Topographic-Anatomic Justification of Various Methods Reducing Tissue Tension at Prosthetic Incisional Hernia Repair by «Sublay»

Abstract


Purpose. To develop a new relaxing incision on the anterior wall of rectus sheath and to compare its efficiency with the classical counterparts in the experiment.

Materials and methods. We measured tension nodal seam with the help of a spring dynamometer on 24 cadavers. This seam was overlaid on the inner edge of the rectus abdominis in the region of the umbilical ring before and after relaxing incision. The objects of study were divided into four groups randomly. We studied the proposed wavelike relaxing incision in the first group and classical methods in other groups.

Results.  Maximum relaxation nodal seam (56%) was observed when using a wavelike relaxing incision of anterior wall of  rectus sheath. Vertical relaxing incision of aponeurosis of the external oblique abdominal muscles along the lateral edge of the rectus abdominis (by O. M. Ramirez) was close in efficiency to the proposed method. It is possible to reduce tension of the nodal seam at 48%. Relaxing effect arc-shaped relaxing incision of anterior wall of rectus sheath by V.I. Belokonev was 39%. Vertical relaxing incision in a staggered pattern by U.Z. Zagirov showed minimal relaxing effect – 25%.

Conclusion. Wavelike relaxing incision of anterior wall of rectus sheath which was proposed allows reducing tissue tension in hernioplasty compared to the classical methods.


Evgeny Ivanovich Zakurdaev

Voronezh State Medical University named after N.N. Burdenko

Author for correspondence.
Email: ezakurdaev@rambler.ru
ORCID iD: 0000-0001-8613-9609
SPIN-code: 2404-1579

Russian Federation, 10  Studencheskaia Str., Voronezh, 394036

PhD, assistant of department Operative Surgery and Topographic Anatomy

Alexander Vasilevich Chernyh

Voronezh State Medical University named after N.N. Burdenko

Email: ezakurdaev@rambler.ru
ORCID iD: 0000-0002-6281-0020
SPIN-code: 8444-7010

Russian Federation, 10  Studencheskaia Str., Voronezh, 394036

MD, Professor, department chair of Operative Surgery and Topographic Anatomy

Evgeny Fedorovich Cherednikov

Voronezh State Medical University named after N.N. Burdenko

Email: ezakurdaev@rambler.ru

Russian Federation, 10  Studencheskaia Str., Voronezh, 394036

MD, Professor, department chair of faculty surgery

Marina Petrovna Zakurdaeva

Voronezh State Medical University named after N.N. Burdenko

Email: ezakurdaev@rambler.ru

Russian Federation, 10  Studencheskaia Str., Voronezh, 394036

Postgraduate at the Department of Operative Surgery and Topographic Anatomy

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Copyright (c) 2017 Zakurdaev E.I., Chernyh A.V., Cherednikov E.F., Zakurdaeva M.P.

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