[Ventral hernias part 1 : Operative treatment techniques]

Area of Science:

• General surgery
• Visceral surgery
• Surgical innovation

Background:

• Ventral hernias (primary and secondary) are common surgical indications.
• Defect characteristics significantly influence treatment and outcomes.
• Preoperative computed tomography (CT) is recommended for large incisional hernias.

Purpose of the Study:

• To review trends in ventral hernia repair techniques.
• To highlight the shift away from the intraperitoneal onlay mesh (IPOM) technique.
• To discuss the development of new minimally invasive approaches.

Main Methods:

• Review of current surgical trends and techniques in ventral hernia repair.
• Analysis of factors influencing treatment decisions, including defect width and location.
• Exploration of minimally invasive access routes and mesh placement strategies.

Main Results:

• A trend away from the intraperitoneal onlay mesh (IPOM) technique due to reported severe complications.
• Development of new techniques utilizing small incisions or endoscopic access.
• Mesh placement in sublay/retromuscular/preperitoneal positions is increasingly favored.

Conclusions:

• Minimally invasive approaches with mesh in the sublay position offer a tailored strategy for ventral hernia repair.
• These newer techniques aim to reduce complications while maintaining benefits of minimally invasive access.
• Continued innovation is crucial for optimizing ventral hernia treatment outcomes.