SU1519659A1 - Method of treatment of oblique inguinal hernia - Google Patents

Abstract

The invention relates to medicine, namely to surgery, and can be used in the treatment of hernias of the anterior abdominal wall. The purpose of the invention is to prevent postoperative hernias by providing trophism along the suture line. After hernia repair, the front surface of the material leaf of the aponeurosis of the external oblique muscle is released from the surrounding tissues to the inguinal ligament. Leaves 1, 2 of the aponeurosis of the external oblique muscle are turned out by the inner surfaces outward to the edge of the 3, 4 dissected aponeurosis. Separate duplicators of the lateral and medial aponeurosis sheets are formed by stitching the edge 3 of the lateral sheet of the folded aponeurosis to the inguinal link 7. At the same time, the needle 8 is punctured from the side of the inguinal link 7 with a seam of the internal oblique muscle 9. the outer surface of the aponeurosis of the external oblique abdominal muscle parallel to the outer edge of the rectus abdominis muscle. Kra 3, 4 sheets of aponeurosis stitch in chess order. After this, duplicators are sutured with the seizure of the internal oblique muscle 9, which contributes to vascular invasion and acceleration of regeneration. The method prevents hernia recurrence. 2 Il.

Description

one

(21) 4124540 / 28-14

(22) 09/29/86

(46) 11/07/89. Bul № 41

(71) Chisinau State Copper iftHCKHfi Institute

(72) M. V. Namashko

(53) 616.34-007.43-031: 611.957-089 (088.8)

(56) Resurrection N. V. et al. Surgeons of abdominal wall hernias. - M .: Meditsnna, 1965. with. 152-153.

(54) METHOD OF M. V. NAMASHKO FOR THE TREATMENT OF ANYAWAY HERBAL TREATMENT

(57) The invention relates to medicine, namely to surgery, and can be used in the treatment of hernias of the anterior abdominal wall. The purpose of the invention is the prevention of postoperative hernia by providing trophism along the suture. After hernia repair, the front surface of the material leaf of the aponeurosis of the external oblique muscle is released from the surrounding tissues to the inguinal ligament. Leaves 1, 2 of the aponeurosis of the external oblique muscle are turned out by the inner surfaces outward to the edge of the 3, 4 dissected aponeurosis. Separate duplicators of the lateral and medial aponeurosis sheets are formed by stitching the edge 3 of the lateral sheet of the folded arto-neurosis to the inguinal ligament 7. At the same time, the needle 8 is punctured from the side of the inguinal ligament 7 with the internal oblique muscle 9 seized 2 are sutured to the outer surface of the aponeurosis of the external oblique abdominal muscle parallel to the outer edge of the rectus abdominis muscle. Kra 3, 4 sheets of aponeurosis stitch in chess order. After this, duplicators are sutured with the seizure of the internal oblique muscle 9., which contributes to vascular invasion and acceleration of regeneration. The method prevents hernia recurrence. 2 Il.

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1 l; () fipfTeiine refers to medicine, and to them (C111o to iurology, and can be used; and | And () 11) and uchial and hernias of the anterior abdominal

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lle. ii) and; and) b) eteni — prevention of and hernia by means of a suture line.

FIG. Figure I shows the formation of duplicates of the aponeurosis of the external oblique muscle of the abdomen: FIG. -2 shows the stitching of the formed duplicators with the capture of the fibers of the new oblique muscle. /

Slyusob M.V. Maman1Ko is carried out as follows.

After treatment of the inguinal area L ° / with iodine tincture, PP / alcohol, and (iranization of the operative floor, production of a 1nT skin and subcutaneous tissue incision in x (1L of the inguinal canal, dissect the aponeurosis of the external oblique muscle, pick out gums). .-cony MC1POK, stitched high, tied at the neck and cut off in the usual way.The front surface of the lateral leaflet of the external oblique muscle is released from the surrounding tissues to the pa-X () ILI bond.

The sheets 1 and 2 of the aponeurosis of the external oblique mypsum are turned out by the inner surfaces outward at obtuse angles to the edges of the L and 4 dissected aponeurosis.

C) Individual duplicates 5 and 6 of the latera are punctured. () Of the th and medial aponeurosis of the npoiiiHi afiMeM edge 3 of the lateral. The removal of the folded aponeurosis to the inguinal ligament 7. The injection of ig.chy 8 is performed from the outer surface of the inguinal ligament 7 with puffing of the internal oblique muscle 9. The edge 4 of the medial leaf 2 is also a folded aponeurosis sewn to the outer

the surface of the aponeurosis of the external oblique abdominal abdomen is parallel to the external primois of the abdominal muscles. The edges 3 and 4 of the aponeurosis are stitched with thin threads in P1 amylate pattern.

After that, the formed lateral and medial duplicators of the aponeurosis of the external oblique muscle are connected with sutures K) with a grip or an internal oblique mouse 9. This creates additional strength of the I 1 suture lines, i.e. anterior wall of the inguinal canal. And fixation of the suture line of duplicatory aponeurosis to the muscle ensures muscle growth of muscle vessels, which accelerates regenerative processes.

The outer ring of the inguinal canal is then formed by tying the lower thread, which is laid along the line of the duplicator. . the remaining threads are then tied and the operation is completed by suturing the superficial fascia, subcutaneous tissue and skin.

Example. R., 26 years old, loader, entered the blame with complaints of sharp

pain in the left inguinal region after lifting. A left-sided inguinal hernia (initial stage) was diagnosed.

Made operation - hernia repair

on the proposed method. After treatment, the operative field, under local anesthetic 0.25 ° / o-novocaine solution, in the direction of the pahsvogo canal to the left, is an incision in the skin and subcutaneous tissue, reveals an aponeurosis of the external oblique muscle, which has a mebel longitudinal defect in the middle part, formed razvolokienn account. By lynn clearing, the aponeurosis is cut above and below the defect. The hernial sac is isolated, highly stitched, transferred at the cervix and cut off more close to the suture. The anterior surface of the dissected aponeurosis is severed from the surrounding tissue to the inguinal ligament.

Then the lateral leaf of the aponeurosis of the external oblique muscle is turned out with its inner surface outward at an angle to the edge of the dissected aponeurosis. Turned edge

the lateral leaf of the aponeurosis is stitched with thin yarns (rarely stitched in the staggered order) to the inguinal bond with a needle puncture from the front surface of the pahrboy of the binder with a seizure of the internal oblique muscle. The medial leaf of the aponeurosis of the external oblique muscle is also turned out with the inner surface outward at an angle to the edge of the dissected aponeurosis. The edge of the inverted medial leaf of the external oblique aponeurosis is stitched to its lower plate parallel to the external edge of the rectus abdominis muscle. Stitches are seldom sewn, in a checkerboard pattern, with thin threads.

After that, stitches are put through the edges of the lateral and medial anot neurosis of the neurosis with the capture of the internal oblique muscle in each suture. The outer ring of the inguinal canal is formed by tying the lower thread. The remaining threads are bounded and the Operation is completed with suturing of the superficial fascia, subcutaneous tissue and skin.

The early postoperative period was uneventful. On the fifth day, the patient was discharged for outpatient treatment. On the seventh day, the sutures were removed from the clinic, the wound healed by primary tension,

and a month after the operation, the patient began his previous work. Examined two months after the operation and clarified that it performs the same work, it does not show any complaints, signs of hernia repair were not revealed. On subsequent examinations after 6,

8 and 1.2 months after the operation, it was established that the patient performs the previous work, does not present any complaints, and in the study of the left arable region, no defects were revealed.

The proposed method of plastic surgery of the front wall of the inguinal hernia was carried out in 15 bo; 1 s. Data for hernia recurrence is not. was observed.

The method of M.V.Namashko is promising for use in hernia surgery.

Claims (1)

Invention Formula A method of treating oblique inguinal hernia, which includes the formation of a duplicatory aponeurosis of the external oblique abdominal muscle, characterized in that, in order to prevent For postoperative hernia by obsg-liver trophism along the ish line, separate duplicators of the lateral and medial aponeurosis sheets are formed, while their inner surfaces are turned outwards, the edge of the lateral leaf is fixed to the compartment ligament, and the edge of the medial leaf is fixed parallel to the edge of the rectus muscle abdomen to the outer surface of the medial leaflet, after the formation of duplicate rounds of the aponeurosis of the external oblique abdominal muscle sewed together, capturing the inner oblique muscle. FIG. 2