ONE OF THE METHODS OF PREVENTING THE OCCURRENCE OF POSTOPERATIVE VENTRAL HERNIAS

Снижение количества коллагена первого типа, существенно влияет на развитие ПВГ. Снизить частоту развития послеоперационных вентральных грыж можно вследствие раннего диагностирования факторов риска снижения коллагена на амбулаторном этапе подготовки к лапаротомии. Чем раньше сделана операция, тем меньше выражены изменения в тканях и органах, а само хирургическое вмешательство является менее сложным и более эффективным. При гладком течении и заживлении после первой операции можно оперировать послеоперационную грыжу спустя 6-8-10 месяцев в зависимости от вида и обширности первого вмешательства, общего состояния больного, величины и динамики роста грыжевого выпячивания. При склонности к ущемлению, а также при развивающемся синдроме спаечной непроходимости следует оперировать в возможно ранние сроки. Если в анамнезе есть указания на тяжело протекавший послеоперационный период в связи с обширным нагноением в ране, длительной тампонадой брюшной полости, тяжелой интоксикацией, перитонитом либо весьма длительным пребыванием в стационаре по поводу релапаротомии, следует выждать больший срок, примерно 12-18 месяцев. На это время надо назначить больному определенный режим, принять меры к улучшению общего состояния, уменьшению страданий в связи с развитием спаечного процесса в грыжевом мешке и в брюшной полости. По показаниям следует рекомендовать ношение хорошо прилаженного бандажа. Тhe decrease in the amount of collagen of the first type significantly affects the development of PVG. It is possible to reduce the incidence of postoperative ventral hernias due to early diagnosis of risk factors for collagen loss at the outpatient stage of preparation for laparotomy. The earlier the operation, the less pronounced changes in tissues and organs, and the surgery itself is less complex and more effective. When you smooth over and heal after the first operation can be operated incisional hernia after 6-8-10 months depending on the type and extensiveness of the first intervention, the patient's General condition, size and growth of hernial protrusion. With a tendency to infringement, as well as with the developing syndrome of adhesive obstruction, it is necessary to operate as early as possible. If in the history there are indications of a difficult postoperative period due to extensive suppuration in the wound, prolonged tamponade of the abdominal cavity, severe intoxication, peritonitis or a very long stay in the hospital for relaparotomy, you should wait a longer period, about 12-18 months. At this time, it is necessary to assign the patient a certain regime, take measures to improve the General condition, reduce suffering in connection with the development of adhesions in the hernia SAC and in the abdominal cavity. According to the indications, it should be recommended to wear a well-adjusted bandage.

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Method of prevention of postoperative gray allohernioplasty in laparoscopic ventral hernia

Clinical Practice ◽

10.17816/clinpract0913-9 ◽

2018 ◽

Vol 9 (1) ◽

pp. 3-9

Author(s):

Yu. V. Ivanov ◽

D. N. Panchenkov ◽

R. S. Chaikin ◽

M. V. Zinovsky ◽

A. S. Avdeev

Keyword(s):

Intellectual Property ◽

Abdominal Wall ◽

Ventral Hernia ◽

Postoperative Period ◽

Abdominal Cavity ◽

Seroma Formation ◽

Trans Position ◽

Hernia Sac ◽

Ventral Hernias ◽

Hernial Orifice

The authors have developed a new method of seroma formation prevention after laparoscopic allohernioplasty in patients with postoperative ventral hernias. The results of the study showed that trans- position of hernia sac into the abdominal cavity and fixation to the unmodified abdominal wall around the perimeter of the hernial orifice can reliably eliminate Grajewo cavity and thereby to eliminate the possibility of seroma formation in the postoperative period. Federal service for intellectual property (Rospatent) decided to grant a patent for this method of seroma formation prevention at the surgery of postoperative ventral hernias as for the invention “Method of laparoscopic plasty of ventral hernias” (№2017120227/14(035085) from 17.01.2018).

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The role of computed tomography in optimizing the surgical treatment of ventral hernias

Український радіологічний та онкологічний журнал ◽

10.46879/ukroj.1.2021.70-77 ◽

2021 ◽

Vol 29 (1) ◽

pp. 70-77

Author(s):

K. Yu. Parkhomenko ◽

V. A. Vovk

Keyword(s):

Computed Tomography ◽

Ventral Hernia ◽

Abdominal Cavity ◽

Clinical Manifestations ◽

Spiral Computed Tomography ◽

Spiral Computed ◽

Chronic Appendicitis ◽

Hernia Sac ◽

Ventral Hernias ◽

Preoperative Examination

In spite of a high informative value, spiral computed tomography is currently an additional optional examination and it is not included in domestic and foreign preoperative examination protocols. Purpose – assessing the feasibility of spiral computed tomography in the complex of presurgery examination of patients with ventral hernias. Materials and methods. The paper deals with analyzing the diagnostic findings of 35 patients with ventral hernias treated at Surgery Department of Municipal Non-Commercial Enterprise of Kharkiv Regional Council “Regional Clinical Hospital” during 2018–2019 period. All patients were operated on after compulsory and additional examinations according to the existing guidelines. Spiral computed tomography was an additional examination for all patients. The frequency of symptoms detected by means of computed tomography and confirmed during surgery was analyzed. Results. Most of the signs revealed during tomography and associated with the combined abdominal pathology, were completely confirmed by laparoscopic exploration of the abdominal cavity and pelvis. Spiral computed tomography was of particular value in patients clinically diagnosed with chronic appendicitis. When assessing the ventral hernia, it was possible not only to clearly determine its content and location towards the abdominal line, but also, before surgery, to calculate the width and length of the hernia gate and the volume of the organs in hernia sac. Unlike ultrasonography, computed tomography makes it possible to thoroughly evaluate the dimensions of the hernia gate and the state of the muscular aponeurotic layer of the anterior abdominal wall. Not least important is diagnosing the combined abdominal pathology, including the oncological one, which has no clinical manifestations but still has to be exposed to surgery. Conclusions. In the complex of preoperative examination of patients with ventral hernias, spiral computed tomography provides useful information on the anatomical features of ventral hernia and the combined abdominal pathology that requires surgical intervention. These data aid in planning a favorable type of hernioplasty of ventral hernia and simultaneous surgery. Spiral computed tomography is recommended to be added to the standard protocol of presurgery examination of patients with ventral hernias.

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A Clinical Study of Incisional Hernia

MVP Journal of Medical Sciences ◽

10.18311/mvpjms/2016/v3/i1/749 ◽

2016 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

Sudhir Dnyandeo Bhamre ◽

Nitin Devidas Pingale

Keyword(s):

Risk Factors ◽

Clinical Study ◽

Incisional Hernia ◽

Abdominal Cavity ◽

Health Care Centre ◽

Medical College ◽

Suction Drain ◽

Abdominal Operations ◽

Unlimited Access ◽

Hernia Incidence

Background: Incisional Hernias are common complication of andominal surgery. Depending on the risk factors Incisional Hernia can occure in 10 - 20 % of patients subjected to abdominal operations. Aims and Objective: A clinical study on risk factors, clinical prentations, management and post oprattive complications in patient with Incisional Hernia. Setting: Department of Surgery of a Tertiary Health Care Centre with an attached medical college. Material and Methods: A total of 43 patients of Incisional Hernia were studied and postoperative complications were evaluated in our institute. Results: Incidence of incisional hernia is more common in females than males and the overall M:F ratio is 1:2, 55.9 % of patients presented with swelling and pain. Incisional hernia incidence is high in lower abdominal incisions. Conclusions: The use of midline incision should be restricted to operations in which unlimited access to the abdominal cavity is necessary. Use of suction drain reducess post-oparative complication.

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Preoperative Progressive Pneumoperitoneum Revisited

Frontiers in Surgery ◽

10.3389/fsurg.2021.754543 ◽

2021 ◽

Vol 8 ◽

Author(s):

Kristen E. Elstner ◽

Yusuf Moollan ◽

Emily Chen ◽

Anita S. W. Jacombs ◽

Omar Rodriguez-Acevedo ◽

...

Keyword(s):

Incisional Hernia ◽

Botulinum Toxin A ◽

Abdominal Cavity ◽

Emergency Procedures ◽

Open Abdominal Surgery ◽

Risk Patients ◽

Preoperative Progressive Pneumoperitoneum ◽

Complementary Techniques ◽

Free Closure ◽

Ventral Hernias

Incisional hernia represents a common and potentially serious complication of open abdominal surgery, with up to 20% of all patients undergoing laparotomy subsequently developing an incisional hernia. This incidence increases to as much as 35% for laparotomies performed in high-risk patients and emergency procedures. A rarely used technique for enabling closure of large ventral hernias with loss of domain is preoperative progressive pneumoperitoneum (PPP), which uses intermittent insufflation to gradually stretch the contracted abdominal wall muscles, increasing the capacity of the abdominal cavity and allowing viscera to re-establish right of domain. This assists in tension-free closure of giant hernias which may otherwise be considered inoperable. This technique may be used on its own, or in conjunction with preoperative Botulinum Toxin A to confer paralysis to the lateral oblique muscles. These two complementary techniques, are changing the way complex hernias are managed.

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Perforated Incisional Littre’s Hernia: A Rare Content of a Common Hernia

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v15i2.395 ◽

2020 ◽

Vol 15 (2) ◽

Author(s):

Kumarappan Al ◽

Norly S ◽

Samuel Tay ◽

Vicknesh C

Keyword(s):

Risk Factors ◽

Small Bowel ◽

Incisional Hernia ◽

Intestinal Obstruction ◽

Meckel’S Diverticulum ◽

Male Gender ◽

Meckel's Diverticulum ◽

Hernia Sac ◽

Ventral Incisional Hernia ◽

Littre’S Hernia

Anticipation of complications is of paramount importance for a surgeon. Incisional hernia is a well-known complication for abdominal surgeries. Risk factors such as increasing age, obesity, male gender are well known. Intestinal obstruction, strangulation and perforation are imminent complications of this type of hernia if they become incarcerated. Common contents of a ventral incisional hernia are small bowel, large bowel and omentum. Even though Meckel’s diverticulum is a common gastrointestinal anomaly, it is rarely found to be the content of a hernial sac. A hernia sac containing Meckel’s diverticulum is also known as Littre’s hernia. Only a few cases have been reported in the literature. Thus here we present a case of perforated Meckel’s diverticulum that was entrapped in the ventral incisional hernia.

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A clinical study of ventral hernia

International Surgery Journal ◽

10.18203/2349-2902.isj20172791 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2326 ◽

Cited By ~ 2

Author(s):

R. D. Jaykar ◽

A. S. Varudkar ◽

Anirudh K. Akamanchi

Keyword(s):

Risk Factors ◽

Incisional Hernia ◽

Ventral Hernia ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Age Groups ◽

Care Hospital ◽

Female Ratio ◽

Surgical Ward ◽

Ventral Hernias

Background: Ventral hernias are one of the most common problems confronting general surgeons. Incisional hernia is a common long-term complication of abdominal surgery and is estimated to occur in 3% to 13% of laparotomy incisions. Because there is no prospective cohort available to determine the natural history of untreated ventral hernias, most surgeons recommend that these hernias should be repaired when discovered. So, there was a need to study the disease with respect to the various presentations, to gauge the awareness levels of the patients coming to us and also to determine the best modality of treatment in our set-up. This study was done to know the proportion of ventral hernias occurring in both sexes, various age groups, various risk factors and complications of different types of ventral hernias, clinical presentations and their treatment. Methods: This was a prospective study done at our tertiary care hospital between August 2014 and August 2015 (12 months). A total number of 50 cases of anterior abdominal hernias excluding groin hernias, posterior abdominal wall hernia was studied. Data collection included a detailed history and a thorough clinical examination. Data was entered in the proforma, tabulated and analyzed using software package for statistical analysis (SPSS 2015).Results: Ventral hernia constituted 4% of all admissions to the surgical ward. Incisional hernia was the most common amongst the ventral hernias with an incidence of 46%. Infra umbilical midline was the most common site for herniation in 42% of cases followed by umbilical region in 32% of cases. Obesity and constipation were found to be the major predisposing risk factors. Small defects (<2cm) presented early with more complications.Conclusions: In the present study of ventral hernias, 50 cases of ventral hernias that were admitted to Department of Surgery in our tertiary care hospital. Ventral hernia constituted 4% of all admissions to the surgical ward. The male to female ratio was 1:1.9 The mean age was approximately 41 years. Incisional Hernia was strangulated umbilical hernia - intra operative the most common variety.

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