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Transcript of Kalinovskiy
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2012
Hardships in Treatment of
Giant Umbilical Hernia
. ..
Khmelnytskyi Regional Hospital
Vlasov V.V., Kalynovskyi S.V.
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The aim:
:
to investigate the hardships of surgical treatment
patients with giant umbilical hernia
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In all patients were organized CT for
analysis hernial defect and exception
pathology of inner organs
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RESULTS
Hardships during surgical treatment of this patients observed
during repositioning of hernia content in abdomen through
the rather small hernia defect, in selecting position of mesh
and in prevention of compartment syndrome.
,
,
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2
We used 2 demylune
incisions with removing of
umbilicus for approach to
giant hernia`s sac
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,
(, ,
)
1. omentum
2. hernia defect
3. paries of hernia sac
In all cases treatment of giant umbilical hernia we uncovered
hernia sac, separated fixed to hernia sac inner organs
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-300-1
The EK -300M-1 MAC was used in coagulation and
welding regimes for safe hemostasis during the
separation of inner organs
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-
,
,.
This problem by us decides by one- or bilateral implementation of the
arched sections of front and back plates of direct muscle of stomach
laterally, which are directed to different sides, and with the
simultaneous taking of direct muscle of stomach laterally
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`
When there were problems with mobilization of preperitoneal spase,
opening of posterior laminas of vaginas of musculus rectus abdominis
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This method allaved
to realized the
mobilization ofplatform for mesh
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The paries of hernia sac were used during the
suturing of hernia defect for minimization of tension
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2
` O.M. Ramirez.
In 2 patients were carried out the aperient incisions of aponeurosis of
external oblique abdominal muscle by the method of O.M.Ramires.
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, ( 15 6 )
,
The defects that formed (nearly 156 cm) were
completed by mesh, fixed along the perimeter.
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O.M. Ramirez
1; 2 , ;
3 ; 4 .
The final resalt of operation of O.M. Ramirez
1musculus obliqus abdominis ext; 2,4mesh; 3
retromuscular spatium
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Operative wound was stitched with help of
tautaum sutures
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During the postoperative period there was diagnosed the seroma of
postoperative injury in one patient with alimentary obesity. The
average bed day for the patients with giant umbilical hernia was 7,4
3,2 days.Control examinations of patients in 1 - 3 years after the surgery
demonstrated any recurrences.
1
. 6 - 12 ( 9 ).
13,
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Conclusions:
Author's widening of hernia defect give an opportunity for easy-going
reposition of hernia content in abdominal cavity and performance ofsingle-plane operation without weakening the strength of anterior
abdominal wall.
The plastic of giant umbilical hernia defect advisably to carry out
with the help of the mesh located in retromuscular spatium with
addition of operation by O.M.Ramires for the prevention of
compartment syndrom.
:
,
.
,
O.M. Ramirez
.
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