Application of endovideosurgery in the treatment of ventral hernias after gunshot wounds of the abdomen

Abstract

Gunshot wounds of the abdomen are often accompanied by a significant destruction of the abdominal cavity with the development of peritonitis, and in the future — various complications (failure of anastomoses, abscess formation, repeated bleeding, etc.), which requires repeated surgical interventions, and as a consequence — the formation of postoperative ventral hernias. The aim of the study is to improve the results of surgical treatment of ventral hernias after gunshot wounds of the abdomen due to the use of laparoscopic techniques. The analysis of treatment of 21 patients with postoperative ventral hernias formed as a result of operations concerning gunshot wounds of the abdomen was carried out. 14 wounded suffered one operation on the abdominal organs in the past (66.7%), 5 — two operations (23.8%), 1 — three operations (4.8%), 1 — five operations (4.8%). The dimensions of the hernial gates and the risk of recurrence were determined according to the SWE classification: W1 — 9 patients (42.9%), W2 — 8 (38.1%), W3 — (9.5%), W4 — 2 (9.5% ). The third patients underwent laparoscopic allogernioplasty according to the IROM technique with a Teflon allograft, which was fixed in 2 cases with the help of a herniostepler, in the 1st — with transdermal separate seams with Teflon filament. Complications after laparoscopic operations were not. The use of laparoscopic techniques can significantly reduce bed-day, avoid the development of abdominal compartment syndrome, previously to activate the patient. Laparoscopic allogernioplasty according to the method of IPOM by the Teflon graft is considered to be the operation of choice.