Surgeon’s view on feature of rehabilitation in patients with large incisional ventral hernia after open retro-rectus hernioplasty

• Nikita A. Demin
• Evgeniy E. Achkasov
• Abdurashidova M.R.
• Kalachev O.A.
• Ivanov G.V.

Abstract

Aim – to assess the opinion of surgeons on the state of recommendations for postoperative physical rehabilitation of patients with large incisional ventral hernias on the basis of a sociological study.

Material and methods. As part of the study, a survey was conducted among surgeons of city clinical hospitals in the city of Moscow, who, as part of their work activities, regularly conduct initial examination, surgical treatment and management of the postoperative period in patients with ventral hernias repair. The questionnaire contained questions about postoperative recommendations, including the timing and mode of wearing the bandage, the duration of physical activity restrictions, and the mode of sexual behavior after hernioplasty.

Results. The analysis of the questionnaires made it possible to assess expert opinion of experts on the postoperative recommendations for patients with large incisional ventral hernia. From 4  to 5 months, such a period of wearing an abdominal bandage after hernioplasty was considered sufficient by 35 (67.3%) survey participants. 35 (67.3%) doctors believe that the mode of wearing the bandage should be constant during the entire period of recommendations. Restrictions on physical activity from 3 to 4 months after hernioplasty are recommended by 25 (48.1%) respondents. The maximum possible weight lifting for patients in the early postoperative period was 5 kg according to 52 (100%) surgeons. It is recommended to start physical exercises 4 or more months after hernioplasty, according to 29 (55.8%) respondents. Only 15 (28.8%) surgeons recommend that patients after hernioplasty seek the advice of an exercise therapy doctor. 32 (61.5%) respondents expressed a positive opinion about the inclusion of postoperative physical rehabilitation in the structure  of recommendations for patients after surgical treatment of large incisional ventral hernia.

Conclusion. As a result of a survey of surgeons, various opinions were obtained regarding postoperative restrictions in patients with large incisional ventral hernias. Discussion of the results of this sociological study indicates a variety of postoperative recommendations under the condition of low reliability  of both positive and negative aspects of the effect of physical rehabilitation on the patient’s body. Thus, emphasizing the importance of studying the postoperative period, with the ability to improve the indicators of the patient’s physical and psychosocial status, through the development and application  of a protocol for postoperative medical rehabilitation. To confirm these conclusions, further clinical studies are required to assess the effect of the duration of physical activity restrictions, wearing an abdominal brace, and the effect of physical rehabilitation on the patient’s body after hernioplasty.

Keywords:postoperative rehabilitation; ventral hernia repair; open hernioplasty retro-rectus; abdominal bandage; questionnaire

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