Modern concept of treatment of patients with ventral hernias

Abstract

INTRODUCTION. The relevance of treating patients with hernias of the anterior abdominal wall is beyond doubt, since the incidence of the disease is on average 5 people per 1000, and hernioplasty itself is one of the most common operations in a general surgical hospital. However, the relapse rate remains quite high. There remains a debate about the choice of surgical option; the issues of prevention and treatment of pain syndrome, as well as tactics for managing patients with a complicated postoperative period, remain unresolved.The OBJECTIVE was to evaluate the effectiveness of the modern concept of treating patients with ventral hernias and to substantiate the principles for choosing a hernioplasty technique.METHODS AND MATERIALS. The study is based on the results of treatment of 1938 patients operated on at the Faculty Surgery Clinic named after S.P. Fedorov Military Medical Academy in the period from 2015 to 2022. Both open and endovideosurgical options for surgical interventions were performed for isolated umbilical hernias or in combination with diastasis of the rectus muscles, hernias of the white line of the abdomen, inguinal and postoperative hernias, including reduction of the volume of the abdominal cavity.RESULTS. During the study, an algorithm for the treatment of patients with ventral hernias was developed, various options for perioperative pain relief were proposed, and the tactics for treating infectious and purulent complications were substantiated.CONCLUSION. A specialized surgical hospital must perform all possible options for both traditional and endovideosurgical hernioplasty, use innovative options for pain relief in the perioperative period, and apply modern methods for diagnosing and treating postoperative complications in order to provide personalized medical care.