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Procedure · Muscle release

TAR & component separation.

When a defect is too wide to close, the muscle layers themselves are released so the wall can be brought back to the midline without tension. The operation behind most large and recurrent reconstructions — and the area Ram is most often sent.

Some hernias are simply too wide to close. The edges of the muscle have drifted so far apart that pulling them back together would put the repair under tension — and tension is what makes a repair fail. Component separation solves this by deliberately releasing one of the layered muscles of the abdominal wall, which lets the whole wall stretch back to the midline and close without strain.

Transversus abdominis release (TAR) is the posterior form of this: the deepest muscle layer is released from inside, which both frees the wall and opens a large, well-supplied space for mesh. It is the technique behind most large and complex reconstructions, and it is usually combined with a retromuscular (Rives–Stoppa) repair.

Who it's for

  • Large ventral and incisional hernias too wide to close by standard repair.
  • Recurrent hernias where previous repairs have given way.
  • Hernias with loss of domain, where much of the abdominal contents sit outside the abdomen.
  • Complex walls — previous mesh, multiple operations, or contamination.

How it's done

  • The hernia is fully dissected and the contents returned to the abdomen.
  • The retromuscular plane is opened, and the transversus abdominis muscle is released on each side as needed.
  • This frees the wall to come back to the midline, where the muscle is closed without tension.
  • A large mesh is laid in the space created, extending well beyond the defect, and the wall is closed over it.

For larger reconstructions this is an open operation. In selected patients, TAR can be performed with a robotic platform, allowing the same release and retromuscular repair to be done through keyhole incisions where the defect suits it.

The aim. Not to patch a hole, but to rebuild a working abdominal wall — muscles meeting in the midline, mesh in a protected plane, no tension. That is what separates a repair that lasts from one that recurs.

Preparation matters as much as the operation

For surgery this size, what happens beforehand shapes the result. Weight loss, stopping smoking and good diabetic control measurably lower the risk of wound problems and another recurrence. Very large hernias with loss of domain sometimes need specific preparation of the abdominal wall so the abdomen can re-accommodate its contents. This preparation is treated as part of the operation, not a delay to it.

Recovery

This is major surgery. Expect several days in hospital and a gradual return over six to eight weeks or more, depending on the size of the repair, with clear limits on lifting while the reconstructed wall consolidates. The trade-off is a wall rebuilt to last. A detailed, individual recovery plan is discussed before surgery.

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Common questions

TAR & component separation — answered

A family of techniques that release one of the layered muscles of the abdominal wall so the muscles can be brought back together at the midline and closed without tension. Used for large, wide hernias that could not otherwise be closed.
A posterior component separation: the transversus abdominis muscle is released from inside, which lets the wall stretch back to the midline and opens a large space for mesh. It is the technique behind most large and recurrent reconstructions.
When a defect is too wide to close even with a standard retromuscular repair. Rather than leave a gap or close under tension — which leads to recurrence — the muscle layers are released so the wall can be reconstructed properly.
This is major surgery — several days in hospital and a gradual return over six to eight weeks or more, with clear limits on lifting. Preparation beforehand — weight, smoking, diabetes — measurably improves the result.