The treatment of giant hiatal hernias with the need to perform a cruroplasty is an urgent problem. This article describes a new method of treating a hernia of the esophageal opening of the diaphragm with laparoscopic access, using a combined xenopericard endoprosthesis as an implant. A clinical observation was carried out. Conclusion: this observation indicates the possibility of using a combined implant a xenopericard band for cruroplasty with giant hernia hiatal, which creates a strong anti-adhesive frame hiatal.
Our experimental study shows a morphological response of the anterior abdominal wall to implantation of a combined (bovine pericardium graft and polyester mesh) hernia prosthesis. For this purpose, fifteen chinchillas were operated on. A combined prosthesis was implanted intra-abdominally, where the pericardium graft adjoined the internal organs with the smooth side, while the synthetic material was facing the peritoneum. Morphological and morphometric assessment of the tissue in the area of implantation of the prosthesis was carried out. Morphology of tissues samples was evaluated in 2 weeks, in 1 month and in 2 months after surgery. Our study revealed that the combined prosthesis implanted in the anterior abdominal wall causes an acute inflammatory response, which progresses within a month after the surgery. However, the signs of inflammation reduced at the end of the second month of the experiment. A new connective tissue grew actively into the implant from the side of the polyester mesh. The pericardium graft adjacent to the abdominal cavity with the smooth side did not cause formation of connective tissue. Thus, the combined hernia prosthesis has protected the abdominal cavity from adhesions in the postoperative period.
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