Ultrasonic monitoring of the abdominal wall in ventroplasty

Abstract

Aim: To optimize the immediate outcomes of surgical treatment of patients with postoperative ventral hernias.Material and Methods. This prospective cohort study analyzed the results of comprehensive diagnostics and surgical treatment of 114 patients with postoperative ventral hernias, admitted to the Dushanbe City Emergency Medical Center between 2014 and 2022. Patients were divided into two groups based on the surgical treatment method used. The control group included 59 (51.8%) patients who underwent hernioplasty using tension techniques. The main group consisted of 55 (48.2%) patients who underwent hernioplasty using non-tension techniques.Results and Discussion. The two groups differed not only in hernioplasty methods but also in pain management techniques, both intraoperatively and postoperatively. Among the 59 patients in the control group, general endotracheal anesthesia was used in 57 (96.6%) patients, while regional pain relief methods were employed in the remaining 2 (3.4%). Coexisting pathologies affecting the degree of surgical risk were identified in 21 (35.6%) patients. Large hernia sizes were observed in 29 (49.2%) patients. Among 55 patients of the main group, the presence of concomitant diseases affecting the degree of operational risk was detected in 23 (41.8%). Large hernias were found in 37 (67.3%) patients. In 41 (74.5%) cases, endotracheal anesthesia was used in patients of this group, and in the remaining 14 (25.5%) cases, regional methods of anesthesia were used, the use of endotracheal anesthesia was combined with the use of spinal anesthesia.Conclusion. Selecting the most optimal anesthesia method, hernioplasty technique using high-quality synthetic material, local application of the drug Diprospan, and extensive use of ultrasonic methods for postoperative monitoring in patients with postoperative ventral hernias (PVH) can improve the outcomes of their surgical treatment.