RU2277384C1 - Method for suturing in an aponeurosis - Google Patents

Abstract

FIELD: medicine, hernial surgery.

SUBSTANCE: one should create aponeurosis duplicature. Moreover, one should apply a reticular implant under one edge and onto the second edge of aponeurosis. Then it is necessary to suture in aponeurosis at developing duplicature with P-shaped sutures. Sutures should be applied through reticular implants from inside outwards, being perpendicular to aponeurosis incision line. Sutures should be tightened at the upper reticular implant. The innovation enables to exclude sutures' cutting through and failure in circulation and aponeurosis innervation.

EFFECT: higher efficiency.

9 dwg

Description

The invention relates to methods for suturing the aponeurosis of the anterior abdominal wall and can be used in hernia surgery.

The closest to the method under consideration is, according to the authors, the method of suturing the aponeurosis in hernioplasty of the hernias of the anterior abdominal wall using a mesh implant, which is performed by stitching the sheets of the aponeurosis of the anterior abdominal wall with subsequent strengthening of the suture line with a mesh implant, when the latter is located under or above the aponeurosis [12]. However, unlike the claimed method, this one has another operational technique, does not provide sufficiently reliable closure of the aponeurosis and causes a number of specific complications.

The invention:

Improving the quality of surgical operations during hernioplasty, eliminating specific complications, reducing the morbidity of surgical procedures, reducing the time of surgery and the economic profitability of the operation.

Features:

When performing hernioplasty, under one edge and on the second edge of the aponeurosis, two mesh implants are placed along the incision line (Figure 1). U-shaped sutures are superimposed, suture threads are carried out through mesh implants, from the inside outwards, perpendicular to the aponeurosis incision line (Figure 2-6). Suture threads are tied on the upper mesh implant with the location of the stitch perpendicular to the aponeurosis incision line (Figure 7-8). Formed duplication of aponeurosis (Figure 9).

A positive result of the use of the invention is achieved in that optimal conditions are created for reliable closure of the aponeurosis, since the seams through the implants and tying on them provide sufficient strength of the aponeurosis seam and the absence of eruption, taking into account the location of the seams perpendicular to the aponeurosis cut line, i.e. along the fibers of the aponeurosis and neurovascular bundles, the violation of blood supply and innervation is excluded, the invasiveness of surgical procedures is reduced, and the time of surgical intervention is reduced.

List of drawings:

Figure 1. Mesh implants placed under one edge and on the second edge of the aponeurosis, along the incision line.

Figure 2. The imposition of a U-shaped suture, from the inside outward, perpendicular to the aponeurosis incision line - the thread is passed through the lower mesh implant.

Figure 3. The imposition of a U-shaped suture, from the inside outward, perpendicular to the aponeurosis cut line - one end of the thread is carried through the upper implant.

Figure 4. The imposition of a U-shaped suture, from the inside outwards, perpendicular to the aponeurosis cut line - the second end of the thread is carried through the upper implant.

Figure 5. The imposition of a U-shaped suture, from the inside outward, perpendicular to the aponeurosis cut line - both ends of the thread are passed through the implants.

Figure 6. The imposition of a U-shaped suture, from the inside to the outside, perpendicular to the aponeurosis cut line - both ends of the thread are passed through the implants.

Figure 7. The imposition of a U-shaped suture, from the inside outward, perpendicular to the aponeurosis cut line - a knot is formed, the stitch is perpendicular to the aponeurosis cut line.

Figure 8. The imposition of a U-shaped suture, from the inside outward, perpendicular to the aponeurosis cut line - a knot is formed, the stitch is perpendicular to the aponeurosis cut line.

Figure 9. The imposition of a U-shaped suture, from the inside outwards, perpendicular to the aponeurosis cut line with the formation of duplicate - in the transverse section.

Bibliographic sources

1. Egiev V.N., Lyadov K.V., Voskresensky P.K. Atlas of operative hernia surgery // Moscow - "Medpraktika-M" - 2003, - pp. 143-187.

2. Zhebrovsky VV, Mohammed Tom Elbashir. Surgery of abdominal hernias and eventrations // Simferopol - "Business-Inform" - 2002, - pp. 355-380.

Claims (1)

A method for suturing an aponeurosis, including creating an aponeurosis duplicate, characterized in that two mesh implants are placed under one edge and on the second edge of the aponeurosis along the incision line, after which the aponeurosis is sutured with the formation of duplication with U-shaped sutures that are passed through the mesh implants from the inside outwards, perpendicular to the aponeurosis incision line and knotted on the upper mesh implant.

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