ABSTRACT
Abdominal wall surgery is usually a significant undertaking with an associated morbidity and mortality, and the exchange of information between doctor and patient is central to good decision-making. Not all surgeons who perform these procedures are able to offer adjuncts such as BT(A) injections or progressive Pre-operative pneumoperitoneum, or techniques such as posterior component separation and many may not have the capability to involve plastic or bariatric surgeons when required for their hernia patients. Operative technique must minimise enterotomy as this significantly increases the risks of post-operative complications in general and specifically the development of an enterocutaneous fistula as well as being a risk factor in itself for subsequent mesh infection. Usually a two-stage technique is used with initial insertion of the tissue expander followed by gradual filling of the expander over subsequent weeks to months, prior to the second stage of definitive abdominal wall repair and expander removal.
