The Intraperitoneal Tension-Free Plasty of Abdominal Wall with Mesh Use — Current State of Problem

Tension-free plasty with synthetic mesh use is the method of choice in modern surgery of abdominal wall hernias. In the review the basics variants of mesh implantation with its benefits and drawbacks are presented. The advantages and disadvantages of Lichtenstein, TAPP, TEP, and IPOM techniques are shown. The benefits and drawbacks of intraperitoneal onlay mesh technique (IPOM) are given in detail. Standard tension-free procedures in surgery of inguinal hernias are described. The important steps in prosthetic repair of medial defects in abdominal wall are estimated.

There are considered the features and results of applying sublay, inlay and onlay procedures. The possibilities of preperitoneal, intraabdominal, and retromuscular placement of synthetic endoprostheses are discussed. Adverse sequela of plasty, and its suspected pathogenetic mechanisms are considered. The ways in prophylaxis of complications are shown: mesh isolation, anti-adhesive covering, sutureless and glue fixation of endoprosthesis, development of new synthetic materials. Based on the analysis of literature reports we have concluded that the danger of intraabdominal complications after IPOM is exaggerated. Tension-free intraperitoneal plasty with synthetic endoprostheses in abdominal wall hernias is a simple and reliable surgical approach.

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Romanov R.V., Fedaev А.А., Petrov V.V., Khodak V.А., Parshikov V.V. The Intraperitoneal Tension-Free Plasty of Abdominal Wall with Mesh Use — Current State of Problem. Sovremennye tehnologii v medicine 2012; (4): 161