[Preventive mesh replacement for postoperative ventral hernia].

OBJECTIVE

To improve the outcomes in patients with morbid obesity via prevention of postoperative ventral hernias.

MATERIAL AND METHODS. W: E analyzed morphological structure of connective tissue of linea alba in patients with normal BMI and morbid obesity. To confirm safety of synthetic prostheses, we harvested aponeurosis after mesh replacement. Considering insufficiency of connective tissue and safety of synthetic prostheses in patients with morbid obesity, we performed preventive mesh replacement via laparotomy.

RESULTS. P: Reventive mesh replacement in patients with morbid obesity for prevention of postoperative ventral hernias after laparotomy reduced the incidence of this complication from 25.8% to 4%.

CONCLUSION

The relevance of preventive mesh replacement in patients with morbid obesity is due to frequent postoperative ventral hernias after laparotomy (≥28%). The implanted synthetic prosthesis is characterized by diffuse germination of mature connective tissue as a natural reaction to foreign body. Preventive closure of laparotomy with synthetic prosthesis is advisable in patients with morbid obesity.