FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to surgery and hernioplasty, can be used for plastic surgery on inguinal canal in inguinal hernias in able-bodied, elderly and senile patients. An implant is made of a xenopericardial plate of 15×15 cm that is middled so that it consists of two sheets. Smooth surfaces of the plate sheets should be opposed. One sheet of the implant is shaped after a space between the inguinal ligament, a joint tendon of the abdominal internal oblique muscle and the transverse muscle of abdomen, a lower edge of said muscles. A size of this sheet exceeds that said space throughout the height of 3-3.5 cm. Through internal and external angles of an upper edge of the sheet of the implant, two ligatures are delivered. A space behind the transverse muscle of abdomen above the inguinal ligament is prepared with separating the muscle from a transverse fascia on the height of the modelled wall of the implant. Through a muscular layer, from the prepared space, there are ligatures fixed to the upper edge of the sheet of the implant and delivered prorsad onto a front surface of the internal oblique muscle. The ligature traction ensures the sheet of the implant to be arranged in the prepared space. Both ligatures are fastened. In a projection of the abdominal inguinal ring, in the other sheet, there is a hole cut out with a horizontal section for the spermatic cord. A lower edge of the implant belonging to both sheets is fixed to the inguinal ligature, starting from the pubic spine with covering the pectineal ligament by the first two-three sutures. The other sheet of the implant is fixed to the aponeurosis of the internal oblique muscle. An external opening of the inguinal canal is created under the standard requirements. Over the second sheet of the implant, the aponeurosis leaves of the abdominal external oblique muscle. The method provides reliable reinforcement of the anterior abdominal wall in the inguinal space, ensures early mobilisation of patients, and prevents formation of femoral hernia in patients with an impaired inguinal ligament.
EFFECT: xenopericardial plates with the spermatic cord arranged between its sheets with the anti-adhesive smooth surface applied as an endoprosthesis prevents a cicatricial deformity the spermatic cord elements.
4 dwg
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Authors
Dates
2010-06-27—Published
2009-05-25—Filed