The paper presents a comparative characteristic of the results of surgical treatment of 27 patients with hiatal hernias using the Rampal–Narbona cardiorespexy technique and 16 patients who underwent laparoscopic Nissen– Rosetti fundoplication with cruroraphy. Cardioterespexy according to the Rampal-Narbona technique consists in the use of lig. Teres hepatis with the aim of forming the angle of His, fixing the cardiac part of the stomach and esophagus in the abdominal cavity. There were no cases of mortality. Complications after surgery were observed in older patients who were associated with concomitant pathology. The patients were examined within 10 to 18 months after surgery; in both groups, several cases of relapses and complications were recorded. In percentage terms, these data are as follows: during cardioterespexia surgery, the recurrence rate was 3.7%, signs of esophagitis were observed in 18%, cardia insufficiency was observed in 11.1%, signs of GER were in 11.1%, while in patients, of those operated on according to the Nissen–Rosetti technique, similar indicators were somewhat different: the percentage of relapse was 6.25%, signs of esophagitis were observed in 18.75%, cardiac insufficiency was observed in 18.75%, signs of GER were also in 18.75%. The results obtained indicate a good efficiency of cardiopexy with the round ligament of the liver, and a lower percentage of recurrence and complications in comparison with the Nissen– Rosetti technique (18.7%). The authors see the expediency of using the cardioterespexia technique in clinical practice both in the classical version and subject to its further improvement, which consists in increasing the mechanical properties of the round ligament of the liver and performing this operation by laparoscopic access.

Summarizing the experience of research and treatment of 218 patients (134 (61.5%) men and 84 (38.5%) women) with pathological symptoms frolicking after surgery on the stomach and duodenum. The average age of patients was (56.7 ± 13.7) years old. The authors formulated the obligatory scope of examination of patients to select possible options for reconstruction of the gastrointestinal tract. The results of the developed methods are demonstrated, confirming the need to restore the natural passage of food, and, if necessary, the creation of functionally active formations that prevent the occurrence of a retrograde pathological flow of contents from the distal parts of the digestive tract to the proximal.

Samples of metal knitted mesh made of the 40 μm, 60 μm and 90 μm diameter TiNi wires are studied by uniaxial tension to rupture and uniaxial cyclic tension. It was found that the metal knitted TiNi mesh behaves like a hyperelastic material under uniaxial tension in contrast to the superelastic wire from which it is made. Using the rheological models of Gent, Neo-Hookean, Mooney–Rivlin and Bergstrom-Boyce, the calculation of the cyclic tension of the knitted mesh was carried out. The similarity of the mechanical behavior of knitted mesh and biological tissues is shown. Criteria for quantitative assessment of the biomechanical compatibility of a knitted mesh implant for plasty of hyperelastic biological tissues are proposed.The main criteria for the rheological similarity of knitted mesh and soft tissues are the ultimate tensile strength, elastic modulus and the range of low-modulus and high-modulus elastic strain under loading and unloading; the residual strain value during cyclic tension.It has been found that knitted mesh made of superelastic TiNi wire exhibits a rubber-like behavior characteristic of hyperelastic materials under soft zero cyclic tension. At the same time, in the most loaded contact areas of the superelastic TiNi wire, the martensitic transition did not affect the tension cycles is due to friction, which counteracts the recovery of elastic strain during unloading. It has been established that the Bergstrom–Boyce model is closest in terms of the stress–strain diagram to the knitted mesh and biological tissues. Knitted mesh implants made of nickeide titanium wire were used for plasty of soft tissues and musculoskeletal complexes. The developed method for quantitative assessment diagram of the hyperelastic knittes mesh. The residual strain during the first two tension of the biocompatibility of the implant and biological tissue make it possible to choosу knitteв mesh with a certain wire diametre, focusing on the forces developed by the knitted mesh and the variable elasticity modulus. The knitted mesh was applied without additional fixation, using elastic self-fixation of knitted mesh loops into soft tissues.