Scholar 

  6. Jones CM, Winder JS, Potochny JD, Pauli EM. Posterior component separation with transversus abdominis release: technique, utility, and outcomes in complex abdominal wall reconstruction. Plast Reconstr Surg. 2016;137:636–46.

    Article  CAS  PubMed  Google Scholar 

  7. Pauli EM, Juza RM, Winder JS. How I do it: novel parastomal herniorrhaphy utilizing transversus abdominis release. Hernia. 2016;20:547–52.

    Article  PubMed  Google Scholar 

  8. Petro CC, Orenstein SB, Criss CN, et al. Transversus abdominis muscle release for repair of complex incisional hernias in kidney transplant recipients. Am J Surg. 2015;210:334–9.

    Article  PubMed  Google Scholar 

  9. Pauli EM, Wang J, Petro CC, Juza RM, Novitsky YW, Rosen MJ. Posterior component separation with transversus abdominis release successfully addresses recurrent ventral hernias following anterior component separation. Hernia. 2015;19:285–91.

    Article  CAS  PubMed  Google Scholar 

  10. Majumder A, Fayezizadeh M, Neupane R, Elliott HL, Novitsky YW. Benefits of multimodal enhanced recovery pathway in patients undergoing open ventral hernia repair. J Am Coll Surg. 2016;222:1106–15.

    Article  PubMed  Google Scholar 

  11. Majumder A, Miller HJ, Patel P, Wu YV, Elliott HL, Novitsky YW. Evaluation of antibiotic pressurized pulse lavage for contaminated retromuscular abdominal wall reconstruction. Surg Endosc. 2016;31:2763–70.

    Article  PubMed  Google Scholar 

  12. Novitsky YW, Fayezizadeh M, Majumder A, Neupane R, Elliott HL, Orenstein SB. Outcomes of posterior component separation with transversus abdominis muscle release and synthetic mesh sublay reinforcement. Ann Surg. 2016;264:226–32.

    Article  PubMed  Google Scholar 

  13. Petro CC, Nahabet EH, Criss CN, et al. Central failures of lightweight monofilament polyester mesh causing hernia recurrence: a cautionary note. Hernia. 2015;19:155–9.

    Article  CAS  PubMed  Google Scholar 

  14. Fayezizadeh M, Majumder A, Belyansky I, Novitsky YW. Outcomes of retromuscular porcine biologic mesh repairs using transversus abdominis release reconstruction. J Am Coll Surg. 2016;223:461–8.

    Article  PubMed  Google Scholar 

  15. Majumder A, Winder JS, Wen Y, Pauli EM, Belyansky I, Novitsky YW. Comparative analysis of biologic versus synthetic mesh outcomes in contaminated hernia repairs. Surgery. 2016;160:828–38.

    Article  PubMed  Google Scholar 

  16. Majumder A, Miller HJ, Sandoval V, Fayezizadeh M, Wen Y, Novitsky YW. Objective assessment of myofascial medialization after posterior component separation via transversus abdominis muscle release. J Am Coll Surg. 2016;223:S57.

    Article  Google Scholar 

  17. Petro CC, Raigani S, Fayezizadeh M, et al. Permissive intraabdominal hypertension following complex abdominal wall reconstruction. Plast Reconstr Surg. 2015;136:868–81.

    Article  CAS  PubMed  Google Scholar 

  18. Fayezizadeh M, Majumder A, Neupane R, Elliott HL, Novitsky YW. Efficacy of transversus abdominis plane block with liposomal bupivacaine during open abdominal wall reconstruction. Am J Surg. 2016;212:399–405.

    Article  PubMed  Google Scholar 

  19. Krpata DM, Blatnik JA, Novitsky YW, Rosen MJ. Posterior and open anterior components separations: a comparative analysis. Am J Surg. 2012;203:318–22. discussion 22

    Article  PubMed  Google Scholar 

  20. Winder JS, Behar BJ, Juza RM, Potochny J, Pauli EM. Transversus abdominis release for abdominal wall reconstruction: early experience with a novel technique. J Am Coll Surg. 2016;223:271–8.

    Article  PubMed  Google Scholar 

  21. Espinosa-de-los-Monteros A, Avendano-Peza H, Gomez-Arcive Z. Comment to comment article “Posterior component separation with transversus abdominis release successfully addresses recurrent ventral hernias following anterior component separation” Pauli EM, et al. Hernia 2015;19:285-291. Tulloh B, de Beaux AC and to Reply to comment article “Posterior component separation with transversus abdominis release successfully addresses recurrent ventral hernias following anterior component separation” Tulloh B et al. Hernia 2015;19:687–688. Pauli EM, Rosen MJ. Hernia. 2015;20:335–7.

    Article  Google Scholar 

  22. Appleton ND, Anderson KD, Hancock K, Scott MH, Walsh CJ. Initial UK experience with transversus abdominis muscle release for posterior components separation in abdominal wall reconstruction of large or complex ventral hernias: a combined approach by general and plastic surgeons. Ann R Coll Surg Engl. 2017;99:265–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Samartsev VA, Gavrilov VA, Parshakov AA, Kuznetsova MV. Posterior separation hernioplasty TAR in treatment of postoperative ventral hernias W3 (Article in Russian). Perm Med J. 2017;XXXIV:35–42.

    Google Scholar 

  24. Oprea V, Radu VG, Moga D. Transversus abdominis muscle release (TAR) for large incisional hernia repair. Chirurgia (Bucur). 2016;111:535–40.

    Article  Google Scholar 

  25. De Silva GS, Krpata DM, Hicks CW, et al. Comparative radiographic analysis of changes in the abdominal wall musculature morphology after open posterior component separation or bridging laparoscopic ventral hernia repair. J Am Coll Surg. 2014;218:353–7.

    Article  PubMed  Google Scholar 

  26. Criss CN, Petro CC, Krpata DM, et al. Functional abdominal wall reconstruction improves core physiology and quality-of-life. Surgery. 2014;156:176–82.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University Hospitals Cleveland Medical Center, Cleveland, OH, USA

    Luis A. Martin-del-Campo & Yuri W. Novitsky

Authors
  1. Luis A. Martin-del-Campo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yuri W. Novitsky
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yuri W. Novitsky .

Editor information

Editors and Affiliations

  1. University of Insubria, Istituto Clinico, Sant’Ambrogio General Surgery Day Surgery, Milan, Italy

    Giampiero Campanelli

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Martin-del-Campo, L.A., Novitsky, Y.W. (2018). The Transversus Abdominis Muscle Release (TAR) Procedure. In: Campanelli, G. (eds) The Art of Hernia Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-72626-7_61

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-72626-7_61

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-72624-3

  • Online ISBN: 978-3-319-72626-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation