FEATURES OF PERFORMING NON-TENSION HERNIALLOPLASTY FOR LARGE AND GIANT VENTRAL HERNIAS TAKING INTO ACCOUNT A DIFFERENTIATED APPROACH
DOI:
https://doi.org/10.37547/Keywords:
ventral hernia; large hernial defects; tension-free hernioalloplasty; Ramirez component separation; intra-abdominal pressure.Abstract
The article presents the materials of a clinical and surgical study of 137 patients with large and giant ventral hernias, operated on in 2018–2025. A comparison was made between standard tactics (2018–2021, n=58) and a differentiated approach (2022–2025, n=79), which included tension-free reconstruction options with Ramirez mobilization and, in cases of a high risk of tension/growth of the IAP and a defect >15 cm, a modified technique with aponeurosis mobilization and formation of a barrier aponeurotic layer. In the main group, the incidence of early postoperative complications was significantly reduced (18.9% versus 8.9%; p=0.045) and the incidence of relapses in the late period was reduced (11.4% versus 1.8%), which confirms the clinical feasibility of the risk-stratified choice of tension-free hernioalloplasty in patients with large defects.
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