METHOD FOR EXTRAPERITONEAL ENDOSCOPIC HERNIOPLASTY Russian patent published in 2017 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: device is used, including a blade made in the form of a steel tray with a longitudinal section of 1/3 of the diameter of the tube with an internal diameter of 10 mm, length of 180 mm, curvature radius of 200 mm, combined with a light source, a gas pipe and olive, 20 mm long, up to 12 mm wide. The device blade together with the laparoscope inserted into its tray is injected through the hypoumbilical incision to create a cavity into which a 5 mm trocar is inserted along the middle line, 5 cm above the pubic symphysis. The second 5 mm trocar is injected in the middle of the distance between the hypoumbilical incision and the access above the pubic symphysis for the first trocar introduction. A bed is created to accommodate the mesh implant so that it covered the area of inguinal and femoral hernias formation. For patients younger than 50 years, with a body mass index of less than 30, with the largest size of hernial gates less than 3.5 cm , the implant is not fixed. For patients older than 50 years, the lower inner area of the implant is fixed with spirals to the Cooper ligament, the upper inner area of the implant is fixed to the posterior surface of the outer edge of the rectus and pyramidal muscles of the abdomen. For patients with a body mass index of more than 30, with the hernial gate size exceeding 3.5 cm, the outer upper corner of the expanded implant is additionally fixed to the transverse fascia by a spiral directed forward from the back.

EFFECT: method allows to prevent damage to the parietal peritoneum, adjacent vessels and bladder wall, to create sufficient space for the safe installation of trocars, and to determine objective criteria for the need for implant fixation, depending on the local and general premorbid background.

4 cl, 1 dwg, 3 ex