| 摘要 |
FIELD: medicine.SUBSTANCE: according to the first version, a rectangular round-cornered reinforced warp mesh endoprosthesis for inguinal hernia repair is presented with using non-absorbable polypropylene monofilaments of different thickness. The endoprosthesis comprises a reinforced area in the form of a vertical strip at least 1cm wide formed by at least four needle wales of monofilaments of a primary area of the thickness dand additional filaments of the greater thickness d. A transition from the reinforced area to the primary area from each side has one needle wale formed of the monofilament of the primary area and the additional monofilament of the thickness determined by the relation d=(d+d)/2. The relation of a cell area of the primary, reinforced and transition areas makes 1:0.5:0.75. One end of the reinforced area is arranged along the vertical axis of the endoprosthesis. According to the second version, the endoprosthesis is similar to that according to the first version, but it uses non-absorbable polyvinylidene fluoride monofilaments. According to the third version, the endoprosthesis is made of non-absorbable monofilaments of different thickness, including polypropylene monofilaments. The endoprosthesis comprises the reinforced area of polypropylene and polyvinylidene fluoride monofilaments in the form of a vertical strip at least 1cm wide formed by at least four needle wales of polypropylene monofilaments of the primary area of the thickness dand additional polyvinylidene fluoride monofilaments of the greater thickness d. The transition from the reinforced area to the primary area from each side has one needle wale formed of the polypropylene monofilament of the primary area and the additional polyvinylidene fluoride monofilament of the thickness determined by the relation d=(d+d)/2. The relation of the cell area of the primary, reinforced and transition areas makes 1:0.5:0.75. One end of the reinforced area is arranged along the vertical axis of the endoprosthesis. A method for the inguinal hernia repair involving an inguinal canal repair wherein any of the above endoprostheses is shaped after a posterior wall of the inguinal canal and arranged along the whole surface to overlap the abdominal internal oblique muscle and the transverse muscle of the abdomen by 2.0-2.5 cm and in the lateral direction from an internal opening of the inguinal canal with the endoprosthesis fixed with the non-absorbable monofilament. The opening with a vertical slot for the spermatic cord is formed closer to the vertical axis of the endoprosthesis and created in the primary area which is fixed to the abdominal internal oblique muscle and the abdominal rectus muscle. The reinforced area of the mesh endoprosthesis is placed above the hernia defect and fixed with a suture covering the reinforced area from one side and Cooper's ligament from the other one.EFFECT: reducing rate of recurrences and postoperative complications ensured by forming a high-density connective tissue scar immediately in the hernia defect which transforms into a less dense scar within surrounding tissues by arranging the reinforced area of the endoprosthesis within the defect in a combination with improving the fixation of the endoprosthesis to the inguinal ligament and Cooper's ligament, reducing an amount of a foreign material implanted into the body with no effect on the endoprosthesis strength.4 cl, 1 tbl, 4 dwg |
