Milos retromuscular alloplasty for umbilical hernias in combination with diastasis of rectus abdominis muscles
DOI:
https://doi.org/10.11603/2414-4533.2023.1.13812Keywords:
umbilical hernia, diastasis of rectus abdominis muscles, "MILOS" mini-invasive alloplastyAbstract
The aim of the work: to increase the effectiveness of surgical treatment of umbilical hernias combined with diastasis of rectus abdominis muscles by using MILOS retromuscular alloplasty.
Materials and Methods. An analysis of surgical treatment of umbilical hernias combined with diastasis of rectus abdominis muscles in 82 patients was performed. The age of patients was from 20 to 75 years. The average age was (42±1.3). There were 52 women and 30 men. Umbilical hernias were divided by size as follows: medium size W2 – 34 patients, large size W3 – 48 patients. The length of the diastasis of the rectus abdominis muscles was determined from the xiphoid process and 3–4 cm below the navel. The width of the diastasis of the rectus abdominis muscles is from 5 cm to 10 cm.
Depending on the method of surgical treatment, patients were divided into two groups:
In the group І (n=42), surgical treatment was performed according to the minimally invasive "MILOS" method with retromuscular placement of a polypropylene mesh implant. In the group ІІ (n=40), surgical treatment was performed according to the traditional "onlay" method with supra-aponeurotic placement of a polypropylene mesh implant. The results were evaluated by studying and comparing immediate and long-term results in patients of groups І and ІІ. The long-term results were studied from 1 to 5 years by repeated examinations and ultrasound control of the anterior abdominal wall.
Results and Discussion. General complications in the early postoperative period were not observed in patients of the groups I and II. Among the complications from the wound in patients of the group I hematoma was observed in 1 (2.3 %), seroma in 2 (4.7 %), wound infection was not observed, chronic postoperative pain was diagnosed in 1 (2.3%), and in patients of the group ІІ hematoma was observed in 3 (7.5 %), seroma in 7 (17.5 %), wound infection in 2 (5 %), chronic postoperative pain in 4 (10 %).
Long-term results in the period from 1 to 5 years through repeated examinations and ultrasound of the abdominal wall showed that among 35 patients of the group ІІ, for whom the "onlay" technique was performed, a recurrence of diastasis of the rectus muscles was detected in 6 (17.1 %), and among 34 patients of the group І after minimally invasive MILOS technique in 1 (2.9 %).
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