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34.4%, p = 0.91).Ĭonclusion: Rates of open and MIS component separation were similar for smaller versus larger hernias. The rate of MIS repair was no different for smaller (< 6 cm) versus larger (6 + cm) hernias (35.0% vs. Notably, 168 (40%) of all component separations were performed for hernias < 6 cm in size, while 29 (7%) of component separations were for hernias measuring less than 2 cm. Median hernia size was not different between open and MIS cohorts (7.5 vs. Hernia size was available for 398 (72%) of patients. Results: Of the 554 total component separations in our sample, 380 (69%) were performed open and 174 (31%) were done via MIS approach. Mann–Whitney U tests were used to compare nonparametric variables. MIS) and hernia size (diameter or width in cm) for all patients in the sample. Descriptive statistics were used to evaluate the distribution of surgical approach (open vs. We specifically excluded patients only undergoing subcutaneous flaps or diastasis recti repairs. We included patients undergoing anterior or posterior abdominal component separation (CPT code 15734) for ventral hernia. Methods: We performed a retrospective cohort study from Januto Jusing data from the Michigan Surgical Quality Collaborative Hernia Registry (MSQC-HR), a state-wide, population-level registry that captures nuanced hernia and operation-specific details. Our study sought characterize hernia size and operative approach for patients undergoing abdominal wall component separation. Moreover, the lack of granular clinical data have prevented exploration into appropriate utilization of component separation by surgeons. Despite increased utilization of component separation over time and the uptake of MIS approaches, it remains unclear how hernia size and operative approach influence a surgeon’s choice to perform component separation at the time of hernia repair. Minimally invasive (MIS) approaches (e.g., laparoscopic or robotic) to component separation may lead to decreased morbidity. Introduction: Abdominal wall component separation includes techniques to facilitate durable repair of large (> 6–10 cm) or complex ventral hernias. Brian T Fry, MD, MS 1 Sean M O'Neill, MD, PhD 1 Ryan A Howard, MD 1 Jenny M Shao, MD 2 Anne P Ehlers, MD, MPH 1 Michael J Englesbe, MD 1 Justin B Dimick, MD, MPH 1 Dana A Telem, MD, MPH 1 1University of Michigan 2University of Pennsylvania