Pathogenesis features and prevention of port-site hernias after laparoscopic cholecystectomy
Was performed morphological study of muscle-aponevrotych tissue para-umbilical areas in 80 patients aged 30 to 75 years after laparoscopic cholecystectomy. Women were - 42 (70%) - 18 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±2,3 sm 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±1,3 sm 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 10 mm. 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.