Existing and forward-looking ways to prevent adhesions in IPOM hernia repair. A research overview

Armashov V.P.; Matveev N.L.; Makarov S.A.

doi:https://doi.org/10.17116/hirurgia2020091116

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Abstract:

IPOM intraperitoneal hernia repair, in comparison with other abdominal wall reconstruction methods, has a number of significant advantages. Among them are a reduction in operative time, low rate of surgical site infections, quick rehabilitation, and good cosmetic results. At the same time, one of the main constraining factors for its widespread use is the rather high frequency of adhesion formation between the implant and the abdominal organs. The first way to solve this serious problem is to improve the structure of the implant itself, and in the first place, its anti-adhesive layer. The second is the search for adjuvant tools that work in «problematic» areas, prone to adhesions formation, such as the points of implant fixation, its edges, or the areas of damage to antiadhesive layer due to a violation of the operative technique. It is desirable that they could exert their effect also in other parts of the abdominal cavity, which, despite the absence of a zone of «active» intervention, can also undergo adhesions. Based on this, the purpose of this review was to summarize modern data on the anti-adhesive activity of both composite implants and specialized membranes and liquid agents.

Keywords:

hernia

intraperitoneal onlay mesh (IPOM) technique

abdominal adhesions

prevention of adhesions

adhesion barrier

icodextrin

Authors:

Armashov V.P.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-5108-1400

Matveev N.L.

Pirogov Russian National Research Medical University

ORCID: 0000-0001-9113-9400

Makarov S.A.

Center for Surgical Treatment of Obesity and Metabolic Disorders — St. George Hospital

ORCID: 0000-0002-8423-8002

Received:

02.06.2020

Accepted:

28.06.2020

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References:

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