TENSION-FREE INGUINAL AUTOHERNIOPLASTY TECHNIQUE Russian patent published in 2010 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery and hernioplasty, can be used for plastic surgery of an inguinal canal in inguinal hernias in males. Skin is incised 2 cm above and parallel to an inguinal ligament, tissues are dissected in layers to aponeurosis of the abdominal external oblique muscle. The aponeurosis of the abdominal external oblique muscle is dissected from an external opening of the inguinal canal 2-2.5 cm upwards at first, in parallel to an external edge of the abdominal rectus muscle, then the incision is extended in parallel to the inguinal ligament to the level of a projection of the external edge of the internal ring, then the incision is directed downwards to the inguinal ligament and perpendicularly. A formed tetragonal aponeurotic flap have a length of the inguinal space and a height by 2-2.5 cm more. The hernial sac is managed by a classical technique. The spermatic cord is mobilised. A transverse fascia is visualised and separated from the transverse muscle at depth to 3 cm. 4 equispaced temporary ligatures are delivered through an upper edge of the formed aponeurotic flap. Free edges of the ligatures are delivered prorsad along an upper edge of a space created behind the transverse muscle through a thickness of the transverse and abdominal internal oblique muscles onto the anterior surface of the aponeurosis of the abdominal external oblique muscle and fastened. A medial edge of said flap is ligatured additionally to a joint tendon of the abdominal internal oblique and transverse muscles, and the anterior wall of rectus sheath, and its lateral edge - to a remained external part of the aponeurosis of the abdominal external oblique muscle.

EFFECT: method allows ensuring the reliable reinforcement of the posterior wall of the inguinal canal due to self-tissues without considerable tension of the sutured edges.

7 dwg