AGE-RELATED EXTERNAL STRUCTURE OF HUMAN GREATER OMENTUM

Currently, the greater omentum is widely used in surgery as a source of grafts in reconstructive plastic surgery. Postmortem studies of the greater omentum taken from male and female died individuals of the second mature, elderly and senile age with brachiomorphic, mesomorphic and dolichomorphic body types were carried out. The methodology included aomatoscopic, morphometric methods and the methods of anatomical preparation. It has been established that the greater omentum consists of two parts: secured and unsecured. The secured part of the greater omentum is located between the great curvature of the stomach and the omental band of the transverse colon and is called the gastrocolic ligament. In the second mature, elderly and senile age, the shape and size of the greater omenta are not dependent on the human body type. At the same age periods, the greater omenta of the quadrangular, triangular and irregular shapes are found in women and men. Quadrangular greater omenta occupy the largest area; while the area occupied by the greater omenta of triangular and irregular shape is less. The quadrangular shape of the greater omentum is more favourable for obtaining the graft for transplantation to organs with a large defect. At all ages, the intensity of the development of the adipose tissue in the greater omentum depends on the prominence of subcutaneous adipose tissue, especially in overweight individuals. In the presence of adipose tissue, the following types of the greater omentum have been identified: 1) the greater omentum without adipose tissue; 2) the greater omentum with moderately developed adipose tissue; 3) the greater omentum with excessively developed adipose tissue. The greater omenta without adipose tissue are plastic with clearly visible vessels and their branching. The adipose tissue is located along the vessels, and the areas without adipose tissue are transparent, resembling a thin lace. In greater omenta with excessively developed adipose tissue, the vessels were not verified due to the numerous fat particles that cover the entire surface of the omentum in a continuous layer. The greater omentum with excessively developed adipose tissue becomes thick and loses its flexibility. Before omentoplasty, laparoscopic examination of the greater omentum of overweight patient is advisable in the preoperative period. One of the causes of bowel entrapment there are through holes in the unsecured part of the greater omentum.