THE USE OF MESH PROSTHESIS MADE OF TITANIUM NICKELIDE TO FORM THE FRAMEWORK OF THE ROUND LIGAMENT OF THE LIVER IN THE SURGICAL TREATMENT OF PATIENTS WITH HERNIAS HIATAL

The paper is devoted to the study of the results of the application of a new technology for strengthening the round ligament of the liver with a titanium nickelide mesh graft in the treatment of patients with hiatal hernia. Material and methods. The study included a group of 27 patients with a hiatal hernia operated on from 2002 to 2019 at the hospital surgery clinic. There were 10 men (37%) and 17 women (63%) in this group. The age of the patients ranged from 33 to 76 years. The average age was (54.51 ± 2.21). In the clinic, we performed reconstructive surgery for all patients-lowering the esophageal-gastric junction below the diaphragm and forming an acute angle of the GIS (Rampal-Narbona operation). In cases where the use of a round ligament of the liver is not possible, we have proposed a new method for strengthening the mechanical strength of this ligament by forming a frame of a tubular mesh prosthesis made of titanium nickelide with a thread diameter of 60-90 microns. Results. Specific complications - swallowing disorder were observed in 4 patients, which was 14.8% of the total number of operated patients. General surgical complications - 1) violation of the motor-evacuation function of the upper gastrointestinal tract, which were manifested by belching, regurgitation, heartburn and hiccups. Most often in our patients (in 4 cases, 14.8%), nosocomial hypostatic lower lobe pneumonia was observed in the early postoperative period. In the late postoperative period (from 10 to 18 months), a comprehensive examination was performed on 24 patients. 1 patient (3.7%) had a recurrent hiatal hernia that required repeated reconstructive intervention in the Volume of Nissen fundoplication.

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