WAYS TO IMPROVE THE RESULTS OF LAPAROSCOPIC NISSEN FUNDOPLICATION FOR HIATAL HERNIA

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.