[The surgical treatment of large ventral hernias in middle-aged and elderly patients]

Changes of intra-abdominal pressure, the degree of abdominal wall stretching, the strength of connection of the tissues and the quality of the operative wound, central hemodynamics, and the indices of external breathing were studied depending on the type of hernioplasty in 44 animals (dogs) and 420 patients with large ventral hernias. The authors suggest a method for surgical treatment of ventral hernias by twisted aponeurotic sutures applied under control of intraabdominal pressure. With the use of this method the number of complications in the main group reduced 3.5 times. With an increase of intraabdominal pressure by more than 1.5 times as compared to the initial value, slackening incisions of the anterior walls of the sheath of the rectus abdominis muscle are recommended. The length of the incisions is controlled by the values of intraoperative tensiomanometry. The number of recurrences with the of the suggested method was 6%.