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RU-2861490-C1 - METHOD FOR PREDICTING RISK OF DEVELOPING RECURRENCE OF POSTOPERATIVE VENTRAL HERNIA IN EXPERIMENT BY MORPHOLOGICAL EXAMINATION OF POSTOPERATIVE SCAR TISSUE

RU2861490C1RU 2861490 C1RU2861490 C1RU 2861490C1RU-2861490-C1

Abstract

FIELD: medicine. SUBSTANCE: invention relates to experimental abdominal surgery. Performing modelling of ventral hernia alloplasty in laboratory animals. On day 14 of the experiment, taking a sample of postoperative scar tissue for morphological examination, analysing regenerative processes, and when detecting morphological signs of collagen immaturity and leukocyte infiltration of the postoperative scar tissue, predicting the risk of developing a recurrence of postoperative ventral hernia. EFFECT: modelling a method for treating postoperative hernia, allowing to reduce the risk of hernia recurrence. 5 cl, 6 dwg, 1 ex

Inventors

  • Gavrukov Dmitrii Sergeevich
  • Kapralov Sergei Vladimirovich
  • Polidanov Maksim Andreevich
  • Mudrak Dmitrii Andreevich
  • Volkov Kirill Andreevich
  • Danilov Andrei Dmitrievich
  • Petrunkin Rodion Pavlovich
  • Kashikhin Andrei Andreevich

Dates

Publication Date
20260505
Application Date
20250611

Claims (5)

  1. 1. A method for predicting the risk of developing a recurrence of postoperative ventral hernia in an experiment by morphologically examining the tissue of a postoperative scar, characterized by the fact that alloplasty of a ventral hernia is modeled in laboratory animals, on the 14th day of the experiment, tissue from the postoperative scar is collected for morphological examination, regenerative processes are analyzed, and upon detection of morphological signs of collagen immaturity and leukocyte infiltration of the tissue of the postoperative scar, the risk of developing a recurrence of a postoperative ventral hernia is predicted.
  2. 2. The method according to paragraph 1, characterized in that alloplasty in laboratory rats is performed retromuscularly with fixation of the mesh transplant.
  3. 3. The method according to paragraph 1, characterized in that alloplasty in laboratory rats is performed retromuscularly without fixation of the mesh transplant.
  4. 4. The method according to paragraph 1, characterized in that alloplasty in laboratory rats is performed antemuscularly with fixation of the mesh transplant.
  5. 5. The method according to paragraph 1, characterized in that alloplasty in laboratory rats is performed antemuscularly without fixation of the mesh transplant.

Description

Field of technology The invention relates to the field of medicine, namely to experimental abdominal surgery, and can be used in scientific research, in modeling the treatment of postoperative ventral hernias to assess the risk of hernia recurrence. State of the art Postoperative ventral hernias develop in 4-15% of patients undergoing laparotomy and are the second most common type after inguinal hernias. Postoperative ventral hernias most frequently occur after emergency procedures, and midline hernias predominate. The issues of surgical treatment of ventral hernias still remain among the most important problems of abdominal surgery (see Belyansky I. et al. A novel approach using the enhanced view totally extraperitoneal (eTEP) technique for laparoscopic retromuscular hernia repair. Surg Endosc, 2018. Vol. 32. No. 3. pp. 1525-1532; see Ermolov A.S. et al. Surgical treatment of patients with large and giant postoperative ventral hernias. Surgery. Journal im. N.I. Pirogov, 2019. No. 9. pp. 38-43; see Ermolov A.S. Choice of surgical tactics depending on the size of the ventral hernia and the deficiency of abdominal wall tissue. Moscow surgical journal, 2018. Vol. 3. No. 61. P. 78). Over the past three decades, the priority direction has been plastic surgery using synthetic prostheses (see Blagovestnov D.A. et al. The role and place of prosthesis fitting methods of forward belly wall plasticity in primary median hernia surgery. Vestnik novykh meditsinskikh tekhnologiy. 2011; Vol. 1. No. 18. pp. 153-155; Ramakrishna H.K., Lakshman K. Intra peritoneal polypropylene mesh and newer meshes in ventral hernia repair: what EBM says? Indian J Surg 2013. Vol. 75. No. 5. pp. 346-351). By now, it has reached the point where there is a need for an in-depth analysis of the accumulated experience. Of particular relevance in this regard are issues related to the need for an individual approach to the selection of a method of prosthetic repair with the development of new methods, a thorough study of immediate and long-term results and the prognosis of late complications associated with mesh migration and hernia recurrence. At the current stage of development of alloplasty, a clear position has been formed on the insufficient reliability of autoplastic techniques in the absence of a differentiated approach to their use (see Rodríguez M. et al. Polymer Hernia Repair Materials: Adapting to Patient Needs and Surgical Techniques. Journal Materials (Basel), 2021. Vol. 14. No. 11. pp. 27-90; Sheen A.J. et al. Comparison of Mesh Fixation Techniques in Elective Laparoscopic Repair of Incisional Hernia - ReliaTack™ v ProTack™ (TACKoMesh) - A double-blind randomized controlled trial. BMC Surg, 2018. Vol. 18. No. 1. p. 46). A method for evaluating the main methods of alloplasty in order to optimize the treatment of patients with postoperative ventral hernias is known from the prior art (see Tsverov I. A., Bazayev A. V. Evaluation of the main methods of alloplasty in order to optimize the treatment of patients with postoperative ventral hernias / I. A. Tsverov, A. V. Bazayev // Clinical Medicine. - 2011. - Vol. 2. - Pp. 73-76.; https://stm-journal.ru/ru/numbers/2011/2/735/pdf), in which the results of different methods of alloplasty are compared to develop a system for optimizing the surgical treatment of patients with postoperative ventral hernias. This method examines an improved version of the sub-lay alloplasty technique and utilizes CT-assisted hernioabdominometry to determine the appropriate type of repair for giant and large hernias, allowing for optimized treatment. An analysis of complications and long-term treatment outcomes in 132 patients with postoperative ventral hernias showed that sub-lay alloplasty yields the best immediate and long-term results. A method for predicting and preventing wound complications in the treatment of postoperative ventral hernias is known (see Ismailov G. M. Prediction and Prevention of Wound Complications in the Treatment of Postoperative Ventral Hernias. - Abstract of the dissertation. +- Makhachkala, 2023 .; https://dgmu.ru/wp-content/uploads/2023/04/Avtoreferat.-Data-razmeshheniya-25-aprelya-2023g..pdf), according to which, at the first stage, a defect in the peritoneal-muscular-aponeurotic layer in the area of the white line of the abdomen was created in experimental animals in order to obtain a ventral hernia model. The second stage of the operation was performed 6 months after the formation of POVH in 12 experimental animals. The experiments were divided into 2 series: 6 animals each. In the experimental group, prosthetic hernioplasty with implant fixation treated with 2.5% argovit solution was performed using the developed technique. In the control group, surgery was performed without treatment of the mesh implant. Tissue samples were collected from the surgical site for morphological studies. Fragments measuring 2.5-1.5 cm were taken from the peripheral aponeurosis, muscles, and implant on d