NON-STRETCHING HERNIOPLASTY OF HERNIA BELLY LINES, RECURRENT POSTOPERATIVE VENTRAL HERNIAS Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery. Hernial sac is exposed. Aponeurosis is mobilized from subcutaneous fat at distance of 3 cm along the circumference from the border of the hernial orifice. White belly line is incised up and down by 3 cm from the edge of hernial opening. Parietal peritoneum is mobilized from the white line and aponeurosis of abdominal rectus muscle by 3 cm. Mesh prosthesis is cut out of polypropylene mesh esphyl standard. Size of the mesh implant is selected so that its external edges from the border of the hernial defect are spaced at a distance of not less than 3 cm. Mesh prosthesis is dissected in a vertical direction into two equal parts. Mesh prosthesis is placed between the peritoneum and the posterior leaf of the belly aponeurosis on the left side. Vertical U-sutures are fixed with an atraumatic needle non-absorbable by suturing filament of size 0. Suture is started from an upper angle of the wound at distance of 2.5 cm in the distal direction from an edge of a hernial defect. Suture is advanced from the top downwards, through the front leaf of the aponeurosis of the abdominal rectus muscle, then through the abdominal rectus muscle, through the posterior leaf of the abdominal rectus aponeurosis, through the mesh prosthesis, through the peritoneum, return to the front sheet of abdominal rectus aponeurosis sheet. Above tissues are stitched in the reverse order, 1 cm from a peritoneal peritoneum in the caudal direction, the interval between sutures is 1 cm. In the same way, the mesh prosthesis is fixed on the opposite side. Peritoneum defect is closed with a continuous suture with an atraumatic needle, which is not absorbed by a suture of size 2\0. Mesh prosthesis is sutured with an atraumatic needle, non-absorbable by a suture of size 2\0 at distance of 0.3 cm from the edge of the mesh prosthesis. Anterior and posterior leaves of the aponeurosis of rectus abdominal muscles are combined with an atraumatic needle non-absorbable by a sutured suture of size 0. Suture is started from the upper angle of the wound at distance of 0.5 cm from the aponeurosis edge. Subcutaneous fat and the skin are closed.

EFFECT: method enables minimizing a risk of recurrent hernia, minimizing the risk of serum formation, infection, that is improving clinical effectiveness.

1 cl, 2 dwg, 1 ex