scholarly journals Polypropylene endoprostheses in the surgical treatment of strangulated postoperative ventral hernias

2012 ◽  
Vol 93 (3) ◽  
pp. 541-544
Author(s):  
I M Fatkhutdinov
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Subcutaneous Tissue ◽  
Abdominal Cavity ◽  
Subcutaneous Fat ◽  
Postoperative Mortality ◽  
Early Postoperative Period ◽  
Mesh Endoprostheses ◽  
Ventral Hernias

Aim. To determine and implement the best ways to position mesh endoprostheses in the anterior abdominal wall during strangulated postoperative ventral hernias; to introduce methods of non-stretch hernioplasty into emergency surgery of giant hernias. Methods. 115 patients (27 males and 88 females) with strangulated postoperative ventral hernias aged 30-73 years were under observation. Depending on the size of the hernia and on the intraoperative findings different methods of implantation of the mesh endoprostheses were used, which prevented the mesh contact with subcutaneous fat and abdominal organs. For small and medium-sized hernias the mesh was placed under or over the abdominal membrane, it was fixed to the abdominal wall, the aponeurosis was sewn together in an «edge to edge» fashion. In cases with giant hernias non-stretch hernioplasty was performed. During the operation of non-stretch hernioplasty, dissection and excision of the hernial sac was performed in such a way that made it possible to use it to cover the abdominal wall defect. Results. In the early postoperative period in 17 (14.8%) patients seromas had formed in the wound, which were treated by needle puncture under ultrasound guidance. Postoperative mortality was 5.2% (6 people). In 5 cases the deaths were due to myocardial infarction and pulmonary embolism. One patient developed peritonitis due to suture insufficiency of the enteric anastomosis. Of all patients with lethal outcomes five patients were admitted after more than 6 hours from the start of the strangulation, one patient was admitted after 3 hours. Conclusion. The usage of techniques that delimit the mesh prosthesis from the abdominal cavity and subcutaneous tissue, and the introduction of non-stretch methods for giant hernias in the surgical treatment of strangulated postoperative ventral hernia contribute to improved outcomes of treatment in this group of patients.

scholarly journals Laparoscopic preperitoneal alloplasty of postoperative ventral hernias

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%.

scholarly journals Efficiency assessment of laparoscopic vs open alloplasty for incisional ventral hernias

2021 ◽  
Vol 11 (5) ◽  
pp. 223-228
Author(s):  
Ya. P. Feleshtynsky ◽  
O. M. Lerchuk ◽  
V. V. Smishchuk
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Wall Defect ◽  
Efficiency Assessment ◽  
Rectus Diastasis ◽  
Group I ◽  
Laparoscopic Hernioplasty ◽  
Mesh Implant ◽  
Ventral Hernias

Materials and methods. During the period from 2009 to 2020 in the clinic of the Department of Surgery and Proctology of the Shupyk National Healthcare University of Ukraine, the surgical treatment of 217 patients with IVH was analysed.The choice of laparoscopic hernioplasty or open allohernioplasty was made taking into account the size of the abdominal wall defect and the width of the rectus diastasis. By intraoperatively conducting a study during a surgery for IVH with an abdominal rectus diastasis involving approximation of the rectus muscles and measurement of IAP, it was found that with an abdominal rectus diastasis measuring up to 5 cm IAP increases to 5.6 ± 1.3 mm Hg and the abdominal wall defect is closed without an undue tension of the supporting tissues.Depending on the method of surgical treatment, patients were divided into 2 groups.In group I, 109 (21.5%) patients with small and medium-sized IVH with a diastasis of up to 5 cm underwent laparoscopic allohernioplasty, in particular, 63 patients underwent laparoscopic preperitoneal alloplasty and 46 underwent laparoscopic retromuscular alloplasty.Conclusions. For small and medium-sized IVH with an abdominal rectus diastasis of up to 5 cm, laparoscopic allohernioplasty with preperitoneal and retromuscular placement of the mesh implant and elimination of the diastasis is optimal. In comparison with open retromuscular allohernioplasty, it contributes to a significant reduction in the incidence of seroma (from 35.2% to 3.7%), postoperative wound suppuration (from 6.5% to 0%), inflammatory infiltrate (from 4.6% to 0%), chronic postoperative pain (from 6.4% to 2.6%), and recurrence of hernia (from 6.4% to 0%).

scholarly journals Evolution of diagnosis and surgical treatment of intra-abdominal infiltrates, abscesses of primary and postoperative origin in patients

2021 ◽  
pp. 15-29
Author(s):  
V.V. Skyba ◽  
◽  
V.F. Rybalchenko ◽  
A.V. Ivanko ◽  
R.М. Borys ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Postoperative Mortality ◽  
Multiple Organ ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Perforated Gastric Ulcer

Purpose – to improve the results of surgical treatment of patients with intra-abdominal infiltrates and abscesses through the introduction of the latest imaging methods and surgical technologies. Materials and methods. In the clinic of the Department of Surgical Diseases No 1, on the basis of the Surgery Center of the Kyiv City Clinical Hospital No. 1 from 2006 to 2019 218 patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 (49.08%) male patients, 111 (50.92%) female patients. Depending on the time of hospitalization (by years), the patients were divided into two groups: the control group (CG) (2006–2012) 117 (53.67%) patients and the study group (SG) (2013–2019) 101 (46.33%) patients. The SG used the latest imaging technologies and improved methods of surgical treatment. Results. The patients were divided into two groups: primary in 191 (87.61%) and secondary postoperative infiltrates and abscesses in 27 (12.39%). The causes of primary infiltrates and abscesses were: complicated forms of appendicitis in 74 (33.94%), perforated stomach and duodenal ulcer in 48 (22.02%), complicated forms of cholecystitis in 69 (31.65%). Postoperative infiltrates and abscesses were observed in 27 (12.39%) patients who underwent urgent surgery: adgeolysis of adhesive ileus in 14 (6.42%) and complicated hernias of various localization in 13 (5.97%). Postoperative complications were diagnosed in 43 (19.72%) patients, of whom 34 (15.59%) from the surgical wound and 29 (15.18%) of the abdominal cavity, who required relaparotomy or laparoscopy, with destructive appendicitis in 10 (13.51%), perforated gastric ulcer and 12 duodenal ulcer in 6 (12.5%), destructive cholecystitis in 9 (13.04%), adhesive intestinal obstruction in 13 (19.12%) and with strangulated and complicated hernias in 14 (17.28%) of the examined patients. During relaparotomy, incompetence of the intestinal wall and intestinal sutures was established in 11 out of 32 patients, an ileostomy was imposed in 7, and cecostomy in 1 patient. Actually, in the control group, 8 (6.84%) patients died on the background of ongoing peritonitis, thrombosis of mesenteric vessels and multiple organ failure and concomitant ailments and in the study group 4 (3.96%) patients died. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis of 69 (36.13%) patients, 48 (25.13%) had laparotomy and 21 (11.00%) had laparoscopic examination. The use of the latest imaging and treatment technologies: Doppler ultrasonography, hydrojet scalpel and laparoscopy in 64 (33.51%), allowed to have better near and long-term results and to reduce postoperative mortality from 6.84% to 3.96%, with an average of 5.5%. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: destructive appendicitis, cholecystitis, perforated gastric ulcer and 12-duodenal ulcer, adhesive leakage, strangulated hernias, diagnosis and treatment.

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

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%.

scholarly journals Drainage as a rare cause of intestinal incarceration

2005 ◽  
Vol 133 (7-8) ◽  
pp. 370-371 ◽  
Author(s):  
Sasa Kadija ◽  
Radmila Sparic ◽  
Vojislav Zizic ◽  
Aleksandar Stefanovic
Keyword(s):  
Surgical Treatment ◽  
Small Bowel ◽  
Abdominal Wall Defect ◽  
Abdominal Cavity ◽  
Pelvic Mass ◽  
Wall Defect ◽  
Causative Mechanism ◽  
Small Bowel Incarceration ◽  
Intestinal Incarceration ◽  
Do So

Silicone drains are often placed in the abdominal cavity for prophylactic reasons. One complication resulting from drainage includes visceral herniation at the drain site of the abdominal wall defect An 82-year-old woman underwent a laparotorny for a large pelvic mass. After the operation, she developed small bowel incarceration, which was caused by aggressive drain extraction. Subsequent surgical treatment resulted in the patient's full recovery. This case emphasises the unusual causative mechanism of intestinal obstruction. Drains should be placed carefully in the abdominal cavity in strictly selected cases, only when it is reasonable to do so.

scholarly journals Intra-Operative Total Bowel Washing: A New Method to Improve the Outcome of Gastroschisis Primary Repair

2020 ◽  
Vol 30 (3) ◽  
Author(s):  
Ahmad Mohammadipour ◽  
Mehran Hiradfar ◽  
Reza Shojaeian
Keyword(s):  
Gastrointestinal Tract ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Primary Repair ◽  
Abdominal Cavity ◽  
Abdominal Wall Reconstruction ◽  
Operation Time ◽  
Oral Feeding ◽  
Main Challenge ◽  
Significant Difference

Background: Gastroschisis is an abdominal wall defect that is managed by surgical reduction of herniated bowel into the abdominal cavity and abdominal wall reconstruction. Loss of abdominal domain is the main challenge that may complicate the process of gastroschisis management. Objectives: This article is about innovative manure called total bowel washing (TBW) that may improve the outcome of gastroschisis primary repair. Methods: All neonates with gastroschisis who met the study inclusion criteria between 2006 - 2019 were enrolled and divided into two groups of conventional and TBW method of gastroschisis management. In TBW group, bowls were washed with warm saline and after a gentle enterolysis, the whole gastrointestinal tract was irrigated via a gastric tube and evacuated completely from thick meconium until the watery stool started to come out of anus slightly. Primary abdominal wall closure was performed after loop by loop bowel reduction. Gastroschisis management outcome was compared between the two groups. Results: 15 neonates were allocated in each group. Demographic and anthropometric variables were compared and any significant difference wasn’t reported between the two groups. We observed a significantly better outcome in terms of faster GI rehabilitation, shorter time to oral feeding tolerance, less need to silo placement and shorter NICU and hospital stay in TBW method. Operation time was slightly longer in TBW group while the difference was not significant statistically. Conclusions: Total bowel washing and complete evacuation of gastrointestinal tract from thick meconium will increase the success rate of primary repair and improve the outcome of gastroschisis management.

scholarly journals Mesh Plug Technique for Umbilical and Paraumbilical Hernias Repair; A Novel Technique

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Muhammad Imran Khan ◽  
Jawad Khalil ◽  
Kaleemullah , ◽  
Athar Badshah ◽  
Zakaullah Jan ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Abdominal Wall ◽  
Operative Time ◽  
Abdominal Wall Defect ◽  
Early Postoperative Period ◽  
Mesh Plug ◽  
Surgical Department ◽  
Mesh Plug Repair ◽  
Male Patients ◽  
Plug Repair

Background: Umbilical and paraumbilical herniae are the most common ventral herniae occurring at or around the umbilical ring.Umbilical hernia accounts for almost 6-10% of all abdominal wall herniae. A ventral hernia is abnormal protrusion of peritoneal sacthrough the musculo-aponeurotic abdominal wall defect. Females are affected five times more as compared to males. The variousrisk factors include obesity, chronic cough and constipation, ascites and pregnancy in females.Objective: To determine the outcome of mesh plug repair of umbilical and paraumbilical hernias in terms of operative time andpostoperative complications.st Material and Methods: This study was conducted at surgical department of Khyber Teaching Hospital, Peshawar from 1 Januaryst 2012 to 31 December 2016. Total of 131 patients with umbilical and Para umbilical hernias were studied. Patients were operatedusing mesh plug technique and operative time and postoperative complications were recorded.Results: There were 91 female patients compared to 40 male patients (M/F ratio 2.2:1). The overall mean age was 41±19.3 years.The mean operative time was 23±9.2minutes. In the early postoperative period 3 patients had superficial surgical site infection.Seroma was observed in 2 patients. Mesh plug infection was observed in 1 patient while chronic pain was observed in 2 patients.None of the patients had recurrence on 24 months follow up.Conclusion: Mesh plug for small umbilical and paraumbilical hernias in adults is a safe, convenient, fast and minimally invasivetechnique with a lower rate of postoperative complications and recurrence.

scholarly journals PLASTICS OF THE ANTERIOR ABDOMINAL WALL IN POSTOPERATIVE VENTRAL HERNIA

2021 ◽  
pp. 91-97
Author(s):  
N. Sivets ◽  
◽  
D. Kluyko ◽  
A. Sivets ◽  
D. Holovach ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Plastic Surgery ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Postoperative Period ◽  
Anterior Abdominal Wall ◽  
Treatment Efficiency ◽  
Ventral Hernias

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.

scholarly journals Vaginal birth vs caesarean delivery: impact on gastroschisis anatomy in newborns (a 33-year experience)

2021 ◽  
pp. 15-19
Author(s):  
O.K. Sliepov ◽  
N.Y. Zhylka ◽  
V.L. Veselskyi ◽  
N.Y. Skrypchenko ◽  
T.V. Avramenko ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Abdominal Wall ◽  
Caesarean Delivery ◽  
Anterior Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Abdominal Cavity ◽  
Delivery Mode ◽  
Wall Defect ◽  
Abdominal Organs ◽  
Group I

Background. Despite the existence of numerous studies on the optimal delivery mode in gastroschisis (GS), their results remain controversial. Therefore, the presented study is focused on establishing the delivery mode impact on GS anatomy in newborns.Research objective. The study was conducted to determine the impact of the delivery mode on the features of GS anatomy in newborns.Materials and methods. A retrospective analysis of medical records of 135 pregnant women and 135 their newborns with GS born between 1987 and 2020 was conducted. All newborns are divided into 3 groups. Newborns delivered by caesarean section are included in group I (n = 80); children born exclusively naturally are included in groups II (n = 25) and III (n = 30). The following anatomical features of GS in newborns were studied: localization and size of the anterior abdominal wall defect, confluence with the abdominal cavity, the nature and frequency of the eventrated organs.Results. The size of the anterior abdominal wall defect was significantly smaller in children with GS delivered by caesarean section (3.02 ± 0.58 cm; p < 0.01) than in children born naturally (4.17 ± 0.3 cm in group II, 4.7 ± 0.29 cm in group III). The frequency of retroperitoneal organs eventration was significantly less (20.0%; p < 0.01) in caesarean delivery grope than in II and III groups (52% and 63.3%, respectively). There was no significant difference in frequency of other abdominal organs eventration, localization of the anterior abdominal wall defect and confluence with the abdominal cavity. Level of evidence – III. Conclusions. The mode of delivery affects the size of abdominal wall defect and frequency of the abdominal organs eventration in newborns with GS.

scholarly journals Exomphalos Major in Adults: A Treatment Modality

2016 ◽  
Vol 02 (02) ◽  
pp. 066-069
Author(s):  
Tanweerul Huda ◽  
Ashok Mhaske
Keyword(s):  
Compartment Syndrome ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Adult Female ◽  
Treatment Modality ◽  
Abdominal Wall Defect ◽  
Abdominal Cavity ◽  
Wall Defect ◽  
High Degree ◽  
Standard Techniques

AbstractOmphalocele (OC) is a congenital abdominal wall defect (CAWD) at the site of the umbilical ring with evisceration of the bowel covered by a three-layered membrane of peritoneum, Wharton's jelly, and amnion. It is associated with an underdeveloped abdominal cavity and a high degree of viscera abdominal disproportion. An adult female giant OC patient was treated at our hospital using the component separation technique (CST) after reviewing different standard techniques. No evidence of any compartment syndrome or ventral hernia was detected postoperatively. Giant OC in an adult healed in the same way using CST as in an infant with favorable outcomes.

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