METHOD OF INSTALLING TROCARS IN PERFORMING ENDOSCOPIC HERNIOPLASTY BY TEH TECHNIQUE Russian patent published in 2020 - IPC A61B17/94 A61B17/00 A61B17/34 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to endovideosurgery. When introducing trocars 1.5 cm from the umbilical ring down along the middle line, a linear skin incision of 15 mm is performed. In an obtuse way, adipose tissue is prepared to an anterior wall of rectus abdominia, which is dissected away 0.5 cm lateral to the median line. Then, after displacement of abdominal rectus muscle lateral to median line transverse fascia is dissected. Then, after introduction of first 10-mm trocars, a laparoscope with oblique optics of 30° is introduced into the interfascial fat space and performing insufflation at pressure 12 mm Hg. After the first trocar is installed and the sufficient cavity is formed in the interfascial fat space, 2nd and 3rd trocars are installed along the median line. 2nd trocar 10 mm, further used to insert a manipulator with a dummy-dissector, as well as for installation of a mesh implant in the prepared pre-peritoneal space, is installed immediately over the pubic bone towards a dissection area. Third 5-mm trocar is placed at the middle of the distance between the first and the second one, below the arc-shaped Douglas line, in the zone where the aponeuroses of all 3 broad abdominal muscles, namely external, internal oblique and transverse abdominal muscles, are located anterior to abdominal rectus muscle, forming an anterior wall of it vagina.

EFFECT: method makes it possible to considerably facilitate the surgical intervention, to reduce the number of intra- and postoperative complications that will increase the treatment results and improve the patients' quality of life.

1 cl, 4 dwg