Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From 200 “Components Separation” Procedures Arch Surg. 2009;144(11): doi: /archsurg Modified “components separation” technique using bilateral transverse subcostal incisions to access the external oblique muscle and fascia. A, Using a narrow Deaver retractor and a Bovie cautery with an extender, the external oblique muscle and fascia are divided superiorly (above the rib cage) and inferiorly. B, At the caudal aspect of the midline incision, the cut edge of the external oblique muscle and fascia is delivered using manual traction for complete release. Figure Legend:

Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From 200 “Components Separation” Procedures Arch Surg. 2009;144(11): doi: /archsurg “Components separation” technique with midline approximation of the rectus abdominis muscles. A, No mesh. B, Acellular cadaveric dermis underlay. C, Soft polypropylene mesh underlay. Figure Legend:

Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From 200 “Components Separation” Procedures Arch Surg. 2009;144(11): doi: /archsurg A 41-year-old man with a history of a perforated appendix treated through a midline incision who later developed an incisional hernia. A, Preoperative oblique view after a hernia repair with polypropylene mesh by another surgeon. B, Preoperative computed tomography scan demonstrating the small bowel herniating to the right of the polypropylene mesh, with wide displacement of the rectus abdominis muscles. C, Six-month postoperative oblique view demonstrates restoration of abdominal wall continuity. D, Postoperative anterior view demonstrates stable midline closure and bilateral transverse subcostal incision scars. Figure Legend:

Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From 200 “Components Separation” Procedures Arch Surg. 2009;144(11): doi: /archsurg Predictors of hernia recurrence and major and minor complications using logistic regression controlling for mesh type and follow-up duration. Error bars represent 95% confidence intervals. BMI indicates body mass index. Figure Legend:

Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From 200 “Components Separation” Procedures Arch Surg. 2009;144(11): doi: /archsurg Overall “components separation” procedures based on mesh type. Only the first surgery (N = 200) was included in this series. Subsequent surgeries were performed for hernia recurrences, which were successfully repaired unless otherwise specified. Figure Legend:

Date of download: 7/6/2016 Copyright © 2016 American Medical Association. All rights reserved. From: Abdominal Wall Reconstruction: Lessons Learned From 200 “Components Separation” Procedures Arch Surg. 2009;144(11): doi: /archsurg “Components separation” procedures performed yearly between 1996 and Figure Legend: