Perioperative intra-abdominal pressure parameters for different surgical techniques in patients with ventral hernias
Aim. To study perioperative IAP parameters with various methods of hernioplasty in patients with ventral hernias.Materials and research methods. The results of the treatment of 148 patients with ventral hernias were studied. The first group included 58 patients for whom an anterior separation plasty was used for hernioplasty. The second group included 44 patients who underwent posterior separation of the abdominal wall muscles. The third group consisted of 46 patients who underwent onlay (n=28) and sublay (n=18) methods of hernioplasty.Results and discussion. In patients with W3 hernias, when closing the edges of the hernia orifice, there was a significant increase in IAP to a level corresponding to the I degree of intra-abdominal hypertension, which averaged 12.8±1.9 mm Hg (p<0.05). In patients with W4 hernias, the level of intra-abdominal pressure after closing the edges of the hernia orifice was significantly higher than in patients with W3 hernias, and on average they were 14.7±1.7 mm Hg. (p<0.05), which corresponded to the upper limit of the I degree of intra-abdominal pressure.Conclusion. The results of perioperative monitoring of intra-abdominal pressure indicate the tension nature of onlay and sublay hernioplasty methods, and therefore their use in hernias of W3 and W4 sizes is contraindicated. For large and giant hernias, the use of separation methods of hernioplasty is recommended.