Novosti
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Year 2015 Vol. 23 No 3
UROLOGY
V.M. POPKOV, D.Y. POTAPOV, A.N. PONUKALIN
THE FEASIBILITY OF MATHEMATICAL MODELING FOR HEMOSTATIC SUTURES COMPARISON IN A PARTIAL NEPHRECTOMY
SBEE HPE "Saratov State Medical University Named after V.I. Razumovsky",
The Russian Federation
Objectives. On the basis of the proposed model to study effect of different modifications of hemostatic sutures on the renal parenchyma in the site of resection.
Material and Methods. To study the deformation degree of the renal parenchyma in tightening of the hemostatic suture and the compression degree of the parenchyma by threads during partial nephrectomy 3 different finite element models using modified technique of double interrupted, U-shaped sutures have been created. The force equal to 1N as an equivalent of thread tightening was applied to them. Thread thickness was 0,2 mm.
Results. The simulation results have found the double ligature suture considered to be the most parenchyma-sparing procedure. The narrow zone of excessive compression allows applying much more force to tightening of the suture without any fear of its eruption and increasing bleeding as within the operation as in the immediate postoperative period. In tightening of the double ligature suture the most displacement falls on the suture exit points on the parenchymal surface and a thick layer of perinephric adipose tissue obligatory used in the imposition of given suture. Meanwhile, the segments of the parenchyma as inside of an organ as between the superposed sutures remain practically intact to the displacement and, therefore, are under the best conditions for primary healing of surgical wounds.
Conclusion. The application of continuous suture is considered to be expedient in its imposition only on the renal capsule which is hermetically closed afterwards. The most suitable method recommended for use is thought to be a double ligature suture providing optimal conditions for successful tissue healing in the resection area.
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410012, Rossiyskaya Federatsiya,
g. Saratov, ul. B. Kazachya d. 112,
GBOU VPO "Saratovskiy gosudarstvennyiy
meditsinskiy universitet
im. V.I. Razumovskogo," kafedra urologii,
tel.: 7 927 104-80-68,
e-mail: potapovmed@rambler.ru,
Potapov Dmitriy Yurevich
Popkov V.M. MD, professor, Rector of HBEE HPE "Saratov State Medical University named after V.I. Razumovsky", a head of the urology chair.
Potapov D.Y. PhD, a surgeon, clinical hospital named after S.R. Mirotvortsev of "Saratov State Medical University named after V.I. Razumovsky".
Ponukalin A.N. PhD, an associate professor of the urology chair of "Saratov State Medical University named after V.I. Razumovsky".
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