kalinovskiy

7/31/2019 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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