METHOD FOR COMBINED INGUINAL HERNIOPLASTY Russian patent published in 2015 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: method involves opening an inguinal canal by dissecting an aponeurosis of abdominal external oblique muscle from an upper edge of an external opening of the inguinal canal in parallel with a femoral arch. A spermatic cord is separated. Forming an aponeurotic flap aiming at reinforcing a posterior wall additionally and separating the spermatic cord from a prosthesis is ensured by making a second incision of the aponeurosis of abdominal external oblique muscle in parallel with the first one and 2 cm higher. An endoprosthesis is shaped after an inguinal space; its lower edge is fixed behind the spermatic cord to an iliac-pubic tract and deep layers of the inguinal ligament with forming an arched internal opening of the inguinal canal along a lower edge of the endoprosthesis so that the arch diameter exceeds the spermatic cord diameter by 2-3 mm. An upper edge of the endoprosthesis is fixed to the common aponeurosis of the external and internal abdominal oblique muscles, passing into a leaf of rectus sheath. The aponeurotic flap formed of the aponeurosis of the abdominal external oblique muscle is placed behind the spermatic cord onto the endoprosthesis. The lower edge of the aponeurotic flap is fixed to the deep layers of the inguinal ligament to form an opening for the spermatic cord according to its diameter. The upper edge of the aponeurotic flap is anchored to the underlying endoprosthesis. The spermatic cord is placed onto the aponeurotic flap, and free ends of the aponeurosis of the abdominal external oblique muscle is sutured together above the spermatic cord to form an external opening of the inguinal canal up to 1.5 cm in diameter.

EFFECT: method prevents recurrences and postoperative complications by fixing the lower edge of the endoprosthesis to the iliac-pubic tract and the deep layers of the inguinal ligament, with its upper edge fixed to a junction of the aponeurosis of the external and internal abdominal oblique muscles, fixing the lower edge of the aponeurosis of the abdominal external oblique muscle to the deep layers of the inguinal ligament, with the upper edge fixed to the underlying endoprosthesis.

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