Issues and challenges in the surgical treatment of anterior abdominal wall hernias. Review

Authors

DOI:

https://doi.org/10.30978/GS-2023-1-58

Keywords:

ventral hernia, incisional hernia, hernioplasty, mesh

Abstract

The literature review discusses contentious issues and challenges that arise in the surgical treatment of anterior abdominal wall hernias. The author identified the causes of hernia formation and examined the dynamics of change in the pattern of hernia incidence. An analysis of the factors that contribute to the development of incisional ventral hernias was given special consideration. The causes of hernia recurrence were also studied. The entire spectrum of existing classifications of primary and incisional ventral hernias was reviewed, along with their advantages and disadvantages. Evaluation of current recommendations regarding the use of additional imaging methods for the examination of patients with ventral hernias was carried out. In the study, considerable attention was paid to surgical methods for hernia treatment. The advantages and disadvantages of “open” and minimally invasive laparoscopic hernioplasty techniques were critically evaluated. The difficulties in selecting an intervention method for certain types of hernias, including large ones, were highlighted, as was the importance of preventing hernia recurrence.

It has been established that there are still many unsolved problems in the surgical treatment of anterior abdominal wall hernias. The author justified the need for a standardized approach to determining the characteristics of anterior abdominal wall hernias and their further classification. It is necessary to study the effectiveness of using imaging methods (ultrasound, computed tomography) for ventral hernias, depending on their size and location. There is a need for wider implementation of laparoscopic hernioplasty techniques, and the degree of the hernial defect should be taken into account when determining the indications for surgical intervention. The possibility of using laparoscopic hernioplasty for large hernias, as well as for hernias associated with rectus abdominis diastasis, requires further investigation. Improving management strategies for patients with anterior abdominal wall hernias is critical in order to reduce the risk of hernia recurrence and complications.

Author Biography

T. V. Tarasiuk, Bogomolets National Medical University, Kyiv

PhD, Associate Professor

References

Vansovych VIe, Osadchyi DM. Laparoskopichna hernioplastyka pisliaoperatsiinykh ventralnykh hryzh iz zastosuvanniam politetrafluoroetylenovoi sitky z nitynolovym karkasom (Rebound System). Shpytalna khirurhiia. 2012;(3):120-3. Ukrainian.

Hrubnik VV, Parfentiev RS, Askerov Ie, Vorotyntseva KO. Perspektyvni metody likuvannia ventralnykh hryzh. Acta Medica Leopoliensia. Lvivskyi medychnyi chasopys. 2009;XV(3):47-9. Ukrainian.

Zhebrovskyi VV, Kosenko AV, Voronov NV. y dr. Osobennosty operatyvnoho lechenyia oslozhnennыkh form posleoperatsyonnыkh hrыzh briushnoi stenky. Klinichna khirurhiia. 2010;(3):31-4. Ukrainian.

Ioffe OIu, Stetsenko OP, Tarasiuk TV, Tsiura IuP, Pradosh IM. Formuvannia pupka pry laparoskopichnii hernioplastytsi za metodykoiu IROM z pryvodu neuskladnenykh pupkovykh hryzh. Khirurhiia Ukrainy. Surgery of Ukraine. 2013;(3):51-4. Ukrainian.

Kashtalian MA, Shapovalov VIu. Yspolzovanye byomateryala polytetraftorэtylen v khode laparoskopycheskoi allohernyoplastyky ventralnыkh hrыzh. Khirurhiia Ukrainy. Surgery of Ukraine. 2011;(3):59. Ukrainian.

Kravchenko BS, Klymenko AB, Klymenko VM, Serhieieva LN. Porivnialnyi analiz operatyvnykh vtruchan z pryvodu pisliaoperatsiinoi ventralnoi hryzhi v patsiientiv z ozhyrinniam. Medychni perspektyvy. 2021;26(3):78-84. http://doi.org/10.26641/2307-0404.2021.3.241958. Ukrainian.

Lerchuk OM, Havrysh IaI, Lerchuk MO, Markevych IuO, Pavlovskyi MP. Laparoskopichna hernioplastyka rubtsevykh ventralnykh hryzh. Halyts. likar. visn. 2002;9(3):179-80. Ukrainian.

Lytvynenko OM, Lukecha II. Laparoskopichna hernioplastyka pisliaoperatsiinoi ventralnoi kyly. Khirurhiia Ukrainy. Surgery of Ukraine. 2014;(3):34. Ukrainian.

Lutkovskyi R. Aloplastyka pisliaoperatsiinykh ventralnykh hryzh zhyvota z vykorystanniam nanomodyfikovanoi polipropilenovoi sitky. Aktualni problemy suchasnoi medytsyny. 2019;3:61-6. http://doi.org/10.26565/2617-409X-2019-3-09. Ukrainian.

Pak VIa, Bereznyi TV, Sytnik OL, Melekhovets IuV, Pererva OO. Protyretsydyvna plastyka hryzh perednoi cherevnoi stinky. Kharkivska khirurhichna shkola. 2022;(4-5):38-41. http://doi.org/10.37699/2308-7005.4-5.2022.08. Ukrainian.

Pepenyn AV, Yoffe YV, Alekseev AV, Pepenyn NA. Laparoskopycheskaia korrektsyia IROM troakarnыkh paraumbylykalnыkh hrыzh. Khirurhiia Ukrainy. Surgery of Ukraine. 2014;(3):42-3. Ukrainian.

P’iatnochka VI. Nevyrisheni pytannia khirurhichnoho likuvannia khvorykh na pisliaoperatsiinu ventralnu hryzhu za umov komorbidnosti. Visnyk naukovykh doslidzhen. 2017;(1):11-5. http://doi.org/10.11603/2415-8798.2017.1.7348. Ukrainian.

Tarasiuk TV. Pershyi dosvid vykorystannia botulotoksynu typu A pry khirurhichnomu likuvanni ventralnykh hryzh. Shpytalna khirurhiia. Zhurnal imeni L. Ia. Kovalchuka. 2020;(2):102-5. http://doi.org/10.11603/2414-4533.2020.2.10775. Ukrainian.

Feleshtynskyi IaP. Pisliaoperatsiini hryzhi zhyvota. K.: Biznes-Lohika; 2012. 200 p. Ukrainian.

Feleshtynskyy̆ YaP, Lerchuk OM, Smishchuk VV. Optymizatsiia vyboru laparoskopichnoï ta vidkrytoï aloplastyky pry pisliaoperatsiy̆nykh ventralnykh hryzhakh. Klinichna ta eksperymentalna patolohiia. 2021;20(2):80-7. http://doi.org/10.24061/1727-4338. XX.2.76.2021.12. Ukrainian.

Feleshtynskyy̆ YaP, Lerchuk OM, Smishchuk VV, Hudyma IaM. Laparoskopichna preperytonealna aloplastyka pisliaoperatsiy̆nykh ventralnykh hryzh. Klinichna khirurhiia. 2020;87(5-6):50-4. http://doi.org/10.26779/2522-1396.2020.5-6.50. Ukrainian.

Adotey JM. Incisional hernia: a review. Niger J Med. 2006;15(1):34-43. http://doi.org/10.4314/njm.v15i1.37113.

Alghamdi F. Ventral hernia: an innovative grading system. International Journal of Clinical Medicine. 2022;13:204-211. https: // doi.org/10.4236/ijcm.2022.135017.

Alnassar S, Bawahab M, Abdoh A, Guzman R, Al Tuwaijiri T, Louridas G. Incisional hernia postrepair of abdominal aortic occlusive and aneurysmal disease: five-year incidence. Vascular. 2012;20(5):273-7. http://doi.org/10.1258/vasc.2011.oa0332.

Ammaturo C, Bassi G. The ratio between anterior abdominal wall surface/wall defect surface: a new parameter to classify abdominal incisional hernias. Hernia. 2005;9(4):316-21. http://doi.org/10.1007/s10029-005-0016-8.

Andersen LP, Klein M, Gögenur I, Rosenberg J. Incisional hernia after open versus laparoscopic sigmoid resection. Surg Endosc. 2008;22(9):2026-9. http://doi.org/10.1007/s00464-008-9924-x.

Andersen LP, Klein M, Gögenur I, Rosenberg J. Long-term recurrence and complication rates after incisional hernia repair with the open onlay technique. BMC Surg. 2009;9:6. http://doi.org/10.1186/1471-2482-9-6.

Beadles CA, Meagher AD, Charles AG. Trends in emergent hernia repair in the United States. JAMA Surg. 2015;150(3):194-200. http://doi.org/10.1001/jamasurg.2014.1242.

Bedewi MA, El-Sharkawy MS, Al Boukai AA, Al-Nakshabandi N. Prevalence of adult paraumbilical hernia. Assessment by high-resolution sonography: a hospital-based study. Hernia. 2012;16(1):59-62. http://doi.org/10.1007/s10029-011-0863-4.

Bittner R, Bain K, Bansal VK, et al. Update of Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS))-Part A [published correction appears in Surg Endosc. 2019 Jul 12]. Surg Endosc. 2019;33(10):3069-139. http://doi.org/10.1007/s00464-019-06907-7.

Bittner R, Bain K, Bansal VK, et al. Update of Guidelines

for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)): Part B. Surg Endosc. 2019;33(11):3511-49. http://doi.org/10.1007/s00464-019-06908-6.

Bittner R, Bingener-Casey J, Dietz U, et al. Guidelines for laparoscopic treatment of ventral and incisional abdominal wall hernias (International Endohernia Society (IEHS)-part 1. Surg Endosc. 2014;28(1):2-29. http://doi.org/10.1007/s00464-013-3170-6.

Bougard H, Coolen D, de Beer R, et al. HIG (SA) Guidelines for the Management of Ventral Hernias. South African Journal of Surgery. 2016;54(4):S1-S32.

Burger JW, Luijendijk RW, Hop WC, Halm JA, Verdaasdonk EG, Jeekel J. Long-term follow-up of a randomized controlled trial of suture versus mesh repair of incisional hernia. Ann Surg. 2004;240(4):578-85. http://doi.org/10.1097/01.sla.0000141193.08524.e7.

Cherla DV, Lew DF, Escamilla RJ, et al. Differences of alternative methods of measuring abdominal wall hernia defect size: a prospective observational study. Surg Endosc. 2018;32(3):1228-33. http://doi.org/10.1007/s00464-017-5797-1.

Chevrel JP, Rath AM. Classification of incisional hernias of the abdominal wall. Hernia. 2000;4:7-11. https://doi.org/10.1007/BF01230581.

Cobb WS, Warren JA, Ewing JA, Burnikel A, Merchant M, Carbonell AM. Open retromuscular mesh repair of complex incisional hernia: predictors of wound events and recurrence. J Am Coll Surg. 2015;220(4):606-13. http://doi.org/10.1016/j.jamcollsurg.2014.12.055.

Dabbas N, Adams K, Pearson K, Royle G. Frequency of abdominal wall hernias: is classical teaching out of date? JRSM Short Reports. 2011;2(1):1-6. http://doi.org/10.1258/shorts.2010.010071.

Davies SW, Turza KC, Sawyer RG, Schirmer BD, Hallowell PT. A comparative analysis between laparoscopic and open ventral hernia repair at a tertiary care center. Am Surg. 2012;78(8):888-92.

Dietz UA, Hamelmann W, Winkler MS, et al. An alternative classification of incisional hernias enlisting morphology, body type and risk factors in the assessment of prognosis and tailoring of surgical technique. J Plast Reconstr Aesthet Surg. 2007;60(4):383-8. http://doi.org/10.1016/j.bjps.2006.10.010.

Dietz UA, Winkler MS, Härtel RW, et al. Importance of recurrence rating, morphology, hernial gap size, and risk factors in ventral and incisional hernia classification. Hernia. 2014;18(1):19-30. http://doi.org/10.1007/s10029-012-0999-x.

Edmiston CE Jr, Leaper DJ. Intra-operative surgical irrigation of the surgical incision: What does the future hold-saline, antibiotic agents, or antiseptic agents? Surg Infect (Larchmt). 2016;17(6):656-64. http://doi.org/10.1089/sur.2016.158.

Eker HH, Hansson BM, Buunen M, et al. Laparoscopic vs. open incisional hernia repair: a randomized clinical trial. JAMA Surg. 2013;148(3):259-/63. http://doi.org/10.1001/jamasurg.2013.1466.

Elango S, Perumalsamy S, Ramachandran K, Vadodaria K. Mesh materials and hernia repair. Biomedicine (Taipei). 2017;7(3):16. http://doi.org/10.1051/bmdcn/2017070316.

Faylona JM. Evolution of ventral hernia repair. Asian J Endosc Surg. 2017;10(3):252-8. http://doi.org/10.1111/ases.12392.

Franklin BR, Patel KM, Nahabedian MY, Baldassari LE, Cohen EI, Bhanot P. Predicting abdominal closure after component separation for complex ventral hernias: maximizing the use of preoperative computed tomography. Ann Plast Surg. 2013;71(3):261-5. http://doi.org/10.1097/SAP.0b013e3182773915.

García-Ureña MÁ, López-Monclús J, Cuccurullo D, et al. Abdominal wall reconstruction utilizing the combination of absorbable and permanent MESH in a retromuscular position: a multicenter prospective study. World J Surg. 2019;43(1):149-58. http://doi.org/10.1007/s00268-018-4765-9.

Gonzalez AM, Romero RJ, Seetharamaiah R, Gallas M, Lamoureux J, Rabaza JR. Laparoscopic ventral hernia repair with primary closure versus no primary closure of the defect: potential benefits of the robotic technology. Int J Med Robot. 2015;11(2):120-5. http://doi.org/10.1002/rcs.1605.

Gough VM, Vella M. Timely computed tomography scan diagnoses spigelian hernia: a case study. Ann R Coll Surg Engl. 2009;91(8):W9-W10. http://doi.org/10.1308/147870809X450629.

Habib E, Elhadad A. Spigelian hernia long considered as diverticulitis: CT scan diagnosis and laparoscopic treatment. Computed tomography. Surg Endosc. 2003;17(1):159. http://doi.org/10.1007/s00464-002-4237-y.

Halligan S, Parker SG, Plumb AAO, et al. Use of imaging for pre- and post-operative characterisation of ventral hernia: systematic review. Br J Radiol. 2018;91(1089):20170954. http://doi.org/10.1259/bjr.20170954.

Henriksen NA, Montgomery A, Kaufmann R, et al. Guidelines for treatment of umbilical and epigastric hernias from the European Hernia Society and Americas Hernia Society. Br J Surg. 2020;107(3):171-90. http://doi.org/10.1002/bjs.11489.

Jolissaint JS, Dieffenbach BV, Tsai TC, et al. Surgical site occurrences, not body mass index, increase the long-term risk of ventral hernia recurrence. Surgery. 2020;167(4):765-71. http://doi.org/10.1016/j.surg.2020.01.001.

Korenkov M, Paul A, Sauerland S, et al. Classification and surgical treatment of incisional hernia. Results of an experts’ meeting. Langenbecks Arch Surg. 2001;386(1):65-73. http://doi.org/10.1007/s004230000182.

Köckerling F. Recurrent incisional hernia repair-an overview. Front Surg. 2019;6:26. Published 2019 May 14. http://doi.org/10.3389/fsurg.2019.00026.

Köckerling F, Hoffmann H, Mayer F, et al. What are the trends in incisional hernia repair? Real-world data over 10 years from the Herniamed registry. Hernia. 2021;25(2):255-65. http://doi.org/10.1007/s10029-020-02319-y.

Kössler-Ebs JB, Grummich K, Jensen K, et al. Incisional hernia rates after laparoscopic or open abdominal surgery-a systematic review and meta-analysis. World J Surg. 2016;40(10):2319-30. http://doi.org/10.1007/s00268-016-3520-3.

LeBlanc KA. Current considerations in laparoscopic incisional and ventral herniorrhaphy. JSLS. 2000;4(2):131-9.

Morris PJ, Malt RA. Oxford Textbook of Surgery. Vol. 1. Oxford: Oxford Medical Publications, Oxford University Press; 1994.

Mudge M, Hughes LE. Incisional hernia: a 10 year prospective study of incidence and attitudes. Br J Surg. 1985;72(1):70-1. http://doi.org/10.1002/bjs.1800720127.

Müller-Riemenschneider F, Roll S, Friedrich M, et al. Medical effectiveness and safety of conventional compared to laparoscopic incisional hernia repair: a systematic review. Surg Endosc. 2007;21(12):2127-36. http://doi.org/10.1007/s00464-007-9513-4.

Muysoms FE, Antoniou SA, Bury K, et al. European Hernia Society guidelines on the closure of abdominal wall incisions. Hernia. 2015;19(1):1-24. http://doi.org/10.1007/s10029-014-1342-5.

Muysoms F, Campanelli G, Champault GG, et al. EuraHS: the development of an international online platform for registration and outcome measurement of ventral abdominal wall hernia repair. Hernia. 2012;16(3):239-50. http://doi.org/10.1007/s10029-012-0912-7.

Muysoms FE, Miserez M, Berrevoet F, et al. Classification of primary and incisional abdominal wall hernias. Hernia. 2009;13(4):407-14. http://doi.org/10.1007/s10029-009-0518-x.

Parker SG, Mallett S, Quinn L, et al. Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis [published correction appears in BJS Open. 2021 May 7;5(3):]. BJS Open. 2021;5(2):zraa071. http://doi.org/10.1093/bjsopen/zraa071.

Pérez-Köhler B, Bayon Y, Bellón JM. Mesh infection and hernia repair: a review. Surg Infect (Larchmt). 2016;17(2):124-37. http://doi.org/10.1089/sur.2015.078.

Poelman M, Apers J, van den Brand H, et al. The INCH-Trial: a multicentre randomized controlled trial comparing the efficacy of conventional open surgery and laparoscopic surgery for incisional hernia repair. BMC Surg. 2013;13:18. Published 2013 Jun 7. http://doi.org/10.1186/1471-2482-13-18.

Ponten JE, Leenders BJ, Charbon JA, et al. Mesh Or Patch for Hernia on Epigastric and Umbilical Sites (MORPHEUS trial): study protocol for a multi-centre patient blinded randomized controlled trial. BMC Surg. 2014;14:33. http://doi.org/10.1186/1471-2482-14-33.

Rose M, Eliakim R, Bar-Ziv Y, Vromen A, Rachmilewitz D. Abdominal wall hernias. The value of computed tomography diagnosis in the obese patient. J Clin Gastroenterol. 1994;19(2):94-6.

Russell RCG, Williams NS, Bulstrode CJK. Bailey and love’s short practice of surgery. 23rd Edition. Hodder Arnold, London; 2000.

Rutkow IM. Demographic and socioeconomic aspects of hernia repair in the United States in 2003. Surg Clin North Am. 2003;83(5):1045-vi. http://doi.org/10.1016/S0039-6109(03)00132-4.

Sauerland S, Walgenbach M, Habermalz B, Seiler CM, Miserez M. Laparoscopic versus open surgical techniques for ventral or incisional hernia repair. Cochrane Database Syst Rev. 2011;(3):CD007781. Published 2011 Mar 16. http://doi.org/10.1002/14651858.CD007781.pub2.

Schumpelick V. Narbenhernie. In: Schumpelick V (ed). Hernien. Thieme, Stuttgart; 2000. P. 266-269.

Seiler CM, Bruckner T, Diener MK, et al. Interrupted or continuous slowly absorbable sutures for closure of primary elective midline abdominal incisions: a multicenter randomized trial (INSECT: ISRCTN24023541). Ann Surg. 2009;249(4):576-82. http://doi.org/10.1097/SLA.0b013e31819ec6c8.

Skrekas G, Stafyla VK, Papalois VE. A Grynfeltt hernia: report of a case. Hernia. 2005;9(2):188-91. http://doi.org/10.1007/s10029-004-0278-6.

Spangen L. Ultrasound as a diagnostic aid in ventral abdominal hernia. J Clin Ultrasound. 1975;3(3):211-3. http://doi.org/10.1002/jcu.1870030311.

Suwa K, Okamoto T, Yanaga K. Closure versus non-closure of fascial defects in laparoscopic ventral and incisional hernia repairs: a review of the literature. Surg Today. 2016;46(7):764-73. http://doi.org/10.1007/s00595-015-1219-y.

Torregrosa-Gallud A, Sancho Muriel J, Bueno-Lledó J, et al. Modified components separation technique: experience treating large, complex ventral hernias at a University Hospital. Hernia. 2017;21(4):601-8. http://doi.org/10.1007/s10029-017-1619-6.

Van Hoef S, Tollens T. Primary non-complicated midline ventral hernia: is laparoscopic IPOM still a reasonable approach?. Hernia. 2019;23(5):915-25. http://doi.org/10.1007/s10029-019-02031-6.

Venclauskas L, Silanskaite J, Kanisauskaite J, Kiudelis M. Long-term results of incisional hernia treatment. Medicina (Kaunas). 2007;43(11):855-60.

Ventral Hernia Working Group, Breuing K, Butler CE, et al. Incisional ventral hernias: review of the literature and recommendations regarding the grading and technique of repair. Surgery. 2010;148(3):544-58. http://doi.org/10.1016/j.surg.2010.01.008.

de Vries Reilingh TS, van Geldere D, Langenhorst B, et al. Repair of large midline incisional hernias with polypropylene mesh: comparison of three operative techniques. Hernia. 2004;8(1):56-9. http://doi.org/10.1007/s10029-003-0170-9.

Walming S, Angenete E, Block M, Bock D, Gessler B, Haglind E. Retrospective review of risk factors for surgical wound dehiscence and incisional hernia. BMC Surg. 2017;17(1):19. http://doi.org/10.1186/s12893-017-0207-0.

Wells JM, Pring C, Olmi S, Scaini GC, Erba L, Croce E. Laparoscopic versus open incisional hernia repair. Surg Endosc. 2007;21:555-9. Surg Endosc. 2008;22(1):266. http://doi.org/10.1007/s00464-007-9590-4.

Wiegering A, Sinha B, Spor L, et al. Gentamicin for prevention of intraoperative mesh contamination: demonstration of high bactericide effect (in vitro) and low systemic bioavailability (in vivo). Hernia. 2014;18(5):691-700. http://doi.org/10.1007/s10029-014-1293-x.

Young J, Gilbert AI, Graham MF. The use of ultrasound in the diagnosis of abdominal wall hernias. Hernia. 2007;11(4):347-51. http://doi.org/10.1007/s10029-007-0227-2.

Zhang Y, Zhou H, Chai Y, Cao C, Jin K, Hu Z. Laparoscopic versus open incisional and ventral hernia repair: a systematic review and meta-analysis. World J Surg. 2014;38(9):2233-40. http://doi.org/10.1007/s00268-014-2578-z.

Downloads

Published

2023-04-13

How to Cite

1.
Tarasiuk T. Issues and challenges in the surgical treatment of anterior abdominal wall hernias. Review. ЗХ [Internet]. 2023Apr.13 [cited 2024Dec.9];(1):58-65. Available from: http://generalsurgery.com.ua/article/view/276906

Issue

Section

Reviews