METHOD FOR INTRAPERITONEAL LAPAROSCOPIC HERNIA REPAIR AT VENTRAL AND POSTOPERATIVE HERNIA

摘要

FIELD: medicine.;SUBSTANCE: during preoperative sonographic examination of the anterior abdominal wall, location and size of all hernial rings and safe places for transfascial fixation are determined and mapped, with due regard to the anterior abdominal wall vessels angioarchitectonics. The obtained data are recorded on the anterior abdominal wall with a marker, and the optimum mesh prosthesis area is determined according to the formula: S=H*(D1+7)*(D2+7), where S is the optimum area of the mesh prosthesis, cm²; D1 and D2 is the distance between the most distant points of hernial ring, in width and length, cm; 7 is the total distance between the mesh edge and the hernial ring edge, cm; H is the increasing ratio of the used mesh area, corresponding to 1.0 at single-chamber hernia, 1.3 at two-chamber hernia, 1.5 and three or more chamber hernia. 6 monolithic ligatures are fixed to the mesh on the perimeter, then the mesh is introduced into the abdominal cavity through a hernitomical skin incision up to 2 cm and arranged according to the marking on the anterior abdominal wall and transfascially fixed by ligatures in secure points.;EFFECT: method allows to improve the results of surgery treatment by reducing trauma and duration of surgical interventions, reducing post-operative bed-days and frequency of postoperative complications.;1 tbl, 1 ex