Unrepaired hernias can get bigger and become more susceptible to incarceration and strangulation. These can lead to more serious health issues such as tissue death or gangrene.
Very large hernias used to be considered irreparable, but with the TAR method, repair of these large hernias is now possible.
We talked with General Surgeon Dr. David Schutter of Premier Surgical Associates of North Knoxville to learn about this new hernia repair technique. Dr. Schutter has specialized training in treating foregut conditions using robotic and laparoscopic technologies.
What is TAR?
“TAR or Transversus Abdominis Muscle Release is kind of a newer technique in repairing very large hernias.
The abdominal wall is composed of different layers and one of those layers is the transverse abdominis, part of that is muscle and part of that is fascia. If you can release that layer from the overlying and underlying layers, you can kind of stretch the body’s own tissues to cover large hernia defects.
We don’t do it in all hernia patients. If it’s just a small hernia, we will utilize other forms of hernia repair. But for large hernias, we recommend this as we can get 10 cm of coverage simply by releasing that layer.”
How new is this technique?
“The open technique was introduced in 2009, but the robotic technique didn’t start until 4 or 5 years ago. I have done two robotic ones here in Knoxville.”
What’s the advantage of using the robotic technique for this procedure?
“Compared to the open technique, the robotic technique involves smaller incisions (six incisions in total compared to the very large incision involved in the open technique).
In-patient hospital stay for those who have open TAR is usually around 6-7 nights. With the robotic technique, it’s just 1 day.”
Who qualifies for TAR?
“People who have large hernias. We don’t normally consider the TAR technique not until a hernia is at a minimum of 6-8 cm in diameter. If the hernia is smaller than 6cm, we would repair the hernia with a different technique. Component separation or TAR is reserved for larger or recurrent hernias that have failed their techniques. The patient also needs to fit for the surgery from a cardiopulmonary standpoint. The TAR surgery can take as long as 2.5 to 3.5 hours.”
What can patients expect after the robotic TAR surgery?
“They can expect to be a little bit better after the surgery and can expect to return to normal functioning earlier.
My only limitation to patients is to not lift anything heavier than 10 lbs in two weeks and nothing heavier over 20 lbs in the next two weeks.
If they’re feeling good after the two consultations, then they can get back to their normal activities.”
To learn if you may be a candidate for robotic TAR surgery is right for you, consult with an experienced surgeon. To request an appointment with Dr. Schutter or any of our excellent Premier Surgical physicians, complete this appointment form: https://www.premiersurgical.com/request-appointment/.