METHOD FOR SURGICAL TREATMENT OF INGUINAL-SCROTAL HERNIA OF LARGE SIZE

摘要

The method for the surgical treatment of the inguinal-scrotal hernia of large size comprises the typical access to the inguinal canal, the incision of the aponeurosis of the external oblique muscle of abdomen, the mobilization of the walls of the inguinal canal, the capture of the spermatic cord by the holder, the separation of the hernial sac, the suturing of the sac and its dissection near the neck, the sewing of the transverse aponeurosis, the internal oblique muscle and transverse muscle with the inguinal ligament, the weakening incision in the transverse aponeurosis, the reinforcement of the posterior wall of the inguinal canal under the spermatic cord by the appropriate polypropylene mesh with the opening for the spermatic cord, the fixation of the polypropylene mesh to the inguinal ligament, the transverse aponeurosis, and the internal oblique muscle of abdomen over the spermatic cord, and layer-by-layer closure of the wound. The walls of the inguinal canal are mobilized beyond the upper wall of the aponeurotic sheath of the rectus muscle of abdomen. The hernial sac is separated near the neck, dissected, sutured, and ligated. The plastics of posterior wall of the inguinal canal is performed. The polypropylene mesh is additionally fixed to the external edge of the aponeurotic sheath of the rectus muscle of abdomen. The distal part of the hernial sac is left in the scrotum and drained through the scrotum using the vacuum drainage.