Topographic-Anatomic Justification of Various Methods Reducing Tissue Tension at Prosthetic Incisional Hernia Repair by «Sublay»
- Authors: Zakurdaev E.I.1, Chernyh A.V.1, Cherednikov E.F.1, Zakurdaeva M.P.1
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Affiliations:
- Voronezh State Medical University named after N.N. Burdenko
- Issue: Vol 10, No 1 (2017)
- Pages: 26-31
- Section: Original articles
- URL: https://vestnik-surgery.com/journal/article/view/906
- DOI: https://doi.org/10.18499/2070-478X-2017-10-1-26-31
- ID: 906
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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.
About the authors
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
PhD, assistant of department Operative Surgery and Topographic Anatomy
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036Alexander 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
MD, Professor, department chair of Operative Surgery and Topographic Anatomy
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036Evgeny Fedorovich Cherednikov
Voronezh State Medical University named after N.N. Burdenko
Email: ezakurdaev@rambler.ru
MD, Professor, department chair of faculty surgery
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036Marina Petrovna Zakurdaeva
Voronezh State Medical University named after N.N. Burdenko
Email: ezakurdaev@rambler.ru
Postgraduate at the Department of Operative Surgery and Topographic Anatomy
Russian Federation, 10 Studencheskaia Str., Voronezh, 394036References
- Belokonev V.I., Kochetkov R.I., Savelev V.N. Sposob kombinirovannogo zakrytiya defekta perednej bryushnoj stenki [Method for combined closure of anterior abdominal wall defect]. Patent RF № 2223045, 2002.
- Zagirov U.Z., Yusef R.D., Magomedov Z.M. Sposob plastiki bryushnoj stenki pri bolshih ventralnyh gryzhah [Method for abdominal wall plasty in case of large-size ventral hernias]. Patent RF, № 2299694, 2003.
- Tarasova N.K., Dinkov S.M., Teterin A.Yu., Kuznetsov A.A. Profilaktika oslozhnenij v rannem posleoperacionnom periode i recidiva pri lechenii bolnyh s posleoperacionnymi ventralnymi gryzhami [Prophylaxis of complications in the early postoperative period and recurrences in treatment of patients with postoperative ventral hernias]. Annaly hirurgii. 2012; 6: 26-30.
- Izmajlov S.G., Popov E.V., Rotkov S.I., Rotkov A.I. Modelirovanie processa ushivaniya rany s pomoshchyu novogo pokoleniya ustrojstv – PAPA [The Computer Simulation of Surgery Cut Sewing with New Generation of PAPA Facilities]. Vestnik Izhevskogo gosudarstvennogo tekhnicheskogo universiteta. 2008; 2: 121-123.
- Kalantarov T. K., Chirkov R.N., Babayan K.V. Sposob uvelicheniya obema bryushnoj polosti pri lechenii pacientov s bol'shimi ventral'nymi gryzhami [Method of increasing volume of abdominal cavity in treatment of patients with large ventral hernias]. Patent RF № 2449735, 2012.
- Koshelev P.I., Gluhov A.A., Hussain M., Leibovich B.E. Innovacionnie puti sovershenstvovaniya metodov nenatyajnoi gernioplastiki [Innovation methods to moderate the process of stretched hernio-plactic]. Sistemnii analiz i upravlenie v biomedicinskih sistemah. 2007; 6: 2: 528-532.
- Parshikov V.V., Hodak V.A., Petrov V.V., Dvornikov A.V., Mironov A.A., Samsonov A.A., Romanov R.V. Retromuskulyarnaya plastika bryushnoi stenki setkoi [Retromuscular plasty of abdominal wall using mesh]. Fundamentalnie issledovaniya. 2012; 7: 159-163.
- Skipidarnikov A.A., Bejin A.I., Netyaga A.A., Skipidarnikova A.N. Osobennosti innervacii pryamih mishc jivota u lyudei s razlichnimi tipami teloslojeniya [Peculiarities of the innervation of rectus abdominis in people with various constitutions]. Kurskii nauchno-prakticheskii vestnik «Chelovek i ego zdorove». 2013; 1: 21-26.
- Chernyh A.V., Zakurdaev E.I., Lyubyh E.N., Vitchinkin V.G. Volnoobraznyj poslablyayushchij razrez perednej stenki vlagalishcha pryamoj myshcy zhivota pri oposredovannoj plastike pahovogo kanala [Wavelike relaxing incision of anterior wall of the rectus sheath mediated plastic repair of the inguinal canal]. Novosti hirurgii. 2015; 23: 1: 17-23.
- Chernyh A.V., Lyubyh E.N., Zakurdaev E.I. Novie dannie po tipovoi i variantnoi anatomii pahovogo promejutka [New data on the typical and variant anatomy of the inguinal gap]. Vestnik eksperimentalnoi i klinicheskoi hirurgii. 2015; 8: 1: 11-20.
- Yurasov A.V. Vybor metoda plastiki posleoperacionnyh ventralnyh gryzh [The choice of method of plasty postoperative ventral hernias]. Annaly hirurgii. 2001; 6: 65-68.
- Novitsky Y.W., Harrell A.G., Hope W.W., Kercher K.W., Heniford B.T. Meshes in hernia repair. Surg Technol Int. 2007; 16: 123-127.
- Ramirez O.M., Ruas E., Dellon A.L. Components separation method for closure of abdominal wall defects: an anatomic and clinical study. Plast Reconstr Surg. 1990; 86: 519-526.