Incisional hernia repair with polypropylene mesh

1. Incisional hernia repair with polypropylene mesh Vladivostok State Medical University Made by: Piskunova Anna

2. RELEVANCE Hernia surgery is a core activity for general surgeons. The annual rate for hernia repair is approximately 200 operations per 100,000 population. Therefore, most district general hospitals will perform many hundreds of hernia repairs each year. Ventral hernias occur in 3 - 7% of population. And incisionalhernias develop in up to 11% of surgical abdominal wounds with a possible recurrence following repair of 44%.

3. PROBLEM OF CHOOSING AN OPERATION METHOD • Types of Repair: • Primary, • Primary with relaxing incisions, • Primary with onlay mesh reinforcement, • Onlay mesh only, • Inlay mesh placement, • Retrorectus mesh placement, • Intraperitoneal mesh placement Using classic hernia repair methods, relapse is observed in 10-35%. During recurrent hernia repair this index measures up 45,5-63,7%. Furthermore, multiple recurrent and huge abdominal hernias are the most difficult one for surgeons to be treated.

4. ABDOMINAL WALL REPAIR WITH DIFFERENT BIOLOGICAL AND SYNTHETIC MATERIALS Material Product name • Polypropylene Marlex (monofilament) • Prolene (double filament) • Surgipro (multifilament) • Atrium (multifilament) • Vypro (multifilament) • Polytetrafluorethylene (PTFE) Teflon (multifilament) • Gore-Tex (soft tissue-patch) • Dualmesh • Parietex • Polyester Mersilene (multifilament) • Dacron • Polyamide Nylon • Polyglactin 910 Vicryl (resorbable) • Polyglycolic acid Dexon (resorbable)

5. Theassessment and elaboration of effective surgical methods of incisional hernias remain relevant.

6. THE GOAL The goal of this paper is to analyze the outcome after surgical treatment of incisional hernias with synthetic netlike materials.

7. RESEARCH TASKS • To work up operations logs of surgical department of Internal Affairs Derectorate Hospital and out-patient medical recordes since 2004 till 2011 year. • To study the method of incisional hernias allogenic, its guides, contra indications, possible complications and their pathogenic mechanism. • To analyze outcome after surgical treatment of incisional hernias to improve the effectiveness of hernia repair with synthetic netlike materials. • To analyze remote results of incisional hernias repair with polypropylene mesh.

8. MATERIALS AND METHODS 82 patients with incisional hernias in age of 28-78 years old were operated with meshyimplants at Hospital of the Internal Affairs Department. There were 51 (62%) male patients and 31 (38%)female patients in the study group.

9. PATIENTS AGE

10. HERNIA GATE SIZE

11. Two variants of tension free combined repair were performed for patching up hernia defect in the studygroup. They were an ‘on lay’ and ‘in lay' synthetic implant position.

12. ON-LAY METHOD

13. IN-LAY METHOD

14. RESULTS AND DISCUSSION 6 post operated patients had seromas, being treated conservatively, during the monitoring at in-patient department. The patients were followed for 2 - 5 years. During this period only two relapses occurred, hernia defects being over 20 cm or multiple defects being observed in fascia.

15. CONCLUSION reduce recurrence level and the amount of purulent after-surgery complications compared to conventional repair methods. Using ‘tension free’ methods for incisional ventral hernias repair with synthetic meshy implants makes it possible for the surgeons to

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