Lipoabdominoplasty in correction of abdominal wall defects

2022

Objective. Clinical assessment of combined application of the calculated dermolipectomy with improved hernioabdominoplasty in treatment of patients, suffering hernias and external abdominal deformities, who have excessive tissues of abdominal wall. Materials and methods. The investigation is based on data of paraoperative examinations and own results of surgical treatment of 67 patients with hernias and external abdominal deformities. Rational methods of their operating were substantiated on background of morphometric characteristics, determined in accordance to the ventral deformity dimensions, and percentages of adipose-containing, fibrous-cicatricial and pathological components content. Results. The program unit «Statistica 6.1» was applied for statistical elaboration of the results obtained. Algorithm of quantitative investigations of the ventral tissues excessives, which have had predominantly supraaponeurotic localization, was elaborated for the first time. Preoperatively calculated volumes of preventive dermo- and fibrolipectomies, which were performed together with hernio- and abdominoplasties in accordance to new principle «without excesses of parahernial tissues» in various hernias and venral deformities, have reduced essentially the local complications rate - to 2% (р < 0.05) and improved the indices of quality of life and the patients’ health. Conclusion. Practical application of the «tension-free» and «nonrebundant» principles in operating of hernias constitute the base for further elaborations of reconstructive-plastic interventions and a real component of the problem decision in medico-social and esthetic rehabilitation of certain herniological patients.

Substantiation of application of «nonrebundant» and «tension-free» principles in hernioabdominoplasty in patients, suffering hernias and ventral deformities

2022

Dermolipectomy and abdominoplasty in surgical treatment of hypogastric postoperative hernias in patients, suffering obesity

Петрушенко

Гребенюк

2021

Objective. To improve clinico–esthetic results of surgical treatment of postoperative ventral hernias of infra–umbilico–hypoabdominal localization and hypogastric cicatricial deformities in patients, suffering obesity. Materials and methods. The work is based on the results of analysis of perioperative investigations, conducted in 37 patients. The main group was consisted of 26 patients, suffering postoperative ventral hernias after lower laparotomies or laparoscopic interventions. In 11 patients, forming a control group, there were present the soft tissue deformities without aponeurotic defects and hernias. All the patients have had general obesity Degrees I–III and/or abdominal obesity. In all the patients there was conducted a various volume calculated excision of excessive and cicatricial–fibrous tissues and, in necessity, – alloplasty of hernial gates. Results. Overall parahernial excess of tissues in formatted hypogastic postoperative ventral hernias have had predominantly supraaponeurotical localization and metric characteristics, determined by the hernial dimensions, emphasis of adjacent lipid–containing layers and fibrous–cicatricious components. While performing of hernioabdominoplasty in such patients it is expedient to apply a combined tactics of standard aponeurotic hernioplasty and dermolipectomy/fibrolipectomy with abdominoplasty. This permits to lower essentially (up to 3%) the rate of the local complications development. Conclusion. The calculated beforehand hernioabdominoplasty constitutes the most rational principle of surgical treatment for hypogastric postoperative ventral hernias in patients, suffering obesity.

The improved principle of hernioabdominoplasty in treatment of the patients, suffering parahernial surplus of tissues

2021

Objective. Estimation of clinical efficacy of combined dermo- and fibrolipectomies with hernioabdominoplasty in treatment of patients, suffering external hernias. Materials and methods.The work was conducted on the base of own results of examinations and operating of 56 patients. Results.Rational principle of surgical interventions in abdominal obesity and other parahernial surplus of abdominal wall was substantiated.There was established, that this surplus have predominantly supraaponeurotic localization and pathometric characteristics in accordance to the hernia dimensions, and the parts of lipid-containing and fibrous-cicatricial tissues in their content. Conclusion.Application of tactics of the preoperatively weighted simultaneous interventions reduces the local complications of hernioplasty and improves the quality of life and health in various cohorts of herniological patients.