Кісляков В. Klinico-morphological characteristic and treatment of relapsed hernias.

The dissertation is devoted to questions eathology, patogenesis, clinical current, diagnostics and treatment of the patients with relapsed and repeatedly relapsed inguinal hernias(RIH and RRIH). The special place is given to study of anatomy-morphological changes of structures in inguinal area and inguinal channel.The researches are carried out at 182 patients. The features of surgical anatomy of the inguinal channel from an earlier used method of repair of hernia are investigated, the questions of a choice of a metod of repeated operation are considered depending on a degree of morphological changes in inguinal area. Besides study of clinic RIH and RRIH the additional methods of diagnostics with use of the techniques, developed in clinic, ultrasound and computer tomograhy are applied. The received information permits to judge character before the made operation, kind of hernia, data about hernias contents, to make measurements not only defect in a back wall of the inguinal channel, but also to determine itself an inguinal interval.The study of surgical anatomy of the inguinal channel RIH and RRIH has allowed to develop engineering of operation, in which basis the principle of strict etape sequence lays during operation, in view of volume of hernia and topograhy-anatomic changes.Is experimentally developed and the most rational way of application prosthesis for plastic of hernias defects is introduced into clinical practice at RIH and RRIH when is completely destroyed inguinal ligament and there are no sites cross fascia. The application of results of work in practical activity has lowered percent of repeated relapsed.