MANAGEMENT OF VENTRAL HERNIAS WITH LOSS OF DOMAIN

Dr. Md. Shakeel and *Dr. Md. Javed

ABSTRACT

Background: Ventral hernias with loss of domain has significant effects on the patient’s quality of life. This study was undertaken to assess the outcomes, complications and recurrence. Methods: This longitudinal descriptive study was done between Jan 2021 and Dec 2021 after ethical clearance. A total of 42 patients were included who reported with and diagnosed with ventral hernia with loss of domain. The data was analyzed using SPSS V21 software. Results: The mean age of the subjects was 58.37±5.307 years consisting of 18 males and 24 females. Almost 60% of the patients were overweight and obese. The mean width was 11.92±2.82 (Cms), mean length 13.38±2.43 (Cms) and mean defect area was 108.3±15.56 (Cm2). As per the EHS classification majority of the subjects had hernia in the M2 region i,e 47.6%, 30.9% had in M3 region, 19.1% had M4 and 2.4% in the L3 region. Table 8 suggests 15 subjects underwent bilateral TAR and 27 subjects underwent unilateral TAR with contralateral RS. On follow-up none of the patients had recurrence. Conclusion: Ventral hernias need be operated cautiously. Unilateral TAR provides a bigger space for mesh placement than the bilateral TAR.

Keywords: Ventral hernia, Loss of domain, Transversus abdominis release (TAR).