The Clinic's first experience in treating large and giant postoperative ventral hernia using the posterior separation technique Transversus Abdominis Release

Abstract

Currently, more than half of open surgical interventions on the abdominal organs are complicated by the formation of large and giant postoperative ventral hernias. At the same time, there is no universal hernioplasty technique, and operations performed for large and giant hernias remain technically complex and traumatic. With a significant size of the hernial orifice, an attempt to connect tissues located bilaterally from the defect can present certain technical difficulties and lead to an uncontrolled and dangerous increase in intra-abdominal pressure. The article presents the clinic's first experience in the treatment of large and giant postoperative ventral hernias using the TAR (Transversus Abdominis Release) posterior separation technique. The medical histories of 18 patients (13 women and 5 men) who were treated at the General Surgery Clinic of the Siberian State Medical University (Tomsk, Russia) in 2022–2023, who underwent TAR posterior separation hernia alloplasty, were analyzed. According to CT herniometry, the volume of the abdominal cavity was on average (6903 ± 2831) cm3, the volume of the hernia – (1780 ± 1381) cm3, the ratio of the hernia volume to the volume of the abdominal cavity varied from 10 to 49%, averaging (24.3 ± 12.2) %. The postoperative period in all patients was without complications. The postoperative hospital stay was (7.5 ± 2.7) days. The observation period for patients ranged from 3 months to 1.5 years. No cases of hernia recurrence were recorded.