Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2016 Vol. 24 No 3

GENERAL & SPECIAL SURGERY

DOI: http://dx.doi.org/10.18484/2305-0047.2016.3.234   |  

A.V. CHERNYH, E.I. ZAKURDAEV, M.P. ZAKURDAEVA

TO THE QUESTION OF INTERCOSTAL NERVE INJURY PREVENTION AT THE POSTERIOR SEPARATION HERNIOPLASTY OF UMBILICAL HERNIAS

SBEE HPE Voronezh State Medical University named after N.N. Burdenko.
The Russian Federation

Objectives. To study the specific features of the topography of the intercostal nerves in the celiac area of the anterior abdominal wall.
Methods. The floating corpses (n=88) of both sexes without any pathology of the anterior abdominal wall were studied. There were 45% of male corpses (mean age 53,811,9 years) and 55% females (51,913,2 years).
The topographic anatomical dissection of the intercostal nerves in the celiac area of the anterior abdominal wall with the determination of the level of their penetration into the rectus abdominis in relation to the inferior edge of the costal arch and the external edge of the rectus abdominis muscle had been performed on each corpse.
Results. In this study the intercostal nerves (1-4 pairs) had been identified in the celiac area of the anterior abdominal wall. Most often 2 pairs of intercostal nerves (71%) met in females, while no statistically significant differences were found in males. Intercostal nerves penetrated into the rectus abdominis often via their external edges (52%), more rarely via posterior surface (39%). In males the variant of the lateral penetration of the intercostal nerves in the rectus abdominis was more common (60%), while in females no statistically significant differences were found. To reduce the risk of intraoperative trauma of the intercostal nerves, the levels of their penetration into the depth of the rectus abdominis muscle had been determined. It had been found out that the distance from the inferior edge of the costal arch on the site of the penetration of rectus abdominis by intercostal nerves was reliably higher in females. The distance from the external edge of the rectus abdominis muscle on the site of the penetration of the muscle thickness by intercostal nerves was significantly greater in males.
Conclusion. The obtained data can be used to predict the topography of the intercostal nerves in the umbilical hernias plasty.

Keywords: umbilical hernia, topography, rectus abdominis, retromuscular hernia repair, penetration, intercostal nerves, chronic pain syndrom
p. 234-240 of the original issue
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Address for correspondence:
394036, Rossiiskaia Federatsiia,
g. Voronezh, ul. Studencheskaia,
d. 10, GBOU VPO "Voronezhskii
gosudarstvennyi meditsinskii
universitet imeni N.N. Burdenko",
kafedra operativnoi khirurgii s
topograficheskoi anatomiei,
tel.: +7 (951) 566-43-61,
e-mail: ezakurdaev@rambler.ru,
Zakurdaev Evgenii Ivanovich
Information about the authors:
Chernyh AV, MD, professor, a Vice-rector, head of department of operative surgery with topographic anatomy SBEE HPE "Voronezh State Medical Academy named after N.N. Burdenko". The Russian Federation.

Zakurdaev EI. PhD, an assistant of the department of operative surgery with topographic anatomy SBEE HPE "Voronezh State Medical Academy named after N.N. Burdenko". The Russian Federation.

Zakurdaeva MP, a student of medical faculty of operative surgery with topographic anatomy SBEE HPE "Voronezh State Medical Academy named after N.N. Burdenko". The Russian Federation.
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