UA123752U - METHOD OF FIXATION OF POLYPROPYLENE Mesh IN RETROMUSCULAR ALLOGERNOPLASTY - Google Patents

Abstract

The method of fixing the polypropylene mesh in the performance of retromuscular allogenioplasty involves the dissection of the anterior leaf aponeurosis throughout the circumference of the hernial gate, imposing a continuous suture on the peritoneum with the capture of the inner leaves of the aponeurosis and the formation of a keel followed by stitching of the apices the formation of duplication. The polypropylene mesh, pre-stitched along the edges of the polypropylene yarns with loose ends, is placed in the space between the peritoneum and the posterior vaginal walls of the anterior abdominal muscles under visual control. Through the notches of the skin in the projection of the placement of the free ends of the polypropylene filaments insert a needle with a rectilinear body, the distal end of which has a conical sharpening with two notches on one side, the proximal end is connected to the rod located in the guide sleeve, the proximal handle a compression spring is placed between the stem handle and the proximal end of the guide sleeve. Pass the needle through the soft tissues of the anterior abdominal wall in the area of connection of the anterior and posterior vaginal walls of the rectus muscle of the anterior abdominal wall into the space formed between the posterior wall of the vagina of the rectus muscle of the anterior abdominal wall and the polypropylene mesh, fix the polypropylene thread for one from the notches of the needle and with the help of the handle and the spring lead the end of the polypropylene thread into the notch of the skin. Similarly spend the other ends of the polypropylene threads, the ends are tied on the front wall of the vagina of the rectum.

Description

A useful model belongs to abdominal surgery, namely the performance of retromuscular allogeneoplasty.

There is a known method, the closest, which includes the dissection of the front leaf of the aponeurosis along the entire circumference of the hernial gate, applying a continuous suture against the peritoneum with the capture of the inner leaves of the aponeurosis and the formation of a keel, followed by suturing of the muscles butt-to-joint with the capture of the keel and the outer leaves of the aponeurosis with the formation duplicates (11.

The disadvantage of the known method is insufficient clinical validity, based on non-specific dysplasia of connective tissue, which is accompanied by other non-specific symptoms (scoliosis, hernias, hemorrhoids, joint hypermobility, asthenic body type, flat feet) |21.

The basis of a useful model is the task of improving the known method by introducing new technological actions aimed at increasing the efficiency of retromuscular hernioplasty for postoperative central hernias.

The task is solved by the fact that the polypropylene mesh, previously stitched along the edges with polypropylene threads with free ends, is placed in the space between the peritoneum and the back walls of the vagina of the rectus muscles of the anterior abdominal wall under visual control, through the skin incisions in the projection of the placement of the free ends of the polypropylene threads needle of a rectilinear body, the distal end of which has a conical tip with two notches on one side, the proximal end is connected to a rod located in a guide sleeve, the proximal end of the rod has a handle, a spring is placed between the handle of the rod and the proximal end of the guide sleeve, which works on compression, is carried through the soft tissues of the anterior abdominal wall in the area of the connection of the front and back walls of the vagina of the rectus muscle of the anterior abdominal wall into the space formed between the back wall of the vagina of the rectus muscle of the anterior abdominal wall and the polypropylene mesh, fixing the polypropylene thread for one of the notches lki and with the help of a handle and a spring, the end of the polypropylene thread is drawn into the notch of the skin, the other ends of the polypropylene threads are similarly drawn, the drawn ends are tied on the front wall of the vagina of the rectus abdominis muscle.

A useful model works as follows: a median dissection of the anterior abdominal wall is performed, hernia elements are isolated, polypropylene mesh, pre-stitched along the edges

With polypropylene threads with free ends, placed in the space between the peritoneal and back walls of the vagina of the rectus muscles of the anterior abdominal wall under visual control, through the incisions of the skin in the projection of the placement of the free ends of the polypropylene threads, a straight body needle is inserted, the distal end of which has a cone-shaped sharpening with two notches on one of the sides, the proximal end is connected to the rod located in the guide sleeve, the proximal end of the rod has a handle, a compression spring is placed between the handle of the rod and the proximal end of the guide sleeve, it is passed through the soft tissues of the anterior abdomen walls in the area of the junction of the front and back walls of the vagina, probing by palpation the edge of the rectus muscle of the anterior abdominal wall, in the space formed between the back wall of the vagina of the rectus muscle of the anterior abdominal wall and the polypropylene mesh, fix the polypropylene thread behind one of the notches of the needle and with the help of a handle and a spring they pull away, butt putting the distal end of the guide sleeve into the skin of the anterior abdominal wall, the end of the polypropylene thread is passed into the notch of the skin, the other ends of the polypropylene threads are similarly conducted, the passed ends are tied on the front wall of the sheath of the rectus abdominis muscle, and a continuous suture is applied to the wound of the anterior abdominal wall. The proposed method provides a significant advantage over the known method, due to which it eliminates the possibility of intestinal loops being caught in the seam with the development of postoperative complications.

Sources of information: 1. SA. 3088. IPC Lb18 17/00. The method of plasty of the hernia gate in postoperative ventral hernias / Donetsk State Medical Institute named after M. Gorky, 16 Illich Ave. m.

Donetsk. 83003 MO 2004010360; statement 17.01.2004. published 15.10.2004, Bull. Mo 10. 2. Narcheva I.A. Connective tissue dysplasia as a marker of generalized dysplasia syndrome. International Journal of Immunoremediation 2009; 11; 1; 66-66.

Claims (1)

USEFUL MODEL FORMULA The method of fixing the polypropylene mesh during retromuscular allogeneoplasty, which includes dissection of the front sheet of the aponeurosis around the entire circumference of the hernial gate, applying a continuous suture against the peritoneum with capture of the inner sheets of the aponeurosis and the formation of a keel, followed by suturing of the muscles butt-to-joint with capture of the keel and outer leaves of the aponeurosis with the formation of a duplication, which differs in that a polypropylene mesh, pre-stitched along the edges with polypropylene threads with free ends, is placed in the space between the peritoneum and the back walls of the sheath of the rectus muscles of the anterior abdominal wall under visual control, through the incisions of the skin in the placement projection a needle with a straight body is inserted into the free ends of the polypropylene threads, the distal end of which has a conical tip with two notches on one side, the proximal end is connected to the rod located in the guide sleeve, the proximal end of the rod has a handle, between the handle of the rod and a compression spring is located at the proximal end of the guide sleeve, the needle is passed through the soft tissues of the anterior abdominal wall in the area of the junction of the anterior and posterior walls of the vagina of the rectus muscle of the anterior abdominal wall into the space formed between the posterior wall of the vagina of the rectus muscle of the front abdominal wall and a polypropylene mesh, fix the polypropylene thread by one of the notches of the needle and with the help of a handle and a spring lead the end of the polypropylene thread into the notch of the skin, similarly lead the other ends of the polypropylene threads, tie the ends on the front wall of the sheath of the rectus abdominis muscle I vote yes.