[Classification criteria and modern principles of surgical treatment for postop abdominal wall hernia]

Issues of differentiated choice of hernial defect (HD) plasty in 546 patients with postoperative (PO) abdominal wall hernia (AWH), taking into account the most informative classification signs of the disease (the hernial protrusion size and localization, the HD width, frequency of recurrences) were discussed. Depending on character of topographic disorder in abdominal wall present four types of PO AWH were delineated. Diagnosis of the AWH type according to criterions proposed, using the ultrasonic and computer tomography data, had permitted to determine the technical conditions and to substantiate pathogenetically the expediency of radical hernioplasty performance in 483 patients and of palliative HD correction--in 63. There was stressed the necessity to indicate technique of the hernioplasty performed, while depicting the operation using terminology "hernioplasty without tension" whether the HD edges were confronted side by side or not, what means performance of radical vs palliative procedure. Indications to performance of alloplasty, using synthetic net-like polymeric materials in all the patients with PO AWH were substantiated.