POSTOPERATIVE VENTRAL HERNIAS: UNRESOLVED ISSUES OF DIAGNOSIS AND SURGERY TACTICS

Abstracts. Introduction. Postoperative ventral hernias are formed in 15-30% of cases after abdominal surgeries. Patients with postoperative ventral hernias rank 2nd after inguinal hernias, accounting for up to 22% of the total number of abdominal hernias. The advent of tension-free hernioplasty using synthetic implants helped solve some herniology issues: Number of relapses in the late postoperative period has significantly decreased. Aim of the study was to analyze the literature in accordance with modern problems regarding the surgical approaches to the treatment of postoperative ventral hernias. Materials and Methods. The literature review was made using the method of searching for publications in the PubMed databases. Results and Discussion. Computed tomography is the most informative in diagnosing the condition of the anterior abdominal wall tissues in patients with postoperative ventral hernias. The fundamental issue is the choice of abdominal wall layers for placing and strengthening the implant. An implant can be placed in the abdominal wall layers by different methods: Intraperitoneal, preperitoneal, retromuscular, and, in some cases, subaponeurotic and supra-aponeurotic. Conclusions. The use of combined methods of plastic surgery of the anterior abdominal wall for large postoperative ventral hernias using the sublay-inlay technique allows avoiding high traumatic effect of the operation and reducing the recurrence rate. In case of large postoperative ventral hernias, improving the optimal open surgery methods remains relevant.