The analysis of the results of surgical treatment of ventral and postopertive hernias with the use of laparoscopic IPOM technology

Introduction. The aim of this work is to study the immediate and long-term results of treatment of ventral and incisional hernias using the laparoscopic IPOM technology. Materials and methods. A comparative retrospective-prospective cohort study of the results of surgical interventions using minimally invasive laparoscopic IPOM (intraperitoneal onlay mesh) plasty and open Sublay plasty was performed in 144 patients who sought medical help for ventral hernia, with a hernia orifice size up to 130 cm2. All patients were employed between the ages of 22 and 56 years. Of these, 63% are women and 37% are men. The average age of the patients was 46±7.3 years. Discussion. An ultrasound examination of the anterior abdominal wall at the preoperative stage made it possible to avoid vascular damage during the operation and, as a consequence, hematomas in the early postoperative period. The study showed that the use of laparoscopic hernioplasty reduces the number of seromas in comparison with the control group by half, significantly reduces the risk of hematomas and infiltrates. The use of IPOM plastic statistically significantly reduces the duration of the operation, the time of restoration of the intestinal motor-evacuation function. There was a significant decrease in the duration of taking analgesics and the length of hospital stay. The analysis of the restoration of working capacity was carried out depending on the method and dimensions of the hernial defect. The ability to work was restored in all cases. It is noteworthy that there was no significant difference in the timing of mental and light work. Performing work of moderate severity was possible after 2.5-3 weeks in patients of the first group, and heavy work after 1.5 months. In the patients of the control group, moderate and hard work was possible only by 2-2.5 months. Conclusions. 1. The use of the modified method of intraperitoneal laparoscopic hernioplasty, IPOM, is a safe method of treating patients with ventral and incisional hernias with hernial orifice sizes W1-W2; it can reliably reduce the risk of postoperative seroma formation by almost 2 times, as well as the formation of anterior abdominal wall hematomas and infiltrates. The use of laparoscopic technologies makes it possible to reduce postoperative pain syndrome, avoid hematomas of the anterior abdominal wall, reduce the length of hospital stay, and reduce the need for the administration of parenteral analgesics (p function show_eabstract() { $('#eabstract1').hide(); $('#eabstract2').show(); $('#eabstract_expand').hide(); }