scholarly journals SURGICAL TREATMENT OF INCISIONAL VENTRAL HERNIAS OF GREAT SIZES USING POLYPROPYLENE MESH MODIFIED BY CARBON NANOTUBES AND AN ANTISEPTIC

2019 ◽  
Vol 1 (2) ◽  
pp. 167
Author(s):  
R. A. Lutkovskyi
2020 ◽  
pp. 135-139
Author(s):  
V. I. Piatnochka ◽  
I. Ya. Dziubanovskyi ◽  
A. M. Prodan

Abstract. In the period from 2001 to 2017, 1419 patients with ventral and postoperative ventral hernia were operated on. The unsatisfactory results of the surgical treatment of this pathology were due to a number of disadvantages: the choice of an inadequate method of hernioplasty in a specific clinical situation, an incomplete revision of the muscle-aponeurotic layer of the anterior abdominal wall, especially in patients with postoperative veterinary hernias, concomitant syndrome of undifferentiated connective tissue dysplasia and obesity, and weak points, the wrong choice of the type of mesh implant (“light” or “heavy” polypropylene mesh) and its size, the choice of an inappropriate type of suture material, as well as the high invasiveness of surgical intervention. Based on the given causes of complications in the operated patients with a high risk of their development, we have made a technical improvement of the existing methods of hernioplasty and development of new ones, which significantly reduced the number of postoperative complications and increased the safety of performing surgical interventions in patients with ventral and postoperative ventral hernia. Purpose. Based on the results of the analysis of surgical treatment of patients with comorbid conditions for primary and incisional ventral hernias to develop technical prerequisites for improving the safety of surgical interventions in this category of patients. Methods. Іn the period from 2001 to 2017, an in-depth comprehensive clinical-instrumental and laboratory examination of 1419 patients with primary ventral hernia (PVH) and postoperative ventral hernia (PVH) was conducted. The patients were divided into groups according to the periods of surgical treatment of patients. For this purpose, two periods were formed: from 2001 to 2009 and from 2010 to 2017. At the first period, 597 (42.07%) patients were examined and operated on. These patients formed a comparison group. The main group corresponding to patients who were treated in the period from 2010 to 2017 was 822 (57.93%) people. Results. Developed techniques for performing retromuscular allogernioplasty, which were based on controlled visualization of suturing when fixing polypropylene mesh to the posterior leaf of the vagina of the rectus muscle, allowed us to reliably and safely place and secure the implant in the retromuscular space, significantly reduce the trauma and duration of surgery. Kind of treatment using the mesh allograft with a liposomal complex with included antibacterial and immunosuppressive agents during the operation on the "onlay" method significantly reduced the number of local infectious complications. The location of the PRF membrane over the polypropylene mesh during retromuscular allogernioplasty improved neoangiogenesis at the mesh implantation site, increased fibroblast activity and the formation of collagen fibers around the mesh material, which provided maximum integration of the "light" abdominal wall with polypropylene tissue. Conclusion. These features of the dynamics of the used methods of surgical interventions and types of polypropylene nets with an individualized approach to each patient were reflected in a significant reduction in the number of both early local and general late postoperative complications, which improved the effectiveness of surgical treatment of patients with primary postoperative ventral hernias.


2019 ◽  
Vol 0 (1) ◽  
pp. 39-43
Author(s):  
Ya. P. Feleshtynsky ◽  
R. A. Lutkovskyy ◽  
V. V. Smishchuk ◽  
V. F. Vatamaniuk

2019 ◽  
Vol 21 (1) ◽  
pp. 122-125
Author(s):  
V A Ragimov ◽  
Sh I Ragimli

Surgical treatment of patients with ventral hernias remains an urgent problem in abdominal surgery. More than 20 million operations are performed annually in the world for hernias. The urgency and complexity of the problem is based on the fact that inadequately performed surgery leads to a recurrence of the disease in 14-54% of cases. The aim of the work is to study the results of surgical treatment of patients with ventral hernias using mesh endoprostheses. The results of a retrospective analysis of 437 hernioplasty performed with hernias of various localizations for the period from 2010 to 2014 were used. Patients were classified by hernia localization and divided into groups depending on the methods of alloplasty. The duration of observation of patients operated by using polypropylene mesh ranged from 6 month to 3 years. An analysis of the complications that developed after alloplasty of the inguinal, postoperative, umbilical hernias and hernias of the linea alba was carried out. Our clinical experience confirms that the operation of Liechtenstein is rightly considered to be the “gold standart” for the treatment of inguinal hernias. However, the use of polypropylene mesh in the treatment of inguinal hernias leads to the development of postsurgical wound complications. Placed next to the polypropylene mesh peritoneum flap plays the role of internal drainage, prevents the development of seromas in the wound. The use of a new inguinal alloplasty technique reduced the number of postoperative complications. Also, the best immediate and long-term results are obtained by alloplasty using a sublay method. In patients with postoperative hernias operated by sublay method, no recurrences were observed and they showed the best quality of life.


2017 ◽  
Vol 10 (1) ◽  
pp. 10-20
Author(s):  
Yury Viktorovich Ivanov ◽  
Dmitry Nikolaevich Panchenkov ◽  
Aleksey Alekseevich Terehin ◽  
Oleg Radomirovich Shablovsky

Relevance. Currently, the problem of effective treatment of postoperative ventral hernias is still not completely solved. The recurrence rate of the disease ranges from 15% to 50%, and repeat surgery causes increasing of the rate up to 20-65%. The purpose of the study is to evaluate the results of laparoscopic hernioplasty in patients with postoperative ventral hernias. Materials and methods. A retrospective analysis of the immediate and remote results of surgical treatment of 140 patients with postoperative ventral hernias. Patients of the main group (63) laparoscopic hernia repair method "ipom" patients in the comparison group (73) – open hernioplasty by the method of "onlay" and "inlay". Results. The use of laparoscopic hernioplasty by the method of "ipom" allow to significantly reduce the number of early and overall postoperative complications (3.7%), duration of hospitalization (from 9.8 ± 1.3 per day to 5.4 ± 0.7 per day), the period of temporary incapacity (from 28.9 ± 3.4 days to 17.2 ± 2.3 days), as well as reduce the number of relapses (from 8.2% to 3.0%). Discussion Laparoscopic hernioplasty is an effective method of treatment of postoperative ventral hernias. The obvious advantages of laparoscopic hernioplasty are: low invasiveness, fewer complications, rapid medical and social rehabilitation of patients. There is an undoubted advantage of laparoscopic hernioplasty over an open operation with the patient several postoperative ventral hernias. Conclusion. In modern conditions, laparoscopic hernia repair can be recommended as the operation of choice in patients with postoperative ventral hernia.  


2021 ◽  
pp. 91-97
Author(s):  
N. Sivets ◽  
◽  
D. Kluyko ◽  
A. Sivets ◽  
D. Holovach ◽  
...  

Objective. Improving the postoperative ventral hernias surgical treatment efficiency. Authors of the article define the clinically developed method of plastic surgery of the anterior abdominal wall in postoperative ventral hernia. Operations with this technique were performed in 37 patients. The endoprosthesis used was a polypropylene net made by “Eticon”. In the postoperative period complications took place in 2 (5,4%) patients. Conclusion. The developed method of the anterior abdominal wall plastics effectiveness was established in the article.


2021 ◽  
pp. 36-38
Author(s):  
Ankur Akela ◽  
Prashant Kumar Singh

Morgagni hernia occurs after a congenital retrosternal diaphragmatic defect; it is a rare form of diaphragmatic hernia (1-3% of cases). In general, this pathology is diagnosed in children; in adults it is frequently discovered in emergency or incidentally. Methods: We prospectively evaluated a series of 6 patients admitted to department of surgery IGIMS. Results: Out of 6 patients the laparoscopic approach was used in all cases: one conversion was recorded due to the tight adherences of the herniated viscera (gastric, colon, epiplon). In 4 cases, the surgical cure of hernia was performed by suture and in 2 cases with prosthesis: dual mesh in one case and polypropylene mesh in another case. We did not register morbidity and the mean postoperative stay was 4 days (range 2-6 days). Conclusions: Hernia Morgagni betrays a rare pathology. The most common is asymptomatic but in complicated cases it is a cause of acute surgical abdomen. Surgical treatment is indicated even for asymptomatic cases due to serious complications Morgagni hernia may develop. The laparoscopic approach is ideal, as reduction of viscera in the abdomen is easy and the defect will be repaired by suturing or using a prosthesis, depending on its size.


Sign in / Sign up

Export Citation Format

Share Document