Evolution of ventral hernia repair

Abstract

The management of ventral hernia is continuously evolving as it responds to new demands and new technology in surgery.

Retromuscular Sublay Technique for Ventral Hernia Repair

“…This tension on the tissues is important to discuss since it has been implicated as the cause of many operative failures. 9 Ramirez et al found a partial solution for this issue in 1990 with the description of a myofascial release, or component separation, of the external oblique muscle from the lateral edges of the rectus abdominis. 15 This maneuver allows for added laxity of the midline, leading to less strain on the fascia when brought back together.…”

“…This chapter reviews the terminology, technique, outcomes, and future directions of retromuscular sublay repairs while explaining why this operative procedure took several years to become popular despite its original description more than 50 years ago. 8,9 Nomenclature Conceptually, a sublay repair can be thought of as mesh placement in a pocket formed anterior to the peritoneum and posterior to the rectus abdominis. 10 However, misperception of the nomenclature arises due to the several terms used (often interchangeably), to describe mesh placement in this tissue plane-such as retromuscular, retrorectus, preperitoneal, and Rives-Stoppa.…”

“…This location of the mesh allows for incorporation into the surrounding autologous tissues and reinforcement of the fascia without contacting intraperitoneal structures. 9,11 Rives translated these principles to VHR but described placement of the mesh as retromuscular (posterior to the rectus muscle but anterior to the posterior rectus sheath). 11 The reason Stoppa and Rives used different terminology was because of the anatomical differences in their respective operative fields.…”

Endovideosurgical retromuscular methods for ventral hernia repair surgery

“…В истории хирургии вентральных грыж было несколько важных этапов. Один из них связан с применением синтетических имплантатов, другойс появлением сепарационных пластик, к третьему этапу можно заслуженно отнести внедрение эндовидеохирургических методов лечения [13,14]. Эру малоинвазивных технологий в хирургии вентральных грыж в 1993 г. начал французский хирург K. LeBlanc.…”

A systematic methodological review of non-randomised interventional studies of elective ventral hernia repair: clear definitions and a standardised minimum dataset are needed

“…With an ageing [2] and increasingly obese [3] population, the risk of incisional hernia post midline laparotomy has increased, from 8% in 1980 to 16% in 2012 [4]. Recurrence after a previous hernia repair is also high, with minimal improvement over the last 30 years [5]. VHs that repeatedly recur, have a wide ventral defect or are contaminated are known as complex VHs, and successful repair is extremely challenging [6].…”