Dependence of the recurrence development on the sutures tension force while performance of laparoscopic cruroraphy

Objective. Intraoperative determination of the threads tension force while performance of laparoscopic cruroraphy. Materials and methods. Using a numerical dynamometer Walcom FM-204-50K the threads tension force was measured while performance of laparoscopic cruroraphy in 62 patients, suffering large hiatal hernias. The measured results have included a middle value of the tension force of every stitch for secure approximation of diaphragmatic crura and presence of any dehiscence in diaphragmatic crura while doing cruroraphy. Results. The middle tension force of the first suture while performing of posterior cruroraphy have constituted 2.1 N, while a second one – 3.2 N and the third – 4.2 N. Positive correlational dependence was revealed between the threads tension force while doing cruroraphy and the hiatus square, as well as with a patient’s age. The correlation link between the threads tension force, while doing cruroraphy, and the patient’s body mass index was not revealed. The diaphragmatic crura muscles dehiscence was observed in the threads tension force, exceeding 4 N. Conclusion. The sutures tension force while cruroraphy conduction, as our data demonstrate, exceeding 4,5 - 5 N, constitutes indication for the net implants application.