Aloplasty of oncisional ventral hernias of using nanomodified polypropilene mesh

Actual problems of modern medicine ◽

10.26565/2617-409x-2019-3-09 ◽

2019 ◽

Keyword(s):

Abdominal Wall ◽

Operative Treatment ◽

Polypropylene Mesh ◽

Anterior Abdominal Wall ◽

Long Term Results ◽

Postoperative Wound ◽

Group I ◽

Method Of Placement ◽

Group Ii ◽

Ventral Hernias

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%.

Download Full-text

Laparoscopic preperitoneal alloplasty of postoperative ventral hernias

Klinicheskaia khirurgiia ◽

10.26779/2522-1396.2020.5-6.50 ◽

2020 ◽

Vol 87 (5-6) ◽

pp. 50-54

Author(s):

Ya. P. Feleshtynsky ◽

O. M. Lerchuk ◽

V. V. Smishchuk ◽

Ya. M. Hudyma

Keyword(s):

Surgical Treatment ◽

Relative Risk ◽

Postoperative Pain ◽

Abdominal Wall ◽

Abdominal Wall Defect ◽

Hernia Recurrence ◽

Postoperative Wound ◽

Group I ◽

Group Ii ◽

Ventral Hernias

Objective. To raise the efficacy of surgical treatment of postoperative ventral hernias, performing laparoscopic preperitoneal allohernioplasty. Materials and metods. Analysis of the surgical treatment results was conducted in 126 patients, suffering postoperative ventral hernias, ageing from 30 to 75 yrs old, who were operated on in the Clinic of Department of Surgery and Proctology of Shupyk National Medical Academy of Postgraduate Education in 2012 - 2019 yrs, was conducted. There were 80 (63.5%) women-patients, and 46 (36.5%) men-patients. Average age of the patients have constituted (54.7 ± 3.3) yrs old. In accordance to classification of European Association of Surgeons-Herniologists (The European Hernia Society - EHS, Gent, Belgium, 2008 yr) distribution of postoperative hernias was following: hernias M1W1R0 were diagnosed in 6 (4.8%) patients, M2W1R0 - in 12 (9.5%), M2W2R0 - in 14 (11.1%), M3W1R0 - in 10 (7.9%), M3W2R0 - in 11 (8.7%), M3W3R0 - in 8 (6.3%), M4W1R0 - in 7 (5.6%), M4W2R0 - in 3 (2.4%), M4W3R0 - in 5 (4.0%), M5W1R0 - in 8 (6.3%), M5W2R0 - in 4 (3.2%), M2-3W2R0 - in 19 (15.1%), M3-4W2R0 - in 8 (6.3%), M3-4W3R0 - in 4 (3,2%), M1-4W3R0 - in 4 (3.2%), M3-5W3R0 - in 3 (2.4%). The patients with large POVH (W3) and diastasis of abdominal rectal muscles more than 5 cm were not included in the investigation. Depending on procedure of allohernioplasty performed for postoperative ventral hernias the patients were distributed into two Groups. In Group I in 63 (50%) patients the improved laparoscopic preperitoneal allohernioplasty with transfascial suturing of the abdominal wall defect edges was performed. In Group II in 63 (50%) patients open preperitoneal allohernioplasty was done. In both Groups of the patients light polypropylene nets were used for allohernioplasty. Results. Laparoscopic alloplasty of postoperative ventral hernias with transfascial sutures, which were applied in Group I, have had essential advantages: significant lesser intensity of postoperative pain, reduction of the seroma rate by 94% - relative risk 0.06 (0.01 - 0.28), p<0.001; risk of suppuration in postoperative wound by 90% - relative risk 0.10 (0.01 - 1.98), p=0.211; risk of chronic infiltrate occurrence by 86% - relative risk 0.14 (0.01 - 2.70), p=0.369. In general, concerning morbidity (immediate results), the risk lowering for their occurrence have enhanced by 93% - relative risk 0.07 (0.02 - 0.28), p<0.001 in patients of Group I in comparison with patients of Group II. Late results of surgical treatment of postoperative ventral hernias also confirms the advantage of laparoscopic preperitoneal allohernioplasty with transfascial suturing of the defect edges over open preperitoneal alloplasty: reduction of risk in chronic pain development in part of anterior abdominal wall by 68% - relative risk 0.32 (0.03 - 3.18), p=0.617 and risk of the recurrent hernia development by 87% - relative risk 0.13 (0.01 - 2.67), p=0.367. Conclusion. Performance of laparoscopic preperitoneal allohernioplasty for postoperative ventral hernias (Group I of patients) due to minimization of surgical dissection of the abdominal wall tissues is accompanied by significantly lesser intensity of postoperative pain and lesser rate of morbidity, comparing with open preperitoneal allohernioplasty (Group II), especially: in Group I a seroma rate have constituted 3.2%, in Group II - 34.9%, in Group I suppuration of postoperative wound was not noted, inflammatory infiltrate of abdominal wall, in Group II a rate of these complications have constituted 6.4 and 4.8% accordingly, in Group I chronic postoperative pain was noted in 2.1% of patients, in Group II - in 6.3%, in Group I hernia recurrence was absent, in Group II hernia recurrence rate have constituted 6.3%.

Download Full-text

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

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2020-179-6-107-110 ◽

2021 ◽

Vol 179 (6) ◽

pp. 107-110

Author(s):

V. V. Semenov ◽

A. A. Kurygin ◽

S. D. Tarbaev ◽

A. A. Mamoshin

Keyword(s):

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Rapid Development ◽

Polymer Materials ◽

Long Term Results ◽

Modern Concept ◽

Urgent Problem ◽

Results Of Treatment ◽

History Of ◽

Ventral Hernias

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.

Download Full-text

Plasty of incisional ventral hernias using a mechanical suture

Kazan medical journal ◽

10.17816/kazmj62016 ◽

1982 ◽

Vol 63 (3) ◽

pp. 37-40

Author(s):

B. L. Elyashevich ◽

F. Sh. Sharafislamov ◽

R. M. Ramazanov

Keyword(s):

Hernia Repair ◽

Abdominal Wall ◽

Ventral Hernia ◽

Ventral Hernia Repair ◽

Anterior Abdominal Wall ◽

Long Term Results ◽

Mechanical Suture ◽

And Function ◽

Ventral Hernias

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.

Download Full-text

EXPERIMENTAL STUDY OF IMPLANTATION OF DIFFERENT KINDS OF MESHES INTO THE ABDOMINAL WALL WITH THEIR INTRAABDOMINAL PLACEMENT

Ukrainian Scientific Medical Youth Journal ◽

10.32345/usmyj.4(119).2020.37-47 ◽

2020 ◽

Vol 119 (4) ◽

pp. 37-47

Author(s):

Mykola Krуvopustov ◽

Tetiana Tarasiuk ◽

Oleksandr Ioffe

Keyword(s):

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Parietal Peritoneum ◽

Regenerated Cellulose ◽

Oxidized Regenerated Cellulose ◽

Mesh Implantation ◽

Implant Placement ◽

Group I ◽

Group Ii ◽

Adhesive Coating

The article discusses the features of implantation of various types of composite meshes into the anterior abdominal wall. The main purpose of the study was to assess the speed and reliability of fixation of the mesh implant to the parietal peritoneum, its integration into the abdominal wall and the severity of the development of adhesions in the abdominal cavity against the background of intra-abdominal implant placement. The relevance of the study lies in the growth in the percentage of laparoscopic hernioplasty with intra-abdominal mesh placement in medical practice. At the same time, data on the rate of implantation of various types of meshes into the anterior abdominal wall are limited. This leads to a discussion about the choice of the optimal mesh type for its intra-abdominal placement. The research technique consisted in studying the degree of implantation of three types of polypropylene composite meshes into the anterior abdominal wall in an experiment on 27 white Wistar rats. A 2 x 2 cm mesh was fixed to the parietal peritoneum of the anterior abdominal wall intra-abdominally. We used composite polypropylene meshes with various types of structure and outer coating: group I - one-sided anti-adhesive coating with oxidized regenerated cellulose (n = 9), group II - double-sided anti-adhesive coating of polylecapron-25 (n = 9), group III - one-sided anti-adhesive coating with fatty acids Omega-3 (n = 9). The article presents the results of a chronic experiment assessing the state of mesh implantation on days 14, 30 and 90. An analysis of the severity of the adhesive process between the antiadhesive coating of the implant and the visceral peritoneum was carried out. There were no statistically significant differences between the groups in the macroscopic assessment of the adhesive process on days 14, 30, 90 of observation (p> 0.05). Histological examination of the “anterior abdominal wall - implant complex” did not confirm statistically significant differences in the strength of mesh fixation in groups I and II to the anterior abdominal wall (p = 0.387) in total for all observation periods, however, on day 30, the formation of a two-layer capsule and seromas was revealed in group II. The formation of neoperitoneum was observed only when using a mesh with an anti-adhesive one-sided coating of oxidized regenerated cellulose on day 90 of observation. The study empirically confirms and theoretically proves that the absence of an anti-adhesive coating in the zone of contact with the parietal peritoneum provides a short time for mesh implantation into the anterior abdominal wall and mesothelium formation. The results of the study can be useful when choosing the type of composite polypropylene mesh in patients with hernias of the anterior abdominal wall, for whom the method of surgical treatment is chosen - laparoscopic prosthetic hernioplasty with intra-abdominal implant placement.

Download Full-text

Clinicoanatomic substantiation of preventing the injury of neurovascular fascicles of the anterior abdominal wall in median laparotomy and drainage of the postoperative wound

Kazan medical journal ◽

10.17816/kazmj84043 ◽

2001 ◽

Vol 82 (5) ◽

pp. 328-330

Author(s):

K. A. Koreiba ◽

L. A. Ibatulin ◽

L. A. Stroitelev

Keyword(s):

Abdominal Wall ◽

Anterior Abdominal Wall ◽

Clinical Anatomy ◽

Postoperative Wound ◽

Median Laparotomy

The clinical anatomy of the anterior abdominal wall and syntopy of its surface neurovascular are worked out in detail. On the basis of this the method of low traumatic median laparotomy and the method of selective drainage of the postoperative wound taking into account preservation of basic neurovascular fascicles of the anterior abdominal wall are developed and introduced.

Download Full-text

A Seven-year Follow-up Study of Patient Satisfaction with Three-implant-retained Mandibular Overdentures

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5896 ◽

2021 ◽

Vol 9 (D) ◽

pp. 103-107

Author(s):

Hisham Samir ElGabry

Keyword(s):

Long Term Results ◽

Complete Dentures ◽

Patients Satisfaction ◽

Follow Up Study ◽

Group I ◽

Significant Difference ◽

Male Patients ◽

Group Ii ◽

Anterior Mandible

PURPOSE: This study aimed to compare patients’ satisfaction with mandibular overdentures retained by three-splinted implants versus conventional complete denture wearers during a 7-year follow-up study period. MATERIALS AND METHODS: Thirty edentulous male patients (mean age: 60 years) were carefully selected and divided into two equal groups. All patients received a new set of complete dentures. Group I patients received three implants in the anterior mandible and were connected after 3 months with bars, clips, and loaded. Group II patients received conventional complete dentures. Patients’ satisfaction was recorded for both groups at 3 weeks (baseline) and after 1, 3, 5, and 7 years. Patients were then asked to grade their overdentures/dentures on a visual analog scale and written questionnaire to evaluate their overall satisfaction. RESULTS: Satisfaction scores of Group I patients were found to be statistically significantly higher than that of Group II patients (p < 0.05) at 3, 5, and 7 years follow-up, meanwhile, no statistically significant difference was found at baseline or after 12 months. CONCLUSION: The long-term results suggest that three-implant-retained mandibular overdenture with a clip-bar attachment appears to be a successful rehabilitation strategy which is superior to conventional dentures for patients with advanced ridge resorption.

Download Full-text

Regarding operative treatment of thoracoabdominal injuries

Perm Medical Journal ◽

10.17816/pmj36114-20 ◽

2019 ◽

Vol 36 (1) ◽

pp. 14-20

Author(s):

Dmitriy G. Amarantov ◽

Mikhail F. Zarivchatsky ◽

Andrey A. Kholodar ◽

Andrey S. Nagaev ◽

Oleg S. Gudkov

Keyword(s):

Operative Treatment ◽

Clinical Situation ◽

Rational Approach ◽

Quality Of Treatment ◽

Results Of Treatment ◽

Group I ◽

Thoracoabdominal Injuries ◽

Group Ii

Aim. To improve the results of treatment in patients with thoracoabdominal injuries (TAI) by means of creating the method of determining indications for the use of classical or endoscopic surgeries in respect of this pathology. Materials and methods. Seventy-six sufferers from TAI were divided into 2 groups. Results. The method of successive determination of indications for the use of classical or endoscopic surgeries in patients with TAI was created on the basis of treatment of 41 (53.95 %) patients of group II. This method was used to treat 35 (46.05 %) patients of group I. Conclusions. Rational approach to the choice between the use of advantages of classical and endoscopic surgeries depending on characteristics of clinical situation permitted to elevate the quality of treatment in patients with TAI.

Download Full-text

Efficacy evaluation of case-specific approach for surgical treatment of incisional ventral hernia

Polish Journal of Surgery ◽

10.5604/01.3001.0014.9756 ◽

2021 ◽

Vol 93 (5) ◽

pp. 1-5

Author(s):

Svetlana Sokolova ◽

Andrey Sherbatykh ◽

Konstantin Tolkachev ◽

Vladimir Beloborodov ◽

Vadim Dulskiy ◽

...

Keyword(s):

Surgical Treatment ◽

Abdominal Wall ◽

Ventral Hernia ◽

Anterior Abdominal Wall ◽

Abdominal Wall Defect ◽

Long Term Results ◽

Treatment Results ◽

Specific Approach ◽

Incisional Ventral Hernia

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%.

Download Full-text