Features of surgical treatment of patients with postoperative ventral hernias

Abstract

Aim. Improvement of methods of hernioplasty of ventral hernias by using endo-mesh with various types of separation plastics.

Material and methods. The material is based on the result of surgical treatment of 148 patients with POVH. Depending on the method of intervention used, all operated patients were divided into 3 groups. The first group included 58 patients who underwent hernia orifice plasty by the anterior separation method. The second group included 44 patients who underwent posterior separation plasty. The remaining 46 patients made up the third group, who underwent standard “stretch” methods of hernioplasty of the Onlay (n=28) and sublay (n=18) types.

Results and discussion. The main points influencing the choice of the method of surgery in patients of all 3 observed groups were the indicators of intraoperative examination of the level of intra-abdominal pressure. In patients of the first group in the immediate postoperative period with the use of anterior separation plasty, complications from the wound occurred in 10 (17.2%) patients. In the second group of patients who underwent posterior separation plasty, a similar complication was noted in 4 (9.1%) patients. In the examined third group, who used tension methods of hernioplasty, complications from the wound were observed in 7 (15.2%) cases.

Conclusion. POVH in 25% of cases remains a complication of laparotomy, especially in obese patients with a lot of concomitant somatic pathologies. The recurrence of hernias and lethality with standard tension methods of hernioplasty remains high compared with the proposed options for separation plastics using endomesh.