Evidence-Based Abdominal Wall Reconstruction: The Maxi-Mini Approach

Jeffrey E. Janis, Ibrahim Khansa

Research output: Contribution to journalArticlepeer-review

39 Scopus citations


Summary: Complex abdominal wall reconstruction is a high-risk procedure, but it can be performed safely if a systematic approach is followed. In this article, the authors present their evidence-based technique for abdominal wall reconstruction. This approach aims at reducing rates of complications and hernia recurrence, starting with critical patient selection; preoperative patient optimization; adherence to intraoperative principles including preservation of vascular perforators through maintenance of composite tissue with limited undermining; direct supported mesh reinforcement of midline musculofascial reapproximation; use of percutaneous transfascial suture mesh fixation; careful attention to dead space obliteration in any plane; and aggressive soft-tissue resection of marginal, undermined, or tenuous skin and subcutaneous tissue. Postoperative strategies to decrease complications are also used. The authors' surgical technique is described in detail, and pilot data are presented to support the authors' approach.

Original languageEnglish (US)
Pages (from-to)1312-1323
Number of pages12
JournalPlastic and reconstructive surgery
Issue number6
StatePublished - Dec 1 2015

ASJC Scopus subject areas

  • Surgery


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