The Importance of Anatomical Study of Abdominal Wall for General Surgeons: A Transversus Abdominis Release (Tar) Eventroplasty Serie

Abstract Aim To know the importance of anatomical study of abdominal wall to prevent possible injuries. Material and methods Observational, descriptive, retrospective study in our hospital of patients operated using TAR technique (2019–2023). Variables used were demographic, EHS (European Hernia Society) incisional hernia classification and complications after surgery. Anatomical study was performed in cadaverical bodies donated to University. Results TAR technique was performed in 13 patients. Medium age was 56 years old, most of them were men (54%). According to the EHS classification, the most frequent incisional hernia was M3 (84.6%), followed by M4 (61.5%) and M2 (53.8%). In our TAR series was W2 (61.5%) and W3 (30.8%) (Graphic 1). All patients were operated by median laparotomy. 46% of the patients had some complication (Table 1): Only one patient operated had flaccidity abdominal wall. Conclusions Knowing anatomical structures is important for all surgeons. One of the most important structures for performing a TAR are nerve branches between transversus and inner oblique muscle. Transversus abdominis muscle goes to 5°–6° ribs and L1–L5 vertebra to iliac crest and goes to medium line (Linea Alba) to cover posterior fase of rectum muscle (except in the inferior part performing Douglas Arc). The most important function is: tigthen abdominal wall, expiration and posture. Anterior abdominal wall (skin, muscles and parietal peritoneum) is nerved by anterior branches of thoracic nerves (T7–12) and L1. This nerves go by Transversus muscle and inner oblique muscle. An experienced abdominal wall surgeon could avoid denervation abdominal wall and therefore flaccidity and no aesthetic abdominal wall avoiding a posterior plastic surgery performed.Table 1:Complications after surgery (n = 13).Seroma0 (0%)Abscess2 (15%)Skin necrosis3 (23%)Mesh infection1 (7%)Hematoma0 (0%)Recurrence1 (7%)Celulitis0 (0%)Ileo0 (0%)Tract urinary infection0 (0%)Pneumonia0 (0%)Deep vein trombosis0 (0%)Pulmonary embolism1 (7%)Flaccidity1 (7%)Graphic 1:Patients with TAR eventroplasty classify by EHS Classification.Image 1:Anatomical study of abdominal wall in cadaverical studies.