THE TISSUE PATHOMORPHOSIS AROUND THE MESH REPEREN®
AT IPOM-PLASTIC'S RELAPSES
Intraperitoneal on-lay mesh (IPOM) laparoscopic hernioplasties using REPEREN® (Russia) mesh were performed at 103 patients with ventral hernias in the surgical department the Road Clinical Hospital at st. Rostov-Glavny from January 2015 to December 2018. The analysis of IPOM-plastic's using REPEREN® mesh immediate and long-term results in patients with hernia area up to 100 cm2 showed good results: no intraoperative and postoperative complications, no pain after surgery, short hospitalization period (average 3.2 days) and rapid rehabilitation (on average, patients resumed normal work within 14 days). In the observation period of up to 1.5 years, no relapse was detected. With a primary hernia defect of ≥100 cm2, relapses were detected in 6 (6.18 %) patients over a period of 3 to 24 months. These patients underwent various consequent surgeries with the removal of the composite prostheses, which were subsequently subjected to morphological (macro- and microscopic) study. Macroscopic examination in all cases showed no compact adhesions between the loops of the intestines and the gel surface of the prosthesis and no dense scar tissue between the adhesive surface of the prosthesis and the anterior abdominal wall. Also, «wrinkling» of the prosthesis to 21.3 % of its original area was noted. Microscopic prosthesis's examination showed fibroblast migration, unstructured collagen fiber formation without connective tissue scar formation and insignificant leukocyte's reaction.