Laparoscopic alloplasty of umbilical hernias of large size
EAES Academy. Feleshtynsky Y. 07/05/22; 363084; P129
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Abstract
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Background:
In umbilical hernias of large size (W3) the recurrence rate remains at 5-10%. One of the causes of recurrence of large umbilical hernias during laparoscopic surgery is diastasis of the rectus abdominis, which is often concomitant and is not eliminated during surgery.
The aim:
Improving the effectiveness of laparoscopic alloplasty of umbilical hernias of large size.
Materials and methods. Analysis of laparoscopic preperitoneal alloplasty of umbilical hernias of large size (W3) was performed in 82 patients. Age of patients from 25 to 75 years. The mean age was 56 ± 1.2 years. There were 64 women (78%) and 18 men (22%). Depending on the method of surgical treatment, patients were divided into two groups. In the first (main) group in 41 patients laparoscopic preperitoneal alloplasty of umbilical hernia of large size with suturing of diastase of rectus muscles, above and below the hernia defect and strengthening with polypropylene mesh. In the second group (comparison), patients underwent laparoscopic preperitoneal alloplasty of umbilical hernia without suturing rectus diastase.
Results and discussion . The immediate results in the main and comparison patients were comparable. Seroma at the trocar wound in patients of the main group was observed in 3 (7.3%) and 4 (9.7%) comparison groups. Long-term results in the period from 1 to 3 years showed that among 38 patients of the main group recurrence of umbilical hernia was found in 1 (2.6%), and among 38 patients in the comparison group in 5 (13.1%). The causes of recurrence of umbilical hernia among patients in the comparison group was not eliminated diastase of the rectus muscles.
Conclusion:
Laparoscopic preperitoneal alloplasty of umbilical hernias of large size with suturing of concomitant rectus diastase in comparison with traditional laparoscopic allohernioplasty improves the results of treatment, namely, helps reduce the recurrence of hernia to 2.6% vs. 13.1%.
In umbilical hernias of large size (W3) the recurrence rate remains at 5-10%. One of the causes of recurrence of large umbilical hernias during laparoscopic surgery is diastasis of the rectus abdominis, which is often concomitant and is not eliminated during surgery.
The aim:
Improving the effectiveness of laparoscopic alloplasty of umbilical hernias of large size.
Materials and methods. Analysis of laparoscopic preperitoneal alloplasty of umbilical hernias of large size (W3) was performed in 82 patients. Age of patients from 25 to 75 years. The mean age was 56 ± 1.2 years. There were 64 women (78%) and 18 men (22%). Depending on the method of surgical treatment, patients were divided into two groups. In the first (main) group in 41 patients laparoscopic preperitoneal alloplasty of umbilical hernia of large size with suturing of diastase of rectus muscles, above and below the hernia defect and strengthening with polypropylene mesh. In the second group (comparison), patients underwent laparoscopic preperitoneal alloplasty of umbilical hernia without suturing rectus diastase.
Results and discussion . The immediate results in the main and comparison patients were comparable. Seroma at the trocar wound in patients of the main group was observed in 3 (7.3%) and 4 (9.7%) comparison groups. Long-term results in the period from 1 to 3 years showed that among 38 patients of the main group recurrence of umbilical hernia was found in 1 (2.6%), and among 38 patients in the comparison group in 5 (13.1%). The causes of recurrence of umbilical hernia among patients in the comparison group was not eliminated diastase of the rectus muscles.
Conclusion:
Laparoscopic preperitoneal alloplasty of umbilical hernias of large size with suturing of concomitant rectus diastase in comparison with traditional laparoscopic allohernioplasty improves the results of treatment, namely, helps reduce the recurrence of hernia to 2.6% vs. 13.1%.
Background:
In umbilical hernias of large size (W3) the recurrence rate remains at 5-10%. One of the causes of recurrence of large umbilical hernias during laparoscopic surgery is diastasis of the rectus abdominis, which is often concomitant and is not eliminated during surgery.
The aim:
Improving the effectiveness of laparoscopic alloplasty of umbilical hernias of large size.
Materials and methods. Analysis of laparoscopic preperitoneal alloplasty of umbilical hernias of large size (W3) was performed in 82 patients. Age of patients from 25 to 75 years. The mean age was 56 ± 1.2 years. There were 64 women (78%) and 18 men (22%). Depending on the method of surgical treatment, patients were divided into two groups. In the first (main) group in 41 patients laparoscopic preperitoneal alloplasty of umbilical hernia of large size with suturing of diastase of rectus muscles, above and below the hernia defect and strengthening with polypropylene mesh. In the second group (comparison), patients underwent laparoscopic preperitoneal alloplasty of umbilical hernia without suturing rectus diastase.
Results and discussion . The immediate results in the main and comparison patients were comparable. Seroma at the trocar wound in patients of the main group was observed in 3 (7.3%) and 4 (9.7%) comparison groups. Long-term results in the period from 1 to 3 years showed that among 38 patients of the main group recurrence of umbilical hernia was found in 1 (2.6%), and among 38 patients in the comparison group in 5 (13.1%). The causes of recurrence of umbilical hernia among patients in the comparison group was not eliminated diastase of the rectus muscles.
Conclusion:
Laparoscopic preperitoneal alloplasty of umbilical hernias of large size with suturing of concomitant rectus diastase in comparison with traditional laparoscopic allohernioplasty improves the results of treatment, namely, helps reduce the recurrence of hernia to 2.6% vs. 13.1%.
In umbilical hernias of large size (W3) the recurrence rate remains at 5-10%. One of the causes of recurrence of large umbilical hernias during laparoscopic surgery is diastasis of the rectus abdominis, which is often concomitant and is not eliminated during surgery.
The aim:
Improving the effectiveness of laparoscopic alloplasty of umbilical hernias of large size.
Materials and methods. Analysis of laparoscopic preperitoneal alloplasty of umbilical hernias of large size (W3) was performed in 82 patients. Age of patients from 25 to 75 years. The mean age was 56 ± 1.2 years. There were 64 women (78%) and 18 men (22%). Depending on the method of surgical treatment, patients were divided into two groups. In the first (main) group in 41 patients laparoscopic preperitoneal alloplasty of umbilical hernia of large size with suturing of diastase of rectus muscles, above and below the hernia defect and strengthening with polypropylene mesh. In the second group (comparison), patients underwent laparoscopic preperitoneal alloplasty of umbilical hernia without suturing rectus diastase.
Results and discussion . The immediate results in the main and comparison patients were comparable. Seroma at the trocar wound in patients of the main group was observed in 3 (7.3%) and 4 (9.7%) comparison groups. Long-term results in the period from 1 to 3 years showed that among 38 patients of the main group recurrence of umbilical hernia was found in 1 (2.6%), and among 38 patients in the comparison group in 5 (13.1%). The causes of recurrence of umbilical hernia among patients in the comparison group was not eliminated diastase of the rectus muscles.
Conclusion:
Laparoscopic preperitoneal alloplasty of umbilical hernias of large size with suturing of concomitant rectus diastase in comparison with traditional laparoscopic allohernioplasty improves the results of treatment, namely, helps reduce the recurrence of hernia to 2.6% vs. 13.1%.
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