SU1316662A1 - Method of treatment of umbilical hernia of children - Google Patents

Abstract

This invention relates to medicine, more specifically to pediatric surgery. The purpose of the invention is to reduce the morbidity of the operation and to shorten the time of treatment with the skin of subcutaneous suturing of the hernial ring without removing the hernial sac. For this, defect 3 of the umbilical ring is sutured. A cutting curved needle with synthetic thread 4 is injected into the upper aponeurotic edge 5 of the umbilical ring from the inside, the needle is pulled out into the lower incision through the aponeurosis of the white line, the thread is pulled into the lower incision of the skin and the lower edge 6 of the umbilical ring is pierced along its perimeter. Next, the needle is guided into the upper incision by vcol from the inside to the edge of the umbilical ring with the needle poked out in the upper incision. Within the skin incision, two stitches are made around the perimeter of the upper edge of the umbilical ring. When this suture is tightened, a defect in the umbilical ring in the transverse and longitudinal direction is tightened, the hernia sac is maximized in the abdominal cavity by pressing the navel. 1 il. (L with with about about

Description

This invention relates to medicine, in particular to pediatric surgery.

The purpose of the invention is to reduce the trauma of the operation and shorten the treatment time by subcutaneous suturing of the hernial ring without removing the hernial sac.

The drawing shows schematically the closure of the hernia gate.

The method is carried out as follows.

After treatment, the operative field is made a notch 1 and 2 of the skin with a scalpel above and below the navel 0.7 cm in length. With the tip of the pointed clamp, the subcutaneous tissue is moved up to aponeurosis. The upper and lower edges of the umbilical ring are gripped with toothed clips.

Then, suture 3 of the umbilical ring is sutured. A cutting curved needle with synthetic thread 4 is injected into the upper aponeurotic edge 5 of the umbilical ring from the inside, retreating from the edge by 0.3 cm, as late as possible from the midline, and the needle is guided to the lower incision through the aponeurosis of the white line. After the needle is pulled out, the thread is pulled into the lower skin incision and then the lower edge 6 of the umbilical ring is forgiven around its perimeter with two stitches, retreating from the edge by 0.3 cm. Next, the needle is drawn into the upper incision by piercing it from the inside to the edge of the umbilical ring Puncture the needle in the upper section. Within the skin incision, 2 stitches are made along the perimeter of the upper edge of the umbilical ring. When this suture is tightened, the defect in the joint is shrunk.

The proposed method of surgical treatment of umbilical hernias in children compared with other methods of hernia repair allows the penile ring to both transversely and reduce the invasiveness of the whole

bottom directions. A compulsory welcome is JJ „;

MOM at the time of suture tightening on the aponeurosis was, tf the maximum reposition of the hernial sac into the abdominal cavity by pressing the navel. If there is a suspicion of the presence of a soldered internal organ in the hernial sac, the sac is opened in the bottom region with a 0.5 cm incision and examined. Umbilical suture thread ends

rings are cut, postoperative wounds are applied on 1 removable interrupted suture or wounds are sealed with cyanoacrylate glue. Overlay aseptic sticker.

surgical intervention by replacing the long and technically more complex phase of the operation — separating the navel and separating the hernial sac — with a simpler and less traumatic surgical procedure. There is no need for ligation of blood vessels. In case of operative access, skin incisions are carried out along the langed lines, do not disturb the blood supply and innervation of the navel, which eliminates the danger of necrosis of the wound edges. Are excluded

 complications of the postoperative period: bleeding from the wound, sharply reducing the risk of suppuration, the formation of ligature fistulas. After healing of the postoperative wound, inconspicuous forms are formed - scars, there is no displacement of the navel. Since the main feature in the pathogenesis of umbilical hernia is a defect in aponeurotic tissues in the region of the umbilical ring, taking into account the high plastic properties of the peritoneum in children, it is possible to completely refuse the long and laborious stage of hernia repair. The duration of general anesthesia is reduced by an average of 20 minutes, an example. Sick I., 10 years old, diagnosis: navel hernia. The girl was disturbed by a protrusion of 2.0x2.0 cm in size, round in shape, increasing with physical exertion, right, painless with palpation, but giving unpleasant sensations in the navel during physical exertion. The ovarian hernia gate, the largest of them is I cm 8 / VI-81, was operated under mask anesthesia - under

skin closure of the umbilical ring. During the operation, two skin incisions were made above and below the navel 0.5 cm long. After moving the subcutaneous tissue apart, the upper and lower edges of the umbilical ring were exposed and seized with clips. Hernial sac is empty and has not been opened. Produced suturing of the umbilical ring by vcol in the upper aponeurotic edge of the umbilical ring with a shot in the lower incision. Needle holding

controlled by the clamp end inserted into the defect of the umbilical ring. After the nylon thread is pulled through the lower skin incision, the edge of the umbilical ring is stitched with two stitches, after which the needle, under the control of the instrument, is drawn into the upper incision. The top edge of the umbilical ring is sewn around the perimeter with two stitches, then the hernial sac is inserted into the abdominal cavity by pressing the navel, and the suture applied to the umbilical ring is attached. On skin incisions imposed on 1 removable seam. Aseptic sticker. The postoperative period in the child was uneventful, the temperature was kept at normal numbers, the girl was active from the first days of the postoperative period. Discharged from the hospital in satisfactory condition on the 5th day after the operation. The wound healed by primary tension. Examined one year after the surgery - there is no recurrence, the scars are almost imperceptible, soft, painless, the navel is not deformed, the cosmetic result is good.

The proposed method of surgical treatment of umbilical hernias in children, as compared with other methods of hernia repair, will reduce the invasiveness of the whole

J „,;.

e

surgical intervention by replacing the long and technically more complex phase of the operation — separating the navel and separating the hernia sac — with a simpler and less traumatic surgical access. There is no need for ligation of blood vessels. In case of operative access, skin incisions are carried out along the lane-balance lines, do not disturb the blood supply and innervation of the navel, which eliminates the danger of necrosis of the wound edges. Are excluded

 complications of the postoperative period: bleeding from the wound, sharply reducing the risk of suppuration, the formation of ligature fistulas. After healing of the postoperative wound, inconspicuous forms are formed - scars, there is no displacement of the navel. Since the main feature in the pathogenesis of umbilical hernia is a defect in aponeurotic tissues in the region of the umbilical ring, taking into account the high plastic properties of the peritoneum in children, it is possible to completely refuse the long and laborious stage of hernia repair. The duration of general anesthesia is reduced by an average of 20 minutes, the postoperative bed-day is reduced, an operation of this type can be performed outpatiently, without hospitalization of the child. The method is physiological, simulates the natural process of closing the umbilical ring. A contraindication to the use of the proposed method is the presence of an irreducible, strangulated umbilical hernia, as well as large sized and umbilical hernias in older children.

Claims (1)

Invention Formula A method of treating umbilical hernias in children, including a skin incision, immersion of the hernial sac, closure of the hernia gate, characterized in that, in order to reduce the morbidity of the operation and shorten the treatment time, skin is cut above and below the navel, the upper and lower edges of the aponeurosis are pierced, at the same time from the sides The method is recommended in a pediatric surgeon. The filaments are subcutaneously, and when they are tightened, the hernial sac is immersed. practice gic. Editor M. Dylyn Order 2380/5 VNIIPI USSR State Committee for Inventions and Discoveries 113035, Moscow, Zh-35, Raushsk nab. 4/5 Production and printing company, Uzhgorod, ul. Project, 4 Invention Formula A method of treating umbilical hernias in children, including a skin incision, immersion of the hernial sac, closure of the hernia gate, characterized in that, in order to reduce the morbidity of the operation and shorten the treatment time, skin is cut above and below the navel, the upper and lower edges of the aponeurosis are pierced, at the same time from the sides the filaments are subcutaneously, and with their Vania immersed hernial sac. Compiled by T. Shakhmatova Tehred I. Veres Circulation 595 Proofreader G. Reshetnik Subscription