About this trial
The goal of our work of optimization of the treatment of postoperative hernias is to improve the results of treatment of patients with median and median-lateral postoperative hernias of medium (W2) and large (W3) sizes by developing new surgical techniques. The main questions it aims to answer are:
1. To study the topographic and variant anatomy of vessels and nerves in the retromuscular, preperitoneal, postperitoneal and pre-abdominal cell spaces of the anterior abdominal wall. To determine the most probable sources of blood flow and lymph from the anatomical formations forming the bed of the endoprosthesis. 2. To develop technical, surgical techniques that allow to form an implant bed with minimal traumatization of blood vessels and nerves and reduce the risk of postoperative complications. 3. To develop a technique for plasty of the anterior abdominal wall in mid-lateral postoperative hernias with a combination of retromuscular and subaponeurotic spaces.
The researchers will compare an experimental group in which a new method of preparing the implant place will be used and a control group in which standard methods of treating postoperative ventral hernias were used to see whether the new method affects the improvement of the postoperative period and the reduction of complications.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
The study will include patients with postoperative ventral hernias of median and lateral localization and an average hernial gate width from 4.1 to 15 cm (W2-W3 according to the EHS classification).. The size of the hernial gate is determined by CT.
Disqualifiers
Patients without postoperative ventral hernias median and lateral localization
Trial design
Crossover
Treatments tested in this trial
A new method of repair of the abdominal wall of mid-lateral postoperative ventral hernias
Procedure/Surgery1. It is planned to study potential sources of bleeding and hematoma formation during SRM plastic surgery. On this basis, recommendations on the technique of the operation will be formulated. 2. It is supposed to find a way to preserve intercostal neurovascular bundles when performing SRM repair. This should improve the quality of abdominal wall reconstruction by preserving neurovascular bundles of muscles and reducing neuroalgic pain syndrome. 3. It is proposed to develop a method for combining retromuscular and subaponeurotic spaces in the treatment of mid-lateral hernias 4. It is planned to substantiate the effectiveness and expediency of the application of the developed surgical techniques based on the analysis of the immediate and long-term results of treatment.
Treatment groups
Trial outcomes
Primary outcomes
rate of seroma
rate of development of seroma in postoperative area
rate of hematoma
rate of development of hematoma in postoperative area
Recurrence rate
Rate of hernia recurrences diagnosed at clinical and/or ultrasound examination
Secondary outcomes
Pus
rate of development of suppuration in postoperative area
Persisting postoperative pain
Pain interfering with daily activities as rated with Ventral Hernia Pain Questionnaire
Sponsors and contacts
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