Hernioabdominoplasty after obstetric and gynecological operations in obese patients

Abstract

Statistics on the healing of obstetric and gynecological laparotomies with the formation of postoperative ventral hernias indicate a correlative and pathogenetic link with abdominal obesity in these patients, and inflammatory complications of subsequent corrective hernioplasty often have the same cause. The aim of the study was to improve the clinical and aesthetic results of surgical treatment of patients with hypogastric postoperative ventral hernias and scarring of the anterolateral abdominal wall on the background of abdominal obesity. The work is based on the analysis of paraoperative studies of 30 patients. The main group consisted of 19 patients who had umbilicalhypogastric postoperative ventral hernias of various sizes and locations after lower laparotomies or laparoscopic interventions. The comparison group included 11 patients who had only soft tissue deformities of the anterior abdominal wall without aponeurotic defects and hernias. Statistical processing of the results was performed using the software "Statistica 6.1". During the analysis of the obtained data it was found that parahernian excess tissues of the anterolateral abdominal wall after obstetric and gynecological operations have mainly supraaponeurotic localization and metric characteristics determined by the set size of the hernia, the severity of surrounding fatty layers and fibro-scar components. When performing hernioabdominoplasty in the conditions of ALAW obesity in patients with umbilical-hypogastric postoperative ventral hernias, sound tactics of dermolipectomy/fibrolipectomy were introduced in combination with abdominoplasty. This combination of surgical interventions reduces the incidence of local complications of hernia surgery to 4.5 %.