SU1745211A1 - Method for plastic restoration of defects in vertical hernia - Google Patents

Abstract

The invention relates to medicine, namely to surgery, and can be used in herniology. The whole of the invention is to reduce the number of relapses. Perforated autodermal graft, subjected to a special treatment, is covered with a non-nodular lavsan mesh, and then fixed together around the circumference of the hernial defect, from the inside, through the entire abdominal wall with through U-shaped seams of non-absorbable material, then a duplicate of the hernia sac is formed with U-shaped sutures. The method allows creating a fully functioning wall in the defect area, avoiding complications and recurrence of the disease. The method is recommended for practical use.

Description

The invention relates to medicine, namely to surgery, and can be used in herniology.

The aim of the invention is to reduce the number of relapses.

The method is carried out as follows.

Two semi-oval cuts excised skin and fat flap. From the epidermis, the excised skin-fat flap is treated with 10-20% iodine solution, then it is poured once with boiling 96-98 ° C. The epidermis is removed with a sharp scalpel, then the dermal flap is perforated in a checkerboard pattern. The hernial sac is opened, its contents are freed from adhesions, the organs are forced into the free abdominal cavity. After that, the edges of the abdominal wall defect are mobilized by 5-6 cm around its circumference. From the hernial bag cut out two flaps on the leg. On the left edge of the defect and along the way my muscle

Yo

The belly of the abdomen imposes preliminary through U-shaped sutures with access to the front wall of the sheaths of the rectus abdominis muscles and take them at the clamps. Then, a prepared dermal flap is placed on the internal organs of the abdominal cavity, and a dacron mesh is injected 3-4 cm from the edge of the defect over the entire circumference of the defect and the graft is fixed with U-shaped seams 6. At the same time, the fixation sutures from the non-absorbable material are placed on the back the surface of the rectus sheaths of the abdominal muscles.

After the drainage tube is brought above the mesh, duplicatory fabrication of previously prepared grafts from the hernial sac is performed. In this case, all the nodes of the fixing seams of non-absorbable material are located between the duplicate sheets, which prevents the occurrence of ligature fistulas. Above the aponeurotic duplicator leads t drainage tube.

SI

the next

Both tubes (above the mesh and duplicates) are brought out through separate counteropeners in the lower corner of the wound, fixed and connected to active aspiration. The wound is sutured in layers tightly.

Example. Sick K., 66 years old, was admitted with a diagnosis - upper median postoperative ventral hernia. The operation was performed: two semi-oval cuts were excised with a skin-fat flap together with a postoperative scar 26x18 cm in size and subjected to special treatment. Next, the hernial sac is isolated and opened, the intestinal loops are freed from adhesions, inserted into the free abdominal cavity. From the hernial sac, two flaps on the pedicle, equal to the diameter of the defect, were cut. Further along the left edge of the defect and along the straight muscle of the abdomen, preliminary through U-shaped seams are applied, which are taken at the clamps. The autodermal perforated flap facing the internal organs of the abdominal cavity, together with the lavsan mesh, are fixed under tension by a distance of 3–4 cm from the edge of the defect and along its entire circumference from the inside through the entire wall through U-shaped nylon sutures.

A drainage tube has been laid above the stitched mesh and duplicatory of patches from the hernial bag has been produced. Above apo-neurotic duplicatory

drainage tube. Both drainage tubes are brought out through separate counterparts in the lower corner of the wound and are connected to active aspiration. The wound is sutured in layers tightly. Postoperative course

smooth When viewed through 1.5, there is no relapse.

The method allows to create a fully functional wall, to avoid the occurrence of complications and relapses.

The method is recommended for use in practice.

Claims (1)

The invention The method of plasty of a defect in ventral hernias, including plastic Hernia gates on the side of the abdominal cavity with an autodermal flap, characterized in that, in order to reduce the number of relapses of the disease by increasing the strength of the plastics, the autodermal flap is placed together with the alloprosthesis, the latter being placed between the duplication of the hernia sac and the skin flap.