METHOD FOR SURGICAL MANAGEMENT OF UMBILICAL HERNIAS WITH DIASTASIS RECTI ABDOMINIS Russian patent published in 2014 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: method involves a fringing paraumbilical approach and the abdomen opening, a separation and a resection of the hernial sac. A combined synthetic implant (CSI) - a polypropylene mesh and the dura mater pre-fixed to each other in parallel planes by peripheral suturing through the whole thickness with separate sutures at an equal distance from each other - is inserted through the approach into the abdominal cavity. The Sapezhko hernioplasty is performed. A pneumoperitoneum is created with the Veress needle and a trocar inserted along the mid-line below the xiphoid process; two other trocars are inserted in the mesogastric region on the right and on the left at the level of the umbilical ring for the endoclamp manipulations. A glover's needle is used to fix the combined synthetic implant to the anterior abdominal wall in 8 points by means of sutures used to suture the combined synthetic implant peripherally. Fixation reference points are the following projections: round ligament of the liver - from above; a point below the umbilical ring at 5-7 cm along the mid-line; points at 3-4 cm in the lateral direction from the Spigelian line on the right and on the left. The implant is arranged in the abdominal cavity so that the dura mater surface is arranged from the side adjoining the abdominal organs. The trocar wounds are closed, while the implant fixation points are left open.

EFFECT: method prevents recurrent hernias and diastasis recti abdominis.

1 ex