BASED ON SELECTION CRITERIA OF GERNIOALLOPLASTIC IN POSTOPERATIVE VENTRAL HERNIAS
Keywords:
Ventral hernia, hernioalloplasty, standart approach, extracorporeal sutures, created preperitoneal pocket.Abstract
According to the World Health Organization, hernia of the anterior abdominal wall is considered one of the most common surgical diseases, it is observed among 3-7% of the population, and the disease is observed mainly among the population of working age. More than 5% of all laparotomies are complicated by the formation of postoperative ventral hernias, and the frequency of their occurrence depends on the nature and urgency of the surgical intervention. About 10% of all surgical interventions are ventral hernia removal operative approach.
When choosing the method of hernioalloplasty for ventral hernias after the operation, it is necessary to determine the size of the defect of the anterior abdominal wall and the ratio of the hernia to the volume of the abdominal cavity, based on the computer tomography data.
Improvement of the technical aspects of endoprosthesis fixation in small and medium-sized (W1-W2) ventral hernias after laparoscopic hernioalloplasty in the IPOM method greatly simplified the technique of performing the operation and shortened its duration.
Optimizing the tactical and technical aspects of implantation of an endoprosthesis with the help of pre-set П-shaped sutures in the "onlay" method and the combined "onlay + sublay" method, the development of compartment syndrome and keying in large and giant (W3-W4) hernias. allowed to reduce the recurrence of the disease.
Based on the criteria for selecting the hernioalloplasty method, the recommended algorithm for the treatment of patients with postoperative ventral hernia allowed to reduce the frequency of postoperative complications from 11.9% to 4.3%, not to develop compartment syndrome, and to reduce the recurrence of the disease (in the main group and in the comparison group). 2.4% and 6.3% respectively.
Optimizing the tactical and technical aspects of implantation of an endoprosthesis with the help of pre-set P-shaped sutures in the "onlay" method and the combined "onlay + sublay" method, the development of compartment syndrome and keying in large and giant ( W3-W4) hernias. allowed to reduce the recurrence of the disease.
Based on the criteria for selecting the hernioalloplasty method, the recommended algorithm for the treatment of patients with postoperative ventral hernia allowed to reduce the frequency of postoperative complications from 11.9% to 4.3%, not to develop compartment syndrome, and to reduce the recurrence of the disease (in the main group and in the comparison group). 2.4% and 6.3% respectively.
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