scholarly journals Rives – Stoppa surgery – the foundation of the modern concept of treatment of patients with ventral hernias (55 years in surgery)

2021 ◽  
Vol 179 (6) ◽  
pp. 107-110
Author(s):  
V. V. Semenov ◽  
A. A. Kurygin ◽  
S. D. Tarbaev ◽  
A. A. Mamoshin

The treatment of ventral hernias in the history of surgery has always been an urgent problem. In the 90s of the XIX century, hernioplasty using metal threads and plates began, but the long-term results of treatment of patients remained unsatisfactory. A particularly urgent problem in herniology during the last century was the treatment of postoperative ventral hernias, and patients with large and even more giant hernias were often recognized as incurable. The great revolution in herniology was the introduction into practice of biologically inert mesh polymer materials. A fundamentally different method of endoprosthesis of the abdominal wall is retromuscular («sublay») hernioplasty, proposed by the French surgeon of Algerian origin Rene Stoppa in 1965. In 1966, a compatriot, colleague and friend R. Stoppa Jean Rives used the principles of this technique when eliminating postoperative median hernia by prosthetics of the anterior abdominal wall retromuscularly through the xiphopubic incision. Decades later, during the rapid development of endovideosurgery, the principle of operation Rives-Stoppa was the foundation for the development of modern minimally invasive and highly effective methods for eliminating inguinal and other ventral hernias. Thus, the method of prosthetics of the anterior abdominal wall proposed 55 years ago by Rives-Stoppa was an ideological breakthrough in herniology and significantly improved the results of operations for external abdominal hernias.

1982 ◽  
Vol 63 (3) ◽  
pp. 37-40
Author(s):  
B. L. Elyashevich ◽  
F. Sh. Sharafislamov ◽  
R. M. Ramazanov

Developed and applied in patients with hernias of the anterior abdominal wall a method of plasty with own tissues using a mechanical suture. 109 patients with postoperative and recurrent ventral hernias were operated on. This method of ventral hernia repair allows to restore the anatomy and function of the abdominal wall, standardizes and simplifies the technique of the operation, reducing the time of its implementation, and gives 95.4% positive long-term results.


2020 ◽  
Vol 13 (1) ◽  
pp. 10-17
Author(s):  
Boris Semyonovich Sukovatykh ◽  
Pyotr Mikhailovich Nazarenko ◽  
Yuriy Yurievich Polevoy ◽  
Yuriy Yurievich Blinkov ◽  
Andrey Alexeevich Netyaga ◽  
...  

Importance. Functional results of treatment of the ventral hernias of the medial localization after endoprosthetics of the abdominal wall by the standard polypropylene prosthesis remain unsatisfactory because of the limited flexibility of the abdominal wall. Purpose. To improve functional results of treatment of patients with ventral hernias of the medial localization by applying a light strengthened endoprosthesis. Materials and methods. There was done a comparative analysis of the results of treatment of 60 patients with medial hernias of the anterior abdominal wall. Patients were divided into two groups with 30 people in each group. In the first group over-aponeurotic endoprosthetics of the abdominal wall defect was provided with the use of a standard polypropylene prosthesis with the thread diameter 120 micron, while in the second group there was used a light strengthened endoprosthesis with the thread diameter in the basic zones 90 micron and in the strengthened zones 120 and 90 micron. Effectiveness of treatment in the nearest post-operative period was evaluated by the degree of severity of inflammatory implantation response, and in the long-term period evaluation was done on the base of functional state of the abdominal muscles, quality of life of patients and results of treatment by four point scale. Results and their discussion. Inflammatory exudative response on implantation of the light strengthened endoprosthesis was less and reparative response was 1,1 times higher compare to a standard prosthesis. Endoprosthetics of the abdominal wall with a light strengthened endoprosthesis improved contractility of the abdominal muscles in 1,2 times. Restoration of the functions of the abdominal muscles had a positive influence on quality of life, namely, physical component of health improved by 4,5%, as well as on long-term results of treatment by the increased number of excellent and good results of treatment by 20% and reduction of satisfactory results by 20%. Conclusions. The use of a light strengthened endoprosthesis enables to improve the functional results of treatment of ventral hernias of the medial localization.


Aloplasty of incisional ventral hernia (IVH), method of placement and fixation nanomodified polypropylene mesh retro muscular, buth this is accompanied by a fairly high freguency of postoperative complications from the postoperative wound. In our view, the use of a nanomodified polypropylene mesh modified by carbon nanotubes and an antiseptic of polyhexamethlene guanidme chloride in combination with the method of placement and fixation retro muscular the results of operative treatment of IVH. Aim – to improve the results of operative treatment of incisional ventral hernias in combination with the method of placement and fixation retro muscular nanomodified polypropylene mesh. Materials and methods. The analysis of operative treatment of 148 patients with IVH of has been performed. Depending on the type of mesh used during surgical treatment, patients were divided into 2 groups. In 74 (50%) of Group I patients, method of placement and fixation nanomodified polypropylene mesh retro muscular. In the 2nd group, 74 (50%) patients method of placement and fixation retro muscular of a classic polypropylene mesh. Results and discussion. Statistically significant results were obtained in patients of Group I compared to Group II: seroma was in 24 (32.4±1.2%) in Group II compared to 5 (6.8±0.5%) in Group I (p<0.05), respectively, the suppuration of the postoperative wound – 7 (9.5±0.5%) to 1 (1.4±0.2%) (p<0.05). The terms of stay of patients of group II on inpatient treatment – 12,1±2,3 days group II – 7,1±1,1 days. Long-term results: ligature fistulas of the anterior abdominal wall were detected in 5 (7.7±0.5%) patients of group II, in patients of group I of the ligature fistulas were not detected (p<0.05), meshoma – in 3 (4.6±0.3%) of patients in group II, in group I there was no stir (p>0.05). Chronic pain in the abdominal wall in 6 – 8 months after surgery was observed in 5 (7.7±0.6)% patients in group II and in 1 (1.5±0.2%) group I (p>0.05), recurrences of hernia were found in 6 (9.2±0.6%) patients of group II, in group I – in 1 (1.5±0.2)% (p<0.05). Conclusion. Operative treatment of IVH method of placement and fixation nanomodified polypropylene mesh retro muscular is more effective compared with the use of the classical polypropylene mesh, namely, reducing the freguency of seroma from 32.4±1.2% in the II group of patients to 6.8±0.5% in group I, respectively, suppurations of postoperative wounds – from 9.5±0.5% to 1.4±0.2%, inflammatory infiltrates – from 12.2±0.6% to 1.4±0.2%, ligaturial fistulas of the anterior abdominal wall – from 7.7±0.5% to 0%, meshoma – from 4.6±0.3% to 0%, chronic postoperative pain – from 7.7±0.6% to 1.5±0.2%, recurrence of hernia–from 9.2±0.6% to 1.5±0.2%.


2013 ◽  
pp. 31-34
Author(s):  
Yu. G. Trofimovich ◽  
◽  
D. V. Cherdancev ◽  
I. N. Bolshakov ◽  
L. A. Shestakova ◽  
...  

2020 ◽  
Vol 7 (10) ◽  
pp. 3348
Author(s):  
Sheetal Ishwarappagol ◽  
Rohit Krishnappa

Background: Loss of continuity of abdominal wall significantly affects the functions of protection of viscera, postural stabilization, and maintenance of intra-abdominal pressure. The newer understanding of abdominal wall reconstruction (AWR) aims at restoring abdominal wall anatomy and function, instead of simply patching the defect. We want to showcase the changing trends and results in hernia repair at a Medical Institution.Methods: This is an observational retrospective study conducted in RRMCH, Bengaluru from July 2018-2019 including all patients with ventral hernia undergoing the specified hernia repairs.Results: A total of 54 patients with ventral hernias undergoing routine hernia repairs/AWR surgeries were retrospectively analysed. The overall mean age was 46.62±12.44 year. Majority subjects were females (n=37; 68.5%), and overweight (Mean BMI=28.07±3.01/m2). 14 patients (25.92%), all males, had history of tobacco consumption. There were 38 (70.37%) primary ventral hernias and 7 recurrent hernias. Overall mean defect size was 10.2±0.4 cm. Most frequently performed was open retro rectus Hernioplasty (n=18; 33.33%), followed by open Preperitoneal Hernioplasty (n=17; 31.48%), laparoscopic intraperitoneal onlay mesh (IPOM) (n=16; 29.62%) and open transversus abdominis release (TAR) (n=3; 5.5%). On statistical analysis, it was found that Open repairs had higher post-operative pain (p=0.0005), longer hospitalization (p=0.0002) and higher incidence of surgical site events (p=0.0134) when compared to Laparoscopic repairs.Conclusion: As known already, minimally invasive techniques of hernia surgeries are shown to have acceptable outcomes when compared to radical open surgeries. Newer techniques of AWR are being employed to routine cases in larger numbers, and not just for complex reconstruction, at most centres with acceptable outcomes. 


2018 ◽  
pp. 116-118
Author(s):  
M.V. Makarenko ◽  
◽  
D.O. Govseyev ◽  
S.V. Gridchin ◽  
N.H. Isaeva ◽  
...  

Desmoid tumors (also called desmoids fibromatosis) are rare slow growing benign and musculoaponeurotic tumors. Although these tumors have a propensity to invade surrounding tissues, they are not malignant. These tumors are associated with women of fertile age, especially during and after pregnancy and postoperative surgeries. Our clinical case is interesting because of the rarity of the pathology and the difficulties in setting the correct diagnosis. The patient, with a history of laparoscopic myomectomy (2012), was preparing for a routine surgery for the endometrioma of the anterior abdominal wall, according to the results of the ultrasound and computed tomography. After surgical treatment, the final diagnosis was changed, based on the histological findings. Key words: desmoid tumor, abdominal wall tumor, fibroid.


2021 ◽  
Vol 93 (5) ◽  
pp. 1-5
Author(s):  
Svetlana Sokolova ◽  
Andrey Sherbatykh ◽  
Konstantin Tolkachev ◽  
Vladimir Beloborodov ◽  
Vadim Dulskiy ◽  
...  

The Aim of research is to improve the results of surgical treatment of incisional ventral hernia by applying a case-specific approach and a new method of plastic repair of anterior abdominal wall. The prospective controlled dynamic study is based on incisional ventral hernia treatment results with the use of meshed endoprostheses among 219 patients. On-lay alloplasty was used in patients younger than 60 years of age, without severe concomitant pathology, with small and medium hernias and anterior abdominal wall defect of up to 10 cm (W1 - W2). The article shows a selection algorithm for anterior abdominal wall plastic repair method. It goes through advantages of the author’s proprietary technique. The article displays frequency and patterns of complications, life quality of the patients after various prosthetic plastic repairs. In the main group, positive treatment results were observed in 65.0%, long-term results of the operation were observed in 88.4%, complications occurred in 13.6%, relapse in 4.5%. «On lay» treatment tactics showed positive results in 59.4%, long-term results of the operation were observed in 74.7%, complications occurred in 40%, relapse in 3.1%. After «sub lay» intervention, excellent results were observed in 40.0% of patients, long-term results of the operation were observed in 81.9%, complications occurred in 12%, and relapse in 1.4%.


2015 ◽  
Vol 81 (10) ◽  
pp. 955-960 ◽  
Author(s):  
Shawn Diamond ◽  
H. Gill Cryer

Grading systems developed by the Ventral Hernia Working Group (VHWG) for complex open abdominal wall reconstruction rely on limited outcomes: surgical site occurrence (SSO) and hernia recurrence. This does not account for the longitudinal restoration of a functional abdominal wall and the ability to correct complications. We performed a single-site, retrospective review of consecutive complex open abdominal wall reconstruction interventions with 24-month minimum follow-up to establish reoperation rates and compare long-term results to the VHWG. About 125 midline hernia repairs (>200 cm2) were studied. All had loss of functional domain and 47-month average follow-up. Demographics included: mean age 57 years, 47 per cent male, 63 per cent obese, and 34 per cent with contamination. Rates of SSO per VHWG grade were 9 per cent grade I, 45 per cent grade II, and 55 per cent grade III. Forty-three of 59 patients who developed complications were eventually successful after reoperation leading to an 87 per cent restoration rate. Select factors independently associated with reoperation included biological mesh and clinical history of infection. Although rates of SSO were higher than the VHWG published, we experienced high salvage rates except in patients who underwent biologic repair. We recommend restricted use of biologic mesh in contaminated and clean fields as well as modifications to the VHWG grading and recommendations.


2019 ◽  
Vol 1145 ◽  
pp. 012010
Author(s):  
I Kalyakanova ◽  
A Protasov ◽  
Z Kaitova ◽  
A Kulakova ◽  
A Kodirova ◽  
...  

2016 ◽  
Vol 3 (2) ◽  
pp. 44-46
Author(s):  
Salamat Khan ◽  
Krishna Bhasyal ◽  
Bhusan Raj Timilsina

We are reporting a case of abdominal wall endometrioma (AWE) in a 32-year-old woman who had an 8 months history of lower abdominal pain and lump. The physical examination revealed an ill-defined mass without tenderness. Computed tomography (CT) showed an enhancing is odense mass at the level of umbilicus right to mid line in right rectus abdominis muscle. The patient was treated with a wide radical resection with a 1 cm margin. There was no postoperative complication. The histological examination confirmed endometriosis. The patient is now on regular follow-up and doing well without any recurrence, five months after her operation.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10Page: 44-46 


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