MINIMALLY INVASIVE METHOD OF TREATING SMALL UMBILICAL HERNIA UNDER ULTRASOUND NAVIGATION Russian patent published in 2025 - IPC A61B17/00 A61B17/04 A61B17/3211 A61B8/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery. Ultrasonic examination of umbilical hernia is carried out and absence of content in hernial sac is specified. Traction is performed for centre of navel skin and hernial sac is set. After local anaesthesia in area of navel is performed in aseptic environment, two symmetric skin punctures by 2 mm on the right and left paraumbilically are performed with a sharp-pointed scalpel. Under visual and ultrasonic control hydraulic preparation of tissues is carried out by injection of local anaesthetic in direction of needle insertion to preperitoneal space. Ligatured needle is inserted through the punctures. Ligature is drawn around the hernia defect. When using the arched cutting needle with the non-absorbable ligature pre-filled therein, the needle is inserted through the puncture to the right of the navel under visual and ultrasonic control. Arc-shaped cutting needle with a ligature is delivered through a musculo-aponeurotic layer into preperitoneal subcutaneous fat. Needle with ligature is carried out through preperitoneal fat to opposite side of navel cranially from hernia defect, and then again through the musculo-aponeurotic layer from the inside out and brought out from the opposite side of the navel through the skin puncture in the paraumbilical region on the left. Needle is again filled with a ligature, leaving through the puncture in the paraumbilical region on the right, and then, under visual and ultrasonic control, the needle manipulation is repeated, passing the arc-shaped cutting needle with a ligature through the puncture in the paraumbilical region to the right to the opposite side of the navel caudally from the hernia defect. When using the single needle with a filament, after the needle is brought through the musculo-aponeurotic layer inside-out and brought out through the skin puncture in the paraumbilical region on the left, the needle is brought in the caudal direction in relation to the navel – towards the right prick-in. Ligature is tied with closure of hernia defect at level of aponeurosis by means of self-tightening knot. Ends of the ligature are cut off, and the knot is immersed under the skin, and the skin punctures are treated with an antiseptic.

EFFECT: method enables eliminating the aponeurosis defect by a minimally invasive method under local anaesthesia.

1 cl, 5 dwg