Molotkovets V. An electrical weld of the epineuria to restore the structural integrity of the nerve trunk (experimental study)

The dissertation is devoted to the actual scientific problem of neurosurgery - improvement of the results of regeneration of the peripheral nerve after restorative surgical treatment of its structural integrity. Traumatic injuries of the peripheral nerves account for 1 to 3% of the general injury of peacetime, which is one of the leading causes of limitation of employment (60-70%) of the population. Despite significant advances in the surgical treatment of peripheral nerve injuries, the optimization of existing and development of new means of restoring the integrity of nerve roots is important. The main method of restoring the spatial integrity of the peripheral nerve is neuroraphy. The suture is characterized by prolonged microsurgical intervention, which stimulates the scarring process. In an experimental study of N.K. Bhatt (2017), for the imposition of microsurgical suture spent 18.2 ± 6.8 min (n = 9), while for the formation of a laser weld (n = 23) 5.8 ± 3.7 min. The presence of negative features of neuroraphy motivates the development of alternative means of hermetic connection. Modern electrosurgical methods of opening and joining biological tissues have proven themselves well in many surgical fields. However, the effectiveness of this method in the case of restoration of the spatial integrity of the nerve trunks was investigated sporadically. The combination of these circumstances motivated a systematic experimental study of the reliability and efficiency of the epineural electric welded joint of the peripheral nerve stump in comparison with classical epineural neurography. The purpose of the study was to improve the results of treatment of peripheral nerve injury by using epineural welding technology.