Small ventral hernias
Small defects are ideal for IPOM-plus: the hernial contents are reduced, the defect is sutured from the inside with a non-absorbable suture (the white line is restored), and a 10–15 cm mesh with an anti-adhesion coating covers the area with a reserve, being fixed around the perimeter. At the same time, the entire abdominal wall is examined - small additional defects (common with trocar and epigastric hernias) are closed with the same mesh. Moderate pain for 2–3 days, bandage for 4 weeks, sports after 6 weeks.
Indications
- postoperative (ventral) hernia in the scar after previous operations;
- hernia of the white line of the abdomen, diastasis with hernia;
- hernia growth, episodes of irreducibility - risk of strangulation;
- recurrent ventral hernias after repair without mesh.
IPOM and E-TAR techniques
During laparoscopic IPOM repair, a composite mesh with an anti-adhesion coating is installed from the inside of the abdominal cavity, covering the defect by 5 cm in all directions and fixing it around the perimeter; If possible, the defect is sutured over a mesh (IPOM-plus). With the E-TAR/eTEP technique, the mesh is placed in the layers of the abdominal wall without contact with the intestine, with restoration of the midline - anatomical reconstruction for medium and large hernias. The choice depends on the size and location of the defect, the condition of the tissues; The cost of the implant is included in the price list. Relapses with mesh techniques are 3–5% versus 30–50% with simple suturing.
Benefits of laparoscopy
Laparoscopic access is the standard of modern abdominal surgery: instead of a 10–20 cm incision, 3–4 punctures are left, the pain after surgery is much less, the patient gets up on the day of surgery and is discharged after 1–2 days, the risk of wound infection, hernias in the scar and adhesions is several times lower, and the enlargement of the camera allows you to operate more accurately. In the clinics below, operations are performed by surgeons with extensive laparoscopic experience; hospital (SKD) is included in the price according to the price list.
