METHOD FOR SURGICAL TREATMENT OF SIDE POST-OPERATIVE ABDOMINAL HERNIAS

摘要

FIELD: medicine.;SUBSTANCE: after external oblique muscle, internal oblique muscle and hernial sac isolation from the scar tissue and dissection, the hernial sac is invaginated without opening. The isolated internal oblique abdominal muscle is sutured above the hernial gates. Then a modeled polypropylene endoprosthesis is placed on top. In the upper part of the polypropylene endoprosthesis two incisions are made at equal distances, forming three flaps, 5 mm longer than the rib width. At the end of each incision, a diamond-shaped aperture is cut out with sides of 5 mm. The 11th rib and the distal part of the 12th rib are isolated and mobilized with neurovascular bundle preservation. The middle flap of the polypropylene endoprosthesis is directed under the 11th rib, and the lateral flaps of the endoprosthesis are placed over the 11th rib and fixed to the rib periosteum and to the middle flap in the upper part. The endoprosthesis is fixed from the lateral edge to the aponeurotic part of the broad back muscle, to the 11th rib periosteum and the distal part of the 12th rib periosteum. From the medial side, the endoprosthesis is fixed to the edge of the rectus abdominis muscle, and from below - to the ligamental part of the inner oblique abdominal muscle. The external oblique abdominal muscle is sutured over the endoprosthesis.;EFFECT: method excludes the possibility of endoprosthesis migration and development of muscles relaxation on the lateral wall of the abdomen.;2 dwg, 1 ex