ABSTRACT
The pre-operative workup of the patient for an Endoscopic Component Separation (ECS) is little different from other hernia repairs and so should include a CT scan to identify any potential problems with the planned approach and to allow the surgeon to construct an alternate plan in the case of problems. ECS was one of the techniques introduced in an attempt to reduce the incidence of surgical site occurrence and wound morbidity. The correct endoscopic working space for ECS is between the external oblique and internal oblique, and it is essential that reliable access to this plane is achieved to become proficient in ECS. ECS is a relatively straightforward technique for the experienced laparoscopic surgeon to learn, especially if they are already experienced in totally extraperitoneal repair of groin hernias. In certain circumstances unilateral ECS may be combined with a contra-lateral TAR or anterior component separation; a common scenario being repair of incisional hernia after reversal of Hartmann procedure.
