DIFFICULT INCISIONAL HERNIA NOSOLOGICAL SETTINGS AND  APPROACH STRATEGIES

D. Ion; R. V. Stoian; D. N. Păduraru; O. Andronic

doi:10.33695/jss.v5i4.247

D. Ion The University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania; University Emergency Hospital Bucharest, Romania
R. V. Stoian The University of Medicine and Pharmacy Carol Davila, Bucharest, Romania; University Emergency Hospital Bucharest, Romania
D. N. Păduraru The University of Medicine and Pharmacy Carol Davila, Bucharest, Romania; University Emergency Hospital Bucharest, Romania
O. Andronic The University of Medicine and Pharmacy Carol Davila, Bucharest, Romania; University Emergency Hospital Bucharest, Romania

DOI: https://doi.org/10.33695/jss.v5i4.247

Keywords: difficult incisional hernia, intraabdominal hypertension, intraabdominal pressure, abdominal compartment syndrome

Abstract

Even in the age of minimally invasive surgery, incisional hernias remain frequent complications where standard resolution is alloplasty in various technical variants. The revolution brought by the introduction of synthetic materials is overshadowed by the unsatisfactory results obtained in some lesional types that seem to go beyond the nosological framework of standard incisional hernias and which can be reunited under the name of difficult incisional hernias. Our work attempts to make a conceptual clarification in a lesional amalgam through the two compulsory targets required for surgical correction: to solidly cover the parieto-abdominal defect and to maintain intra-abdominal postoperative pressure to values that did not trigger the pathophysiological cascade of intraabdominal hypertension.