Modern approaches to the treatment of patients with hernias of the spigel line of the abdomen

Introduction. In recent years, various types of open, endovideosurgical surgical interventions and various options for the placement of mesh endoprostheses have been used to treat patients with spigel line hernias (GSL). Due to the rare occurrence of this pathology and the insufficient coverage of this problem in the worldliterature, it is necessary to develop optimal surgical tactics in patients with HSV. Aim. To substantiate the tactics of surgical treatment of patients with HSV based on a comparative analysis of the immediate,long-term, and cosmetic results of various types of surgical interventions.

Materials and methods. A comparative study of the immediate and long-term results of surgical treatment of 69 patients with HSV was conducted. Of these, group 1 included 22 (31.9%) patients who underwent open tension hernioplasty, group 2 included 24 (34.8%) patients who underwent non-tension hernioplasty from traditional access, group 3 included 15 (21.7%) patients afterlaparoscopic intra-abdominal hernioplasty, group 4 consisted of 8 (11.6%) patients who have undergone extraperitoneal videoendoscopic hernioplasty.

Results. The average duration of open surgeries in patients of groups 1 and 2 was 1.8–2.2 timesless than the duration of endovideosurgical interventions in patients of groups 3.4. The severity of postoperative pain on the VAS scale after open surgeries was 1.6–2.1 times greater than in patients who underwent endovideosurgical hernioplasty. In the early postoperative period, wound complications were noted in 1 (4.2%) patient of the first group and in 1 (4.5%) patient of the second group, no complications were observed in patients of 3.4 groups. Hernia recurrence was detected in thelong-term period in only 1 (4.8%) patient of the first group after open tension hernioplasty.

Discussion. The use of endovideosurgical interventions can reduce the traumatic nature of surgery, the level of postoperative pain and postoperative complications, and improve the cosmetic result of surgery.

Conclusion. The most effective operations in patients with HSV are open and endovideosurgical intraabdominal, extraperitoneal prosthetic hernioplasty.

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