ОСОБЛИВОСТІ ПАТОГЕНЕЗУ ТА ПРОФІЛАКТИКИ ТРОАКАРНИХ ГРИЖ ПІСЛЯ ЛАПАРОСКОПІЧНОЇ ХОЛЕЦИСТЕКТОМІЇ

Дадаян В. А.

Україна, Національна медична академія післядипломної освіти імені П. Л. Шупика,
Кафедра хірургії та проктології, КЗ КОР «Київська обласна клінічна лікарня»

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Abstract.

Was performed morphological study of muscle-aponevrotych tissue para-umbilical areas
in 80 patients aged 30 to 75 years after laparoscopic cholecystectomy. Women were -56 (70 %) -24 men (30 %). Patients were divided into 3 groups. The first group consisted of 30 patients who performed laparoscopic cholecystectomy over cholelithiasis. Among them, 21 (70 %) was observed diastasis direct muscle size 3±2,3sm paraumbilical area. The second group consisted of 30 patients with port-site hernias paraumbilical area after laparoscopic cholecystectomy. The third comparison group consisted of 20 patients who performed upper midline laparotomy. Among them diastase recti size 2±1,3sm paraumbilical areas was observed in 6 patients operated on perforated ulcer 12 duodenal ulcer, and in 9 patients who performed laparotomy for acute adhesive obstruction. Morphological study of muscle-aponevrotych tissue conducted with paraumbilical area. It was proved that the main pathogenetic link port-site hernia in paraumbilical region after laparoscopic cholecystectomy is thinning aponevrosis this site, its moderately severe atrophy and aponevrosis recti and strengthening of atrophy after setting trocar 10mm.
Also, prevention port-site hernia paraumbilical region after laparoscopic cholecystectomy can be
achieved by using light polypropylene mesh which is placed preperitoneal before closing the wound.

Keywords: diastasis direct muscle, atrophy of muscle-aponevrotych tissue, port-site hernias,
laparoscopic cholecystectomy, prevention of port-site hernias.

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