The topographical, anatomical and clinical substantiation of total extraperitoneal inguinal hernioplasty

Romashchenko, P. N.; Фомин, Н. Ф.; Майстренко, Н. А.; Kurygin, A. A.; Semenov, V. V.; Mamoshin, A.A.

doi:10.17116/endoskop20202605116

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…В настоящее время востребованным направлением прикладных анатомических исследований является изучение особенностей строения предбрюшинного клетчаточного пространства для описания строения и топографии предбрюшинной фасции. Изучением данной проблемы занимались классики топографической анатомии: D. Gerota, J. Malgaine, А. Таренецкий [3]. Японскими герниологами M. Ohuchi и Y. Nagahisa при лапароскопических диссекциях тканей установлено, что предбрюшинная фасция состоит из двух листков [4,5].…”

Section: Introductionunclassified

“…Анализ результатов эндовидеохирургического лечения паховых грыж показывает, что сетчатый имплантат для снижения травматизации брюшины целесообразно устанавливать между дополнительным фасциальным листком предбрюшинной фасции и поперечной фасцией [3]. Вместе с тем отсутствие единых представлений об архитектонике фасциального аппарата предбрюшинного слоя препятствует топографо-анатомическим и экспериментальным обоснованиям методов установки сетчатого эндопротеза и внедрению данного вида малоинвазивных хирургических технологий в ежедневную клиническую практику.…”

Section: Introductionunclassified

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On the features of the preperitoneal space multifascial structure in clinical and anatomical issues

Boytsova¹,

Фомин²,

Shvedyuk³

2021

Russian Military Medical Academy Reports

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AIM: to determine the prospects for the preventive endoprosthetics of the abdominal wall at preventing the development of postoperative ventral hernias. MATERIALS AND METHODS: A meta-analysis of the literature data performed to determine the effectiveness of preventive endoprosthetics for the prevention of ventral hernia formation. Topographical study has been conducted to explore the most promising levels of the mesh location. RESULTS: During the meta-analysis it has been found that performing preventive endoprosthesis of the anterior abdominal wall t in the preperitoneal space reduces the frequency of ventral hernias. There were no significant differences in the frequency of infectious complications and serom in the experimental and control groups according to studied publications. During the preparation it has been distinguished that between the transverse fascia and the peritoneum there is a preperitoneal fascia consisting of two leaves, which is most manifest in the lateral parts. In the umbilical region above linea arcuata the preperitoneal fascia is thinned and represented by separate fibers that are difficult to differentiate as a structure between the transverse fascia and the peritoneum. In the lateral parts of the abdominal wall, the preperitoneal fascia is well expressed. It has been distinguished that the retroperitoneal fascia, formed by the junction of two sheets of the Gerot fascia continues into the fascia between the transverse fascia and the peritoneum. CONCLUSION: Preventive endoprosthesis of the anterior abdominal wall is an effective and safe method of preventing the formation of postoperative ventral hernias. The anterior abdominal wall is characterized by a complex multifascial structure, which is of fundamental importance for various types of surgery. Between the transverse fascia and the peritoneum there is preperitoneal fascia which is represented by two leaflets. Its continuation is the retroperitoneal fascia (5 figures, 2 tables, bibliography: 8 refs).

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Section: Introductionunclassified

On the features of the preperitoneal space multifascial structure in clinical and anatomical issues

Boytsova¹,

Фомин²,

Shvedyuk³

2021

Russian Military Medical Academy Reports

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Endovideogernioplasty in patients with inguinal hernias: advantages and disadvantages

Romashchenko

Kurygin

Semenov

et al. 2021

Bulletin of the Russian Military Medical Academy

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This study analyzed the results of treatment of patients with inguinal hernias, with an assessment of the advantages and disadvantages of endovideosurgical hernioplasty techniques. The clinical study used the data of 1317 patients with inguinal hernias. The results revealed that the totally extraperitoneal inguinal hernia repair had some advantages over laparoscopic hernioplasty, such as a shorter duration of surgery (43 15 min), mild pain on a visual analog scale, and an average bed-day after surgery. Complications were diagnosed in 16 (1.2%) patients, and most had ClavienDindo grade II complications. Relapses were detected in 7 (0.5%) cases. Thus, endoscopic hernioplasty (laparoscopic and totally extraperitoneal inguinal hernioplasty) was the preferred surgery for patients with bilateral inguinal hernia, recurrent hernia after traditional hernioplasty, and metabolic syndrome and young people of working age. The use of a modified technique of totally extraperitoneal inguinal hernioplasty with a clear understanding of the multifascial structure of the anterior abdominal wall may reduce the risks of both intraoperative and postoperative complications and increase the cost-effectiveness of treatment of patients with inguinal hernias, allowing us to obtain good results.

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Modern concept of treatment of patients with ventral hernias

Romashchenko,

Kurygin,

Semenov

et al. 2024

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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INTRODUCTION. The relevance of treating patients with hernias of the anterior abdominal wall is beyond doubt, since the incidence of the disease is on average 5 people per 1000, and hernioplasty itself is one of the most common operations in a general surgical hospital. However, the relapse rate remains quite high. There remains a debate about the choice of surgical option; the issues of prevention and treatment of pain syndrome, as well as tactics for managing patients with a complicated postoperative period, remain unresolved.The OBJECTIVE was to evaluate the effectiveness of the modern concept of treating patients with ventral hernias and to substantiate the principles for choosing a hernioplasty technique.METHODS AND MATERIALS. The study is based on the results of treatment of 1938 patients operated on at the Faculty Surgery Clinic named after S.P. Fedorov Military Medical Academy in the period from 2015 to 2022. Both open and endovideosurgical options for surgical interventions were performed for isolated umbilical hernias or in combination with diastasis of the rectus muscles, hernias of the white line of the abdomen, inguinal and postoperative hernias, including reduction of the volume of the abdominal cavity.RESULTS. During the study, an algorithm for the treatment of patients with ventral hernias was developed, various options for perioperative pain relief were proposed, and the tactics for treating infectious and purulent complications were substantiated.CONCLUSION. A specialized surgical hospital must perform all possible options for both traditional and endovideosurgical hernioplasty, use innovative options for pain relief in the perioperative period, and apply modern methods for diagnosing and treating postoperative complications in order to provide personalized medical care.

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The topographical, anatomical and clinical substantiation of total extraperitoneal inguinal hernioplasty

Cited by 4 publications

References 14 publications

On the features of the preperitoneal space multifascial structure in clinical and anatomical issues

On the features of the preperitoneal space multifascial structure in clinical and anatomical issues

Endovideogernioplasty in patients with inguinal hernias: advantages and disadvantages

Modern concept of treatment of patients with ventral hernias

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