METHOD FOR LOCATING MANIPULATION TROCARS IN INTRAPERITONEAL PLASTIC SURGERY OF INGUINAL AND FEMORAL HERNIAS

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to herniology. Angle of surgical action is calculated depending on anatomical features of the operated patient, for which, using data of the main anatomical landmarks of the operated patient, triangle is constructed, points of two tops of which are taken as points of input of two working trocars, and point of third vertex is behind projection of internal inguinal ring. For all patients, a triangle is constructed, the vertex points of which are the umbilical middle (E), the superior anterior iliac spine (F) and the pubic articulation (D). Inside the triangle, one more triangle is additionally constructed, the vertex points of which are: point C of the projection of the internal inguinal ring on the skin located in the middle of the line connecting the anterior superior and pubic articulation (DF), point B of the apex of the internal triangle applied, having deviated from point E by 5 cm and point of vertex A, deposited, having deviated 5 cm from point D, further, lengths of sides AB, BC, AC are measured and cosine of angle between its sides AC and BC is calculated by cosine theorem. According to Bradis table cosine table, value of this angle is determined in degrees, and if this angle is not less than 45 degrees, points for installation of all trocars are determined below optical trocar along median line, connecting centre of umbilicus and pubic joint, and if this angle is less than 45 degrees, then point for installation of one of working trocars is determined below, and second - lateral than optical trocar.;EFFECT: method enables reducing a risk of the human factor for high quality of the intraperitoneal plasticisation performed in the internal inguinal ring, providing adequate operational exposure and the required volume of operative actions.;1 cl, 2 ex, 4 dwg