RU73780U1 - GRID IMPLANT FOR ATENION PLASTIC OF THE FRONT ABDOMINAL WALL - Google Patents

Abstract

The utility model relates to the field of general surgery. An implant for atopic plastic surgery of the anterior abdominal wall, made as a single block of elastic polymer material, consisting of the central and peripheral parts, in which the central part is made in the form of a monolithic mesh plate of a rectangular shape with rounded edges, hexagonal (or rectangular, or triangular, or round) cells, reinforcing elements and a border around the perimeter of the plate, allowing to completely close the defect in the tissues of the anterior abdominal wall, acting as an endoprosthesis of the last d, and the peripheral part is made in the form of monolithic strips that serve to fix the implant in the abdominal wall during the operation, the strips being located radially from the geometric center of the structure, which ensures uniform load distribution on the implant and the tissues of the anterior abdominal wall, and the edges of the strips are sawtooth , which guarantees their reliable retention in the tissues, prevents the implant from shifting relative to the defect in the abdominal wall and eliminates suturing, and the use as a material spatially cross-linked polymer eliminates deformation of the implant, provides reliable operation and a favorable course of the reparative process.

Description

The utility model relates to the field of general surgery.

The problem of surgical treatment of hernias is both medical and socio-economic. This is due to the high percentage of hernias, unsatisfactory results of surgical treatment of postoperative ventral hernias, large inguinal hernias, especially recurrent. The successes of modern herniology are due to the introduction into practice of atension methods of surgical treatment using mesh endoprostheses made of synthetic polymers (polyester, polypropylene and polytetrafluoroethylene), which allows to reduce the number of relapses to 1.1-2.2%. Currently, at the final stage of surgery for large ventral hernias, in most cases, plastic surgery of the anterior abdominal wall is performed using an allograft - a polypropylene mesh.

An endoprosthesis is a square or rectangular mesh made of unpainted polypropylene fibers. The mesh weaving process ensures fixation in all places of fiber connection and extensibility in both directions, at the same time the mesh has sufficient rigidity. The most common method of implanting it is sublay, which consists in the fact that the operation is performed by an open method; after opening the hernia sac, and in some cases excising it, mobilization of the hernia gate from the side of the abdominal cavity at least 5 cm from the edges of the hernia defect and processing of the hernia gate from the side of the wound with separation of the subcutaneous tissue from aponeurosis, then the endoprosthesis is placed in the abdominal cavity, and sutures are applied starting from the aponeurosis, while injecting the needle with the thread from the outside inward through the aponeurosis, muscle, peritoneum and then passing it through the endoprosthesis, after which the direction of the needle changes to the inside outward endoprosthesis, peritoneum, muscles, aponeurosis, after which the thread is tied with a knot; in this way, the endoprosthesis is fixed around the perimeter, and the aponeurosis is sutured over it. The existing endoprosthesis has the following disadvantages.

When using a polypropylene mesh, adverse reactions can develop: local transient irritation in the area of the surgical wound, as well as a transient inflammatory reaction in response to the introduction of a foreign body. The net can contribute to the development of an existing infection. The tissue reaction to the endoprosthesis proceeds as an aseptic inflammation and in some cases ends with seroma, and then suppuration. Polypropylene not

possesses shape memory and is often deformed in a confined space, constantly in motion. Displacement and deformation leads to relapse. Endoprostheses made from polypropylene are reduced in size by 30% during the year, which also leads to relapse. Fixation of the named endoprosthesis is carried out by methods of sublay, inlay, onlay by suturing. The presence of suture material in the plastic zone in some cases leads to the formation of ligature abscesses. The eruption of one or more sutures leads to peeling of the mesh endoprosthesis from the tissues of the abdominal wall, which requires repeated intervention.

The named mesh endoprosthesis is taken as a prototype with the indicated disadvantages. Very promising for the manufacture of endoprostheses is a fundamentally new synthetic material - a spatially cross-linked polymer from methacrylic oligomers, hydrophobic, resistant to biologically active and aggressive fluids. This material is a product manufactured by Reper-NN LLC since 1996, and has established itself as an intraocular lens used in ophthalmology, compression plates used in combustiology for the treatment of burn wounds, and is actively used to replace the cartilage of the auricle, nasal septum in otorhinolaryngology, experimental clinical trials of the use of the polymer for cranioplasty in neurosurgery are underway. For herniosurgery, the material is available in the form of elastic monolithic mesh plates with a thickness of 0.3 to 0.8 mm, sizes from 50 to 300 mm. The method of photochemical synthesis underlying the polymer production is unique and allows you to synthesize implants of any thickness and size. The products are sterile, the sterilization method is gas, the plates are packed in an individual disposable container. The material is registered in Russia and included in the State Register of medical devices and medical equipment (certificate No. FS 01032006 / 4786-06 dated 12/19/2006).

The technical task is to create a mesh implant to close defects of the anterior abdominal wall, prevent complications during surgical treatment of large ventral hernias, reduce the risk of postoperative complications associated with tissue reaction to allograft material, increase the reliability of the operation and reduce the number of relapses, exclude deformation and displacement of the endoprosthesis. The technical problem is solved by the fact that the implant for athenic plastic surgery of the anterior abdominal wall (Fig. 1), made as a single block of elastic polymer material, consists of a central (1) and peripheral parts (4), in which the central part is made in the form of a monolithic mesh plate rectangular shape with rounded edges, hexagonal (or rectangular, or triangular, or round) cells, reinforcing elements and a trim around the perimeter of the plate, allowing you to completely close the defect in the tissues of the anterior abdominal tenki, performing the role of the endoprosthesis of the latter, and the peripheral part is made in the form of monolithic strips that serve to fix the implant in the abdominal wall during the operation, and the strips are located radially from the geometric center of the structure, which ensures uniform distribution of the load on the implant and tissue of the anterior abdominal wall, and the edges of the strips are sawtooth, which guarantees their reliable retention in the tissues, prevents displacement

the implant with respect to the defect in the abdominal wall and eliminates the need for suturing, and the use of a spatially cross-linked polymer as a material eliminates the implant deformation, ensures reliable operation and a favorable course of the reparative process.

The utility model is illustrated in the drawing:

Figure 1 - General view of the mesh implant:

1 - the central part of a rectangular shape with rounded edges with hexagonal cells (or rectangular, or triangular, or round) in shape from 1 to 3 mm in size and with side lengths:

A - from 50 to 300 mm;

B - from 50 to 300 mm;

2 - edging with a width of 1 to 2 mm;

3 - reinforcing element with a width of 1 to 3 mm;

4 - the peripheral part of the sawtooth shape with dimensions:

C - from 50 to 150 mm;

D - from 2 to 15 mm.

Claims (3)

1. A mesh implant for athenic plastic surgery of the anterior abdominal wall, made as a single block of elastic polymer material obtained by photopolymerization from oligomers of a methacrylic series, consisting of the central and peripheral parts, in which the central part is made in the form of a monolithic mesh plate of a rectangular shape with rounded edges, hexagonal, or rectangular, or triangular, or round cells, reinforcing elements and a border around the perimeter of the plate, and the peripheral part is made it is in the form of monolithic strips located radially from the geometric center of the structure, and the edges of the strips are sawtooth. 2. The mesh implant according to claim 1, characterized in that the central part, made in the form of a monolithic mesh plate of rectangular shape with rounded edges, hexagonal (or rectangular, or triangular, or round) cells from 1 to 3 mm in size, reinforcing elements with a width from 1 to 3 mm and a border around the perimeter of the plate with a width of 1 to 3 mm, can have a length of sides of 50 to 300 mm and a thickness of 0.5 to 1 mm. 3. The mesh implant according to claim 1, characterized in that the peripheral part is made in the form of monolithic sawtooth strips in an amount of 4 to 12 pieces, a length of 50 to 150 mm and a width of 2 to 15 mm.