Pre-emptive

Eliminate the hernia can only surgically. Application of the tie is palliative measure. It was shown only in those cases where, for one reason or another operation can not be completed. In developed countries, America and Europe operative method is also a key. However, quite widespread, especially in the United States, injection method. Its essence consists in the introduction into the fabric of the hernial ring and into the cavity of the hernial sac annoying and sclerosing agents (acid and alkaline solutions), the limited aseptic inflammation with the formation of nonabsorbable dense scar tissue.

Thus, the achieved obliteration of the hernial sac hernial defect and scarring. Obligatory condition of injection therapy is complete reducible hernia. When injection method often poses serious complications: necrosis of the spermatic cord, injury to blood vessels and bruising, septic abdominal abscesses, gangrene, ulcers, chemical peritonitis, etc.

The basic principle of surgical treatment of abdominal hernia is an individual, differentiated approach to the selection method of herniotomy. Solving this problem should be considered a form of hernia, its pathogenesis, condition of the tissues of the abdominal wall and hernia defect size.

Surgery for hernia should be as simple and least traumatic. This principle, however, must be based on the belief that the chosen intervention will provide a radical cure. If in the bulk of uncomplicated inguinal, femoral and umbilical hernias can achieve good results using relatively simple methods of herniotomy, then for complex hernias (postoperative, vast, gigantic, recurrent, relapsing several times, moving, combined and phrenic) operative treatment is often a difficult task .

A cardinal principle of operation for hernia is its flawless technical brand viagra execution. Poor surgical technique for the aptly VI Dobrotvor "... may discredit anyone, even the best way." Herniotomy in the light of cases does not require the vertices of operational excellence and years of experience. However, it is here shown a surgeon take care of the tissues, easy to navigate in the topographic relationships to ensure maximum aseptic operation and careful hemostasis.

Deeply meaningful and well executed operation brings great satisfaction and with a good outcome strengthens the faith of a surgeon in the forces.

Numerous methods of operations for hernias are systematized on the basis of pre-emptive use of any tissue of the abdominal wall.

There are five basic methods of hernioplasty:

1. fascial-aponeurotic;
2. musculo-aponeurotic;
3. muscle;
4. plastic with additional biological or synthetic materials (homoplasty, ksenoplastika, explantation);
5. combined (using autotkaney and foreign tissues).

The first three methods are combined in autoplastic the other two are called alloplastic. Each method of plastics are currently studied in detail. On this basis, suggested many ways of operations. If the choice is determined by the method of herniotomy pathogenetic entity hernia, then the choice of method of operation must ensure its reliability in the aspect of long-term results.

The advantage of fascial-aponeurotic plasty is that this method is the most fully realized by the principle of compound homogeneous tissue, resulting in their reliable splice.

Examples of such operations are ways Martynov and Roux-Oppel for inguinal hernias, the way Mayo in umbilical, ways Napalkov, Vishnevsky and Martynov in the treatment of postoperative hernias.

Typically, operations that are based on the creation of fascial-aponeurotic dublication the least traumatic. However, their reliability is directly dependent on the size of hernia defect, the degree of tension in the tissues of their cross-linking and strength qualities of the fascia and aponeurosis. In those cases where they are thinned, atrophic or razvolokneny, as well as scarring of tissue in the area of plastics, with extensive use of fascial defects-aponeurotic plasty leads to frequent relapses.

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