IMPROVING THE TECHNIQUE OF PROSTHETIC VENTROPLASTY OF THE ANTERIOR ABDOMINAL WALL

Aim. Search for a more advanced technique for installing a mesh implant during ventroplasty of the anterior abdominal wall.

Materials and methods. Modeling of prosthetic venteroplasty was carried out using laboratory animals - rabbits weighing 2000±50 g and rats weighing 400±50 g. As part of the experiment, implantation mesh material was used: "Prolene" and "REPEREN". Ventroplasty was performed using the following techniques: onlay, inlay and sublay. The implant was fixed with a continuous suture. On the 21st day of the experiment, the material was collected to study its biomechanical and morphological properties.

Assessment of the morphological properties of preparations stained with hematoxylin-eosin and picrofuchsin according to Van Gieson was performed by histological methods. Biomechanical properties were evaluated using an INSTRON-5944 bursting machine.

Results. In the course of comparing the biomechanical properties of the abdominal wall with the maximum value of load (H), stress (Mpa), and Young's modulus, the following results were obtained, a significantly significant dependence of the biomechanical and morphological properties of prosthetic ventroplasty on the mesh implant suturing technique was confirmed, and the advantages of sublay separation ventroplasty technology were scientifically substantiated.

Conclusion. The experiment made it possible to confirm the dependence of biomechanical and morphological properties of prosthetic ventroplasty on the technique of mesh implant stitching used, to substantiate the advantages of separation ventroplasty using sublay technology.

1. Clinical recommendations. Inguinal hernia. Year of approval: 2021. (In Russian). URL: https://www.garant.ru/products/ipo/prime/doc/402809399 [accessed: 04.11.2022].

2. Clinical recommendations. Postoperative ventral hernia. Year of approval: 2021. (In Russian). URL: https://sudact.ru/law/klinicheskie-rekomendatsii-posleoperatsionnaia-ventralnaia-gryzha-utv-minzdravom/klinicheskie-rekomendatsii [accessed: 04.11.2022].

3. Moazzez A., Dubina E.D. A Novel Approach to Mesh Fixation in Retrorectus Ventral Hernia Repair Using Fibrin Sealant. Journal Am Coll Surg. 2017;225 (3):e1-e4. https://doi.org/10.1016/j.jamcollsurg.2017.05.015

4. Rastegarpour A., Cheung M., Vardhan M., et al. Surgical mesh for ventral incisional hernia repairs: Understanding mesh design. Plast Surg (Oakv). 2016;24(1):41-50. https://doi.org/10.4172/plastic-surgery.1000955

5. Rodríguez M., Gómez-Gil V., Pérez-Köhler B. et al. Polymer Hernia Repair Materials: Adapting to Patient Needs and Surgical Techniques. Journal Materials (Basel). 2021;14(11):27-90. https://doi.org/10.3390/ma14112790

6. Kroese L.F., Gillion J.F., Jeekel J., Kleinrensink G.J. et al. Primary and incisional ventral hernias are different in terms of patient characteristics and postoperative complications - A prospective cohort study of 4,565 patients. International Journal of Surgery. 2018;51:114-119. https://doi.org/10.1016/j.ijsu.2018.01.010

7. Plymale M.A., Davenport D.L., Dugan A. et al. Ventral hernia repair with poly-4-hydroxybutyrate mesh. Surgical Endoscopy. 2018;32(4):1689-1694. https://doi.org/10.1007/s00464-017-5848-7

8. Kurek M.F., Anichkin V.V., Shilko S.V., Doroshenko R.V. Mechanical properties of the skin: contractility and extensibility, their relationship, histological basis and the possibility of prediction. Problems of health and ecology. 2009;3(21):89-94 (In Russian). https://doi.org/10.51523/2708-6011.2009-6-3-20

9. Nosovsky A.M., Pichlak A.E., Logachev V.A. et al. Statistics of small samples in medical research. Russian medical journal. 2013;19(6):57-60 (In Russian). https://doi.org/10.17816/rmj38204

10. Kitsul I.S., Mikhalevich I.M. Parametric analysis of variance in public health and medical and biological research (using STATISTICA). Irkutsk: Irkutsk State Medical Academy of Postgraduate Education;2013:32 (In Russian).

11. Lukoyanychev E.E., Izmajlov S.G., Emelyanov V.A. et al. General views on treatment technologies for patients with incisional ventral hernia. Research and Practical Medicine Journal. 2021;8(3):84-96 (In Russian). https://doi.org/10.17709/2410-1893-2021-8-3-8