FIELD: medicine.
SUBSTANCE: skin, subcutaneous fat and aponeurosis of the external oblique abdominal muscle are dissected according to the generally accepted technique. The hernial sac is isolated from the elements of spermatic cord, opened on the front surface to the neck, the contents are inspected and immersed in the abdominal cavity. A purse suture stitch is applied in the area of the hernial sac neck. A non-free flap is formed from the hernial sac. The transverse fascia is restored. The transplant is fixed to the fallopian arch. In the projection of the inner inguinal ring center, a hole is formed in the mesh, with a subsequent dissection of the grid upwards. The spermatic cord and the allocated flap of the hernial sac are placed in front of the mesh through the prepared hole. The upper edge of the mesh is fixed with a continuous seam from the inside to the external oblique abdominal muscle aponeurosis. After the mesh is spread in the inguinal space, its integrity is restored by a continuous suture with formation of a window for the spermatic cord of the required size. The flap of the hernial sac is then placed with its visceral surface up between the mesh and the spermatic cord and the edges are fixed with individual nodal sutures to the transplant.
EFFECT: method excludes the productive inflammation in the spermatic cord tissues in the postoperative period.
1 ex, 2 dwg
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Authors
Dates
2017-11-28—Published
2016-09-20—Filed