Without implant: fair conditions
Autoplasty is viable in a narrow range of indications: small defect, elastic strong aponeurosis, normal BMI, absence of cough and constipation; under these conditions, duplication with two rows of sutures gives a good result. For defects larger than 4 cm and weak tissues, relapses reach 30–50% - then a mesh is required (options with an implant are nearby in “Options and prices”). After the operation - bandage for 8 weeks, prohibition of heavy weights for 3 months; The final strength of the scar takes six months to form.
Indications
- postoperative ventral hernias of medium and large size with wall deformation;
- hernias with excess skin and scars requiring excision;
- relapses after plastic surgery without mesh;
- cases when laparoscopic access is impractical (extensive scars, risk of anesthesia).
ON LAY technique
In open ON LAY repair, the mesh is placed over the sutured aponeurosis, covering the defect by 5 cm in all directions and fixing it around the perimeter: a technically reliable and reproducible method for medium and large postoperative hernias, allowing simultaneous excision of the scar and excess skin (improving the contour of the abdomen). Mandatory elements are active drainage of the mesh bed and a compression bandage, which reduce the risk of seromas. The choice between ON LAY, sublay and laparoscopic techniques (IPOM, E-TAR - in the “Options and prices” block) is made by the surgeon based on the size of the defect and the condition of the tissues.
