Lateral release in the repair of large ventral hernia

Lateral release or component separation technique for the repair of large midline ventral hernias show encouraging results. Successive modifications to the initial technique have incrementally improved outcome. Modifications include minimizing subcutaneous dissection, mesh reinforcement, perforator sparing dissection, variations of released muscle, and application of minimally invasive surgery techniques. Pre-operative assessment may provide valuable cues on the feasibility of or predict successful abdominal wall reconstruction with the lateral release technique. In cases with loss of domain, the application of adjunct pre-operative tissue lengthening techniques may allow successful abdominal wall reconstruction with component separation.