FIELD: medicine.
SUBSTANCE: pre-mesh implant is formed by joining the polypropylene mesh and the polytetrafluoroethylene mesh with Prolene 3/0 threads. When laparoscopic plastic of large and giant hernia of the esophageal aperture of the diaphragm is removed parietal peritoneum from the legs of the diaphragm. Fix an implant onto the feet of the diaphragm with a herniostepler. The polypropylene mesh adhesively adheres to the diaphragm stems. Non-adhesive polytetrafluoroethylene mesh is facing the peritoneum. Sew the parietal peritoneum, forming a pocket for the implant, excluding its contact with the esophagus.
EFFECT: strengthening the frame properties of the diaphragm legs with an implant, reduces the risk of complications, perforation of the esophagus, bedsore from contact with the prosthesis, development of dysphagia.
3 cl, 8 dwg, 2 ex
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