[A biomechanical concept of the pathogenesis of postoperative ventral hernias]

A biomechanical concept of pathogenesis of incisional ventral hernias is presented. The main point is that during the formation of a defect along the abdomen medium line, the lateral muscles of the abdominal wall loose the medial point of attachment. The function of the muscles is disturbed and there appears a myogenic contracture. Thus, the contraction ability is gradually slowing down. Special morphological, ultrasonographic and electromyographic researches were made. The authors consider that all types of surgery when the muscle-aponeurotic elements of the hernial hilus become closer under tension result in a less volume of the abdominal cavity and compression of the fascial muscles which gives rise to pathogenetic mechanisms for the development of early and late postoperative complications.