Experience in performing posterior separation plasty in giant postoperative ventral hernias

Aim. To present the experience in performing posterior separation plasty according to Yu. Novitskiy, to evaluate the efficacy and safety of the technique.

Methods. The results of treatment of 22 patients with giant middle postoperative ventral hernias, treated in the surgical department №1 of Kazan City clinical hospital №7 in 2013-2016, were analyzed. 9 patients had open posterior separation plasty of the abdominal wall in Yu. Novitskiy’s modification performed (study group). Comparison group included 13 patients who had standard tension-free inlay-plasty.

Results. The average duration of surgery in the study group was 143.9±10.7 min, in comparison group - 136.6±12.1 min. In the study group there were no serious complications in the immediate postoperative period. In 3 cases at control ultrasound examination clinically insignificant seromas were found which did not require additional treatment and self-resolved within the period of 3 weeks. In one case there was lymphorrhea from the wound for 9 days. Healing of a surgical wound in all cases was by primary intention. Average hospital stay was 10.2±0.6 days. There were no lethal outcomes. Recurrence of the disease in the observed period was not registered.

Conclusion. Posterior separation plasty of the abdominal wall in Yu. Novitskiy’s modification is a safe and effective technique that allows recommending this surgery to the surgeons operating patients with giant postoperative ventral hernias.