BACKGROUND
Abdominal pseudohernia is a rare disease that manifests itself as a protrusion of the abdominal wall, visually resembling a true hernia, but without an accompanying fascial or muscular defect. Given the variety of possible causes that trigger the pathogenesis of the disease, approaches to its treatment and the timing of surgical intervention should be determined strictly individually, taking into account the etiology and clinical picture of the pseudohernia. The available literature contains isolated works demonstrating individual clinical observations without a systemic analysis and generalized surgical treatment tactics.
OBJECTIVE
The purpose of the work: to study the current state of the problem and present our own experience in treating pseudohernia of the abdominal wall that developed after the lipoaspiration procedure.
MATERIAL AND METHODS
An analysis of the literature and clinical observations published in the period from 2021 to 2024 on the problem of diagnosis and treatment of pseudohernias of the abdominal wall in the Pubmed, Google and e-library databases was carried out. Our own experience of hybrid surgical treatment of a patient with a pseudohernia is presented.
RESULTS
It is important to search for the cause of abdominal wall muscle atrophy in patients with pseudohernia, since the course of the disease is reversible in the case of non-mechanical genesis of innervation disorder. In this case, conservative treatment of the underlying disease is indicated. Diagnosis of abdominal wall pseudohernia should include computed tomography or magnetic resonance imaging, which will allow differential diagnosis with a true hernia, as well as planning surgical intervention in case of irreversible denervation of the abdominal wall muscles. Within 6 months to 1 year after traumatic nerve injury, partial or complete compensatory reinnervation (the so-called sprouting) of the denervated region is possible. In this regard, the decision on surgical treatment of pseudohernia should be made by a multidisciplinary team of doctors (including a neurologist, neurosurgeon, plastic surgeon) no earlier than a year after denervation.
CONCLUSION
The combination of laparoscopic and open access to the pseudohernia area allows for precise determination of the suturing boundaries and optimal aesthetic effect. However, isolated extended transabdominal preperitoneal laparoscopic access is possible. Laparoscopic transabdominal preperitoneal access, along with hybrid access, allows for precise determination of the muscle atrophy area boundaries and optimal suturing of this zone. The use of a large mesh implant is advisable for creating an abdominal wall frame and preventing further thinning of the formed scar.
