Abstract:
Aim of the study: to determine the optimal zones for trocar insertion when performing laparoskopik
fundoplication (LFP) by Nissen, taking into account the physique of the patients.
Material and methods: The results of a survey of 216 patients with hiatal hernia (HH) who were
hospitalized in a multidisciplinary clinic of the TMA, were analyzed. All of them underwent LFP by
Nissen. All patients were divided into two groups. The I group included 96 patients who underwent standard
LFP by Nissen. In the II group of 120 patients, when performing LFP, the points of trocar insertion
were determined according to the calculations of a computer program developed by us. Among the
operated patients, 130 had axial HH (type I), 33 - type II, 45 - type III, and 8 - type IV. There were 104
(48,1%) women, 112 (51,9%) men. The average age was 55,2±4,6 years. Their average BMI was
32,2±2,5 kg/cm2. In I and II groups, the number of patients with a normosthenic physique was respectively
40 and 51, with an asthenic physique - 23 and 30, and whith a hypersthenic physique - 33 and 39.
In the II group, the points of insertion of instruments for physical therapy depended on the body type
of the patients, which were determined on the basis of the program we developed for calculating parameters
for inserting instruments for LFP.
