SU1616617A1 - Method of surgical treating of incisional hernia - Google Patents

Abstract

This invention relates to surgery for hernia of the white line of the abdomen. The purpose of the invention is to prevent the recurrence of hernias. The bordering incision with the excision of the "old" scar opens the abdominal cavity. From the abdominal cavity, the gland and the intestinal loops are distributed to the peritoneum, dissect the peritoneum and release the posterior vaginal wall of the rectus abdominis muscles on both sides. Then, on both sides, two aponeurotic flaps are formed from the U-shaped incisions, of which a duplicate is created with the capture of the separated peritoneum. Then along the entire length of the wound, the medial margins of the vagina are sutured in the midline. Then, the opened front wall of the sheaths of the rectus abdominis muscles is inserted with the inserted duplicator inserted into the suture. The method allows to prevent the recurrence of hernias. The method is recommended for practical use.

Description

The invention relates to medicine, namely to surgery for hernia of the white line of the abdomen.

The purpose of the invention is the prevention of hernia recurrence.

The method is carried out as follows.

A bordering incision with excision of the old scar opens the abdominal posterior; lost. To the right and left of the skin with subcutaneous tissue, the aponeurosis of the straight muscles that have spread to the sides is separated from the scars. On the side of the abdominal cavity, the omentum and intestinal loops are distributed to the peritoneum and immerse them in the s abdominal cavity. The peritoneum is cut through the entire length of the surgical wound, respectively, the hernial defect, and the posterior vaginal wall of the rectus abdominis muscles is released from both sides. Then on both sides of the U-shaped

cuts form two aponeurotic flaps that are thrown on opposite sides. Duplicates are created from them with a seized peritoneum seized. Then, along the entire length of the operative wound, the medial edges of the vagina of the rectus abdominis are sutured in the midline. After a vertical dissection of the anterior vaginal wall of the rectus abdominis muscles on both sides, over the length of the hernial defect, retreating 1.0-2.0, optimally 1.5 cm from the line of the performed sutures, sew the medial and lateral aponeurosis edges . If there is a pronounced tension, after the lateral edges of the aponeurosis are crossed, vertical incisions are made on it up to 2.0 cm, in the amount of 6-8, to reduce the tension of the aponeurosis. When suturing the front

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the walls of the vagina of the rectus abdominis muscle in the suture include formed duplications.

Example. Patient K., 23 years old, was admitted with a diagnosis of postoperative recurrence in a hernia of the epigastric region. After splenectomy for spleen injury,

Under intubation anesthesia, with semi-oval skin incisions, the scar of the skin is excised. The discrepancy of the rectus abdominis muscles is 12 cm. After the omentum, stomach, and intestines are adhered to the abdominal wall, the peritoneum is mobilized from the posterior vaginal wall of the abdominal muscles on both sides. Two P-circumferential cuts on both sides, two flaps were cut out from the back of the aponeurosis, which were turned to opposite sides and fixed to each other by creating arcs; Then along the entire length of the wound, the medial edges of the vagina of the abdominal muscles are sewn. On the front wall of the vagina of the rectus abdominis muscles, vertical incisions were made on both sides along the entire length of the hernial defect, and then the aponeurosis of the resulting sheets was stitched in two floors; stitches on subcutaneous fat and skin. The postoperative period was uneventful. In a satisfactory condition, he was discharged home.

The proposed method of plasty of postoperative hernias of the abdominal wall is effective, provides a multi-layered restoration of disturbed anatomical structures of the abdominal wall, which prevents the recurrence of the hernia. Stitching homogeneous fabrics promotes their better healing.

The method is recommended for practical use.

Claims (1)

The method of surgical treatment of hernias of the white line of the abdomen, including the opening of the vagina of the rectus abdominis muscle, the multiple plastic repair of the hernia gate, characterized in that, in order to prevent postoperative hernia, the posterior wall of the vagina is opened U-shaped and form duplications with the peritoneum, and when the anterior wall of the vagina is sutured into the suture, the formed duplex is captured.