SU1796166A1 - Method for surgical treatment of gigantic umbilical hernia - Google Patents

Description

The invention relates to medicine, namely to surgery.

Closest to the claimed method is the Mayo method, which is used for extensive umbilical hernias. In this case, the skin and subcutaneous tissue are dissected in two transverse incisions in the transverse direction. The skin-subcutaneous flap is cut off from the aponeurosis, reach the hernial portal and the neck of the hernial sac. The navel is excised, hernioplasty is performed.

The disadvantage of this method is a pronounced cosmetic defect as a result of belly button removal. Patients experience psychological and social discomfort.

The purpose of the invention is to increase the cosmetic effect by restoring the navel in a typical place.

The invention is as follows.

A lower horizontal incision is made along the hypogastric fold. A skin-fat flap of the anterior abdominal wall is separated cranially from the umbilical hernia. Perform hernioplasty according to Mayo, move the skin-fat flap caudally, outside the projection of the navel, excise the excess of soft tissues, suture. In the region of the anatomical location of the umbilicus, two vertical semi-oval incisions form a full-layer skin flap on the leg, displace it down, and fiber is dissected crater-like at the bottom of the wound. An offset skin flap is spread over the wound, its apex is fixed to the bottom of the wound. A free skin flap is formed from the scrap skin of the excised soft tissues, which covers the wound defect, which remained after the plastic surgery with a non-free skin flap.

Example. Patient 3., 38 years old. Diagnosis:

umbilical hernia, excess soft tissue m o o o o o>

the front wall of the abdomen. The patient had a stretched front wall of the abdomen, a picture of a sagging abdomen, a belly button displacement downward, smoothing of the navel fossa. The patient was psychologically depressed, there was an installation on the connection of domestic troubles with a defect in the anterior abdominal wall. The operation was performed: a lower horizontal incision was made along the hypogastric fold. A skin-fatty flap of the anterior abdominal wall was separated cranially from the umbilical hernia. Performed hernioplasty according to Mayo, a skin-fat flap was caudally moved, an excess of soft tissues was excised, sutures were placed on the wound. In the region of the anatomical location of the navel, two vertical semi-oval incisions form a full-layer skin flap on the leg, shifted down. Cellulose is dissected crater-like at the bottom of the wound. A previously displaced skin flap was spread over the wound; its tip is fixed to the bottom of the wound. A free skin flap was formed from the scrap skin of the excised soft tissues, which closed the wound defect remaining after plastic surgery with a non-free skin flap. The postoperative period was uneventful. The wounds healed by primary intention. On examination, after a year of complaints, the patient did not show complaints, the anterior abdominal wall is of the correct form, the cosmetic result is good.

The proposed method providing a cosmetic result of a traditional operation. improves patients psychological and social comfort.

Claims (1)

Claim A method of surgical treatment of giant umbilical hernias, including excision of a hernia with an umbilicus, characterized in that, in order to increase the cosmetic effect by reconstructing the navel in a typical place, hernia is performed outside the umbilical zone, and after suturing the skin wound in the umbilical region with two vertical semi-oval incisions a full-layer skin flap is formed on the leg, it is displaced downward and tissue is excised crater-like at the bottom of the wound, then the displaced skin flap is spread over the wound, the tip of which is fixed to the aponeur a ram, and a wound defect is filled with a free skin flap.