Сurrent methods of treating patients with large midline postoperative ventral hernias
https://doi.org/10.17238/2072-3180-2025-3-190-197
Abstract
Introduction. Ventral hernias are a common postoperative complication, particularly following midline laparotomy, with an incidence exceeding 30%. Surgical treatment presents significant challenges due to pronounced anatomical abnormalities, fibrotic tissue changes, severe comorbidities, and the complexity of planning the extent and nature of reconstructive interventions during preoperative preparation. In recent years, new approaches to treating large postoperative midline ventral hernias (POVH) have emerged, requiring systematic analysis and evaluation of their effectiveness.
Objective. To conduct a systematic analysis of modern surgical techniques for treating large POVH, including various separation-based repair techniques, and to assess the efficacy of preoperative botulinum toxin type A (BTA) in the comprehensive management of this condition
Results. A reduction in postoperative complications and recurrence rates was observed with the use of posterior separation-based repair (Transversus Abdominis Muscle Release, TAR). Preoperative BTA administration in these patients contributed to an average increase in lateral abdominal wall muscle mobility of 3.2–4.7 cm on each side, facilitating effective closure of midline defects and reducing the extent of separation-based repair.
Conclusion. Preoperative BTA administration in patients with large midline hernias allows for a reduction in the extent of separation-based repair, thereby decreasing surgical trauma and the risk of compartment syndrome.
About the Authors
H. Othman
Department of hospital surgery with a course of pediatric surgery of the RUDN University named after Patrice Lumumba
Russian Federation
Russian Federation
Othman Hassan – Phd student
117198, Miklukho-Maklaj str., 6, Moscow
M.K.M. Al-Ariki
Department of hospital surgery with a course of pediatric surgery of the RUDN University named after Patrice Lumumba
Russian Federation
Russian Federation
Al-Ariki Malik Kiaed Mohammed – Candidate of Medical Sciences, assistant professor
117198, Miklukho-Maklaj str., 6, Moscow , 8 977 685 10 28
M. A. Chinikov
Department of hospital surgery with a course of pediatric surgery of the RUDN University named after Patrice Lumumba
Russian Federation
Russian Federation
Chinikov Maxim Alekseevich – Doctor of Medical Sciences, professor
117198, Miklukho-Maklaj str., 6, Moscow
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Review
For citations:
Othman H., Al-Ariki M., Chinikov M.A. Сurrent methods of treating patients with large midline postoperative ventral hernias. Moscow Surgical Journal. 2025;(3):190-197. (In Russ.) https://doi.org/10.17238/2072-3180-2025-3-190-197
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