Minimally invasive components separation--an updated method for closure of abdominal wall defects.

Purpose: We describe a new minimally invasive percutaneous/laparoscopic-assisted technique based on the principles of the original open components separation described by Ramirez et al.

Methods: The technique of minimally invasive components separation (MICS) is described in detail as a stepwise approach. The main advantages of MICS are compared with its traditional open counterpart and previously described endoscopic/laparoscopic modifications.

Results: Open components separation is associated with increased wound problems due to extensive dissection. The MICS technique minimizes the need for large myocutaneous flap dissection, which in turn decreases postoperative wound complications. We have successfully corrected abdominal defects as large as 12 cm in diameter (113 cm(2)) with our MICS technique in a high-risk group of patients with minimal morbidity.

Conclusion: The objectives of abdominal wall reconstruction, which includes restoring structural support, providing stable soft-tissue coverage, and optimizing aesthetic appearance, were all obtained with this newly described MICS technique. We believe that MICS is a safe, practical choice for repair of ventral hernia defects, because it minimizes postoperative morbidity and restores abdominal wall physiology.