ENDOPROSTHESIS FOR PLASTY OF MEDIAN VENTRAL HERNIAS WITH LIFTING OF MUSCULO-APONEUROTIC TISSUES OF ABDOMINAL WALL AND METHOD OF ITS APPLICATION

摘要

FIELD: medicine.;SUBSTANCE: group of inventions relates to medicine, namely to herniology and plastic surgery of abdomen and can be used in treatment of median ventral hernias in combination with abdominoplasty. Endoprosthesis consists of two wide posterior flaps and two narrow anterior flaps, connected to each other with connector, six fixation tapes, originating from anterior flaps, three from each side, and made in a few versions depending on connector width. Method includes application of endoprosthesis with fixation tapes. Posterior flaps of endoprosthesis are placed in preperitoneal space. Three "П"-shaped sutures from each side are applied through posterior flap and all musculo-aponeurotic layers more laterally from spigelian line in direction from inside outside in correspondence with location of anterior flap tapes. Ends of threads are brought outside through separate skin cuts in ligature projections. Anterior flaps are placed in subcutaneous cellular tissue, laying them from two sides on medial edges of anterior walls of aponeurotic sheath of rectus muscles. Three tunnels are formed immediately above aponeurosis in direction to skin cuts. Tapes are passed through tunnels and located in subcutaneous cellular tissue. Edges of defect are brought together in such a way that internal edges of rectus muscles are located immediately near connector edges. All tapes are fixed with ligatures of earlier applied "П"-shaped sutures through the layer of lateral muscles more laterally from spigelian line.;EFFECT: inventions provide possibility of preventing sharp increase of intra-abdominal pressure and possibility of regulating its level in operation on large and giagantic ventral hernias, as well as possibility of lifting musculo-aponeurotic tissues of abdominal wall for prevention of their anatomo-functional insufficiency after hernioplasty and prevention of progressing of anatomo-functional insufficiency of abdominal wall by preservation of function of rectus muscles and lifting of musculo-aponeurotic tissues of abdominal wall.;2 cl, 1 ex, 3 dwg