RU2764953C1 - Method for navel plasty with local tissues in children - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to pediatric surgery. The navel is divided into two equal halves by an incision from the tip to the base. Excess skin flaps are resected, wherein the height of the remaining skin flaps is 1/2 of the diameter of the umbilical cavity plus 1 to 2 mm. The edges of the skin flaps are then imparted an arc shape. The flaps are sutured with interrupted sutures.

EFFECT: method provides a possibility of forming a linear postoperative scar, imparting a shape close to physiological to the navel, improving blood supply to the skin flaps, facilitating formation and fixation thereof, reducing the time of surgery.

1 cl, 4 dwg

Description

The invention relates to medicine, namely to pediatric surgery, can be used in the surgical treatment of umbilical hernia and skin navel.

With long-term umbilical hernias, the navel increases, protrudes from the umbilical cavity, a fold forms between the navel and the wall of the umbilical cavity. After hernia repair, the navel decreases in volume, but the excess skin remains, which is a cosmetic disadvantage and complicates the hygienic care of the navel. A similar thing happens with the skin navel in newborns (Reference book of a neonatologist. Edited by Corresponding Member of the AMSSR Professor V.A. Tobolin, Professor N.P. Shabalov Leningrad "Medicine" Leningrad Department 1984, p. 156).

In the available literature, there are recommendations for reducing the navel in volume during hernia repair in children, without its resection.

For better formation of the navel and elimination of the residual cavity, several thin synthetic threads can be applied between the remnants of the hernial sac and fiber on the one hand and the aponeurosis on the other ("Hernias of the abdominal wall" K.D. Toskin, V.V. Zhebrovsky. Moscow "Medicine" 1990 p. 173).

Umbilical plasty for umbilical hernia in adults: “Method of plasty of uncomplicated small umbilical hernias. RU 2735928 C1 November 10, 2020 authors: Shishihin A.V., Filipkova K.V.

Access to the hernial sac is carried out through the umbilicus by means of a cruciform incision that does not extend beyond the umbilicus, as a result of which four identical skin flaps are obtained with uniform excision of excess skin on each side of the flap. Then the hernial sac is isolated and set into the abdominal cavity or excised without going beyond the area of the scar tissue attached to the umbilical ring around the circumference. The umbilical ring is sutured in the zone of the white line of the abdomen, starting to the right and below the umbilical ring, performing the first injection from the inside to the outside. Then, on the same side to the right of the umbilical ring, but at the same time, in the upper sections, they are stitched from the outside to the inside. After that, they move diagonally to the opposite edge and stitch it from the inside out, completing the plastic stage with a stitch also to the left and above the umbilical ring from the outside to the inside, which ultimately ends up with the first and last stitches on opposite sides diagonally. After the plastic stage, the remains of the thread are not cut off, but the navel is formed from the above skin flaps by means of an intradermal continuous suture. The skin is sutured in the area of the corners of the skin flaps to their middle, and at the end of the operation, knots are also tied, which are submersible in nature. The method increases the reliability of the results of hernioplasty in uncomplicated small umbilical hernias, allows you to form a full-fledged navel in aesthetic terms ("Method of plastics of uncomplicated small umbilical hernias." RU 2735928 C1 10.11.2020, authors: Shishikhin A.V., Filipkova K.V.) .

The disadvantage of this method is: the formation of four skin flaps of a triangular shape, complex fixation of the skin flaps - intradermal and percutaneous sutures, flat navel, cruciform postoperative scar.

The objective of the invention: resection of the excess of the navel and the formation of the navel with two skin flaps.

The result is achieved as follows: with an umbilical hernia - an incision from the top of the navel to its base, without going to the walls of the umbilical cavity, into two equal halves. Hernioplasty is desirable while maintaining the shape of the umbilical cavity. Resection of skin flaps, the remaining part is equal to 1/2 of the diameter of the bottom of the umbilical cavity plus 1-2 mm to give the navel a shape close to physiological. The edges of the skin flaps, with the help of curved clips of the "Mosquito" type, are given an arched shape. Stitches on the skin.

Plasty of the navel with a skin navel differs in that the contents of the navel are the remains of the vessels of the umbilical cord, which must be removed, since cysts sometimes form from the remainder of the vitelline duct, the plastic must be performed without expecting a change in the skin of the navel - it shrinks and becomes rough, which worsens the result of the plastic.

The result of the proposed method of navel plasty with local tissues is the formation of the navel with two skin flaps, which improves their blood supply, simplifies their formation and fixation, reduces the time of surgery, and a linear postoperative scar. The shape of the navel is close to physiological.

The invention is illustrated by diagrams, which show the sequence of the proposed method.

Fig. 1 - incision through the navel.

Fig. 2 - removal of excess skin.

Fig. 3 - formation of arcuate edges of skin flaps.

Fig. 4 - seams on the skin, the navel is formed.

Designations:

1. - navel.

2. - wall of the umbilical cavity.

3. - the skin of the abdomen.

4. - incision through the navel.

5. - line of cutting off the excess of the navel.

6. - formation of skin flaps.

Claims (1)

A method for plasty of the navel with local tissues, including the formation of two skin flaps, characterized in that the navel is divided into two equal halves from the top to the base, the excess skin flaps are resected, while the height of the remaining skin flaps is equal to 1/2 of the diameter of the umbilical cavity plus 1- 2 mm, then the edges of the skin flaps are arched, the flaps are sutured with interrupted sutures.

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