RATIONALE OF SEPARATION PROSTHETIC PLASTY FOR POSTOPERATIVE VENTRAL HERNIAS

The results of treatment of 107 patients with postoperative ventral and recurrent hernias who underwent hernia defect repair using onlay and sublay methods, as well as using separation plasty with restoration of normal topographic anatomy were studied. The algorithm of choosing the method of standard (onlay, sublay) or separation (anterior, posterior) plasty for postoperative ventral hernias W2, W3, W4 is based on the state of muscular-aponeurotic structures of the anterior abdominal wall and the intraoperative intra-abdominal pressure monitoring index. Optimisation of tactical and technical aspects of surgical treatment of patients with postoperative ventral hernias allowed to reduce the frequency of immediate postoperative complications from 16.1% to 9.1% and recurrence from 10.7% to 4.5% (p˂0,05).