Abdominal wall prosthetic repair in ventral and incisional hernia treatment: Classification, terminology and technical aspects (review)

Abstract

The review considers in detail the most important aspects of open abdominal wall prosthetic repair techniques applied in surgical treatment of ventral and incisional hernias according to contemporary foreign and domestic experience. We have presented the views of leading researchers on the use of synthetic endoprostheses. The authors have suggested a modern classification of primary ventral and incisional hernias indicating its variation from the previous classification SWR (Chevrel and Rath) and others. We have assessed and interpreted the English terms compared to those used in Russia. The review has traced the change of the term “tension-free plasty” in its historical perspective. The work has presented the main up-to-date techniques for mesh endoprostheses implantation, their advantages and drawbacks. There have been estimated the key points of prosthetic repair surgeries in median abdominal wall closure. We have considered correct names of variants of surgeries depending on mesh placement in relation to hernia orifices, anatomical layers of abdominal wall, and self-tissue displacement. We have clarified some peculiarities of operative techniques relying on intra-abdominal pressure control, and estimated the advantages and disadvantages of these techniques. The review has specified the most urgent problems of modern herniology, and presented one of promising directions of surgical technique improvement in the treatment of patients with large ventral and incisional hernias. We have shown the necessity of proper usage and understanding of the implication of terms standing for operative interventions, as well as correct use of corresponding classifications and terminology for adequate comparison of our research results with those of our colleges.