Abdominal Wall Prosthetic Repair in Ventral and Incisional Hernia Treatment: Classification, Terminology and Technical Aspects (Review)

Abstract

Nizhny Novgorod State Medical Academy, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russian federationThe review considers in detail the most important aspects of open abdominal wall prosthetic repair techniques applied in surgical treatment of ventral and incisional hernias according to contemporary foreign and domestic experience. we have presented the views of leading researchers on the use of synthetic endoprostheses. The authors have suggested a modern classification of primary ventral and incisional hernias indicating its variation from the previous classification SwR (Chevrel and Rath) and others. we have assessed and interpreted the English terms compared to those used in Russia. The review has traced the change of the term "tension-free plasty" in its historical perspective.The work has presented the main up-to-date techniques for mesh endoprostheses implantation, their advantages and drawbacks. There have been estimated the key points of prosthetic repair surgeries in median abdominal wall closure. we have considered correct names of variants of surgeries depending on mesh placement in relation to hernia orifices, anatomical layers of abdominal wall, and self-tissue displacement.we have clarified some peculiarities of operative techniques relying on intra-abdominal pressure control, and estimated the advantages and disadvantages of these techniques.The review has specified the most urgent problems of modern herniology, and presented one of promising directions of surgical technique improvement in the treatment of patients with large ventral and incisional hernias. we have shown the necessity of proper usage and understanding of the implication of terms standing for operative interventions, as well as correct use of corresponding classifications and terminology for adequate comparison of our research results with those of our colleges.

Prevention of Complications of Incisional Hernia Repair: Current Problem State (Review)

“…The technique has become relevant in patients with large hernias and loss of domain (loss of domain is abdominal cavity volume loss due to the fact that the organs are constantly in hernia sac is determined when a hernia sac occupies over 25% abdominal cavity) [40]. Hernia repair in such patients is accompanied by postoperative intraabdominal hypertension and mortality in 5% cases [41]. Clinical studies [42,43] when using botulinum toxin type A show a significant decrease in hernia transverse size that finally enables intraoperatively bring together hernia edges more closely reducing the tension of lateral abdominal muscles retaining their integrity.…”

Technologies of Prosthetic Plasty of Strangulated Hernia

“…Хирургическое лечение грыж с применением протезирующей пластики представляет собой актуальную проблему современной хирургии и герниологии [2,6,8,4]. Широкое применение сетчатых имплантов приобрело популярность не только при открытых вмешательствах, но и в лапароскопической хирургии первичных, рецидивных и послеоперационных вентральных грыж [1,5,3,10,14].…”

“…Наибольшую сложность в лечении представляют собой ущемленные грыжи, где выбор хирургической тактики с использования протезирующей пластики является дискуссионным и неоднозначным [12,9]. Довольно высокая частота гнойно-септических осложнений (14-34 %) в значительной мере сдерживает широкое применение протезирующей пластики, как наиболее рационального метода хирургического вмешательства при ущемленных грыжах различной локализации [13,14]. Вместе с тем в настоящее время появляется все больше сторонников применения сеток различных типов в хирургическом лечении ущемленных грыж [1,11,13].…”

“…Вместе с тем в настоящее время появляется все больше сторонников применения сеток различных типов в хирургическом лечении ущемленных грыж [1,11,13]. Вопрос еще далек от окончательного решения и определения четких и дифференцированных показаний к протезирующей пластике ущемленных, в особенности, послеоперационных вентральных грыж [12,10,14].…”

Conceptual and Methodological Approaches to Choosing a Method for Marking a Surgical Site for Reconstructive Surgery on the Anterior Abdominal Wall

“…A significant percentage of these interventions consists of surgery for postoperative ventral hernias (POVH). (5,6) This category of patients is a constant contingent of surgical hospitals. Thus, over the past 25 years, due to the increase in the number of surgical interventions on the abdominal organs, the frequency of POVH has increased by 9 times or more.…”