RU2007114707A

RU2007114707A - PLASTIC METHOD FOR POSTOPERATIVE VENTRAL HERNIA

Info

Publication number: RU2007114707A
Application number: RU2007114707/14A
Authority: RU
Inventors: Сергей Владимирович Шалашов (RU); Сергей Владимирович Шалашов; Александр Леонидович Михайлов (RU); Александр Леонидович Михайлов; Юрий Константинович Усольцев (RU); Юрий Константинович Усольцев; Иван Александрович Егоров (RU); Иван Александрович Егоров
Original assignee: Сергей Владимирович Шалашов (RU); Сергей Владимирович Шалашов; Александр Леонидович Михайлов (RU); Александр Леонидович Михайлов; Юрий Константинович Усольцев (RU); Юрий Константинович Усольцев; Иван Александрович Егоров (RU); Иван Александрович Егоров
Priority date: 2007-04-18
Filing date: 2007-04-18
Publication date: 2008-10-27
Also published as: RU2366367C2

Abstract

1. Способ пластики при послеоперационных вентральных грыжах, включающий разрез кожи и подкожной клетчатки, выделение и обработку грыжевого мешка, обнажение и пластику грыжевого дефекта с предбрюшинным или подмышечным расположением синтетического сетчатого протеза, отличающийся тем, что прямоугольный синтетический сетчатый протез моделируют, делая надрезы с двух противоположных или с четырех его краев по направлению к противоположным краям, выкраивая полоски, которые проводят через мышечно-апоневротические края грыжевых ворот изнутри наружу с последующим после подтягивания сшиванием каждой полоски с другой полоской или с участком синтетического сетчатого протеза у края грыжевого дефекта.2. Способ по п.1, отличающийся тем, что при возможности полного сближения краев грыжевого дефекта, полоски в синтетическом сетчатом протезе выкраивают, делая надрезы только с двух длинных противоположных его краев, проводят их через мышечно-апоневротические структуры сближаемых краев грыжевого дефекта, и после подтягивания до сведения краев грыжевого дефекта сшивают с противоположно расположенными полосками.3. Способ по п.1, отличающийся тем, что при невозможности полного сближения краев грыжевого дефекта, полоски в синтетическом сетчатом протезе выкраивают, делая надрезы со всех четырех его краев, при этом вырезая углы, и каждую из выкроенных полосок после проведения ее через мышечно-апоневротические структуры сшивают с участком синтетического сетчатого протеза у края грыжевого дефекта.4. Способ по п.1, отличающийся тем, что полоски, выкроенные в синтетическом сетчатом протезе, имеют ширину 2-4 см.5. Способ по п.1, отли1. Plastic surgery for postoperative ventral hernias, including a cut of the skin and subcutaneous tissue, isolation and processing of the hernial sac, exposure and plasticity of the hernial defect with a preperitoneal or axillary location of the synthetic mesh prosthesis, characterized in that the rectangular synthetic mesh prosthesis is modeled by making incisions from two opposite or from its four edges towards the opposite edges, cutting out strips that pass through the muscular-aponeurotic edges of the hernial portal from the inside and outward, followed by pulling together stitching of each strip with another strip or with a section of a synthetic mesh prosthesis at the edge of the hernial defect. 2. The method according to claim 1, characterized in that if it is possible to completely approach the edges of the hernial defect, the strips in the synthetic mesh prosthesis are cut out by making incisions from only two long opposite edges of it, pass them through the muscle-aponeurotic structures of the adjacent edges of the hernial defect, and after pulling until the edges of the hernial defect are stitched with opposite strips. 3. The method according to claim 1, characterized in that if it is impossible to completely approach the edges of the hernial defect, the strips in the synthetic mesh prosthesis are cut out, making cuts from all four of its edges, while cutting the corners, and each of the cut strips after passing it through the muscular aponeurotic the structures are sutured to the site of the synthetic mesh prosthesis at the edge of the hernial defect. 4. The method according to claim 1, characterized in that the strips cut in a synthetic mesh prosthesis have a width of 2-4 cm. The method according to claim 1, otl

Claims

1. Plastic surgery for postoperative ventral hernias, including a cut of the skin and subcutaneous tissue, isolation and processing of the hernial sac, exposure and plasticity of the hernial defect with a preperitoneal or axillary location of the synthetic mesh prosthesis, characterized in that the rectangular synthetic mesh prosthesis is modeled by making incisions from two opposite or from its four edges towards the opposite edges, cutting out strips that pass through the muscular-aponeurotic edges of the hernial portal from the inside and outward, followed by pulling together stitching of each strip with another strip or with a section of a synthetic mesh prosthesis at the edge of the hernial defect.

2. The method according to claim 1, characterized in that, if it is possible to completely approach the edges of the hernial defect, the strips in the synthetic mesh prosthesis are cut out, making cuts from only two long opposite edges of it, pass them through the muscular aponeurotic structures of the adjacent edges of the hernial defect, and after pulling to the edges of the hernial defect, they are sutured with opposite strips.

3. The method according to claim 1, characterized in that if it is impossible to completely approach the edges of the hernial defect, the strips in the synthetic mesh prosthesis are cut out, making cuts from all four of its edges, while cutting the corners, and each of the cut strips after passing it through muscular -aponeurotic structures are sutured to the site of the synthetic mesh prosthesis at the edge of the hernial defect.

4. The method according to claim 1, characterized in that the strips cut in a synthetic mesh prosthesis have a width of 2-4 cm

5. The method according to claim 1, characterized in that the strips cut out in a synthetic mesh prosthesis are passed through the muscle-aponeurotic structures, departing from the edges of the hernial defect by 2-4 cm.

6. The method according to claim 1, characterized in that the strips cut in a synthetic mesh prosthesis are carried out through muscle-aponeurotic structures at a distance of 2-4 cm from each other.

7. The method according to claim 1, characterized in that the width of the synthetic mesh prosthesis between the cut strips, if possible, reduce the edges of the hernial defect is 4-8 cm

8. The method according to claim 1, characterized in that the dimensions of the synthetic mesh prosthesis between the cut strips when it is impossible to reduce the edges of the hernial defect more than the hernial defect by 2-4 cm in all directions.