METHOD FOR ALLOGENOUS HERNIOPLASTY OF INGUINAL AND FEMORAL HERNIAS

摘要

A method for allogenous hernioplasty of the inguinal and femoral hernias provides for the standard access to the inguinal canal and the mobilization of its walls. The spermatic cord is then placed onto the holder. The hernial sac is separated up to the neck and treated. The transverse fascia is cut in parallel to the inguinal ligament, and preperitoneal space is tailored where the polypropylene mesh with the opening for the spermatic cord is placed and sutured beneath to iliopubic tract of the inguinal ligament and at the top to the upper flap of the transverse fascia and the tendinous connection of transverse and internal oblique muscles of abdomen. The deep opening of the inguinal canal is generated by suturing the cut flaps of the transverse fascia covering the implant at thye edges of the opening for spermatic cord. Over the spermatic cord, the flaps of aponeurosis of the external oblique muscle of abdomen are sutured. The subcutaneous layer and the skin are sutured layer-by-layer. The lower end of the mesh is sutured to the Cooper ligament. The upper end of the mesh is sutured to the transverse aponeurosis and transverse and internal oblique muscles of abdomen. The medial edge of the mesh is passed preperitoneally beneath rectus muscle of abdomen and sutured to the said muscle. The lateral edge of the mesh is sutured to the internal oblique muscle. Upper, medial and lateral edges of the mesh are sutured with the single stitches at the distance of one from another. Between the stitches, the mesh is attached with the aid of Cutseal adhesive.