MD3396F1 - Method of combined hernioplasty in case of difficult inguinal hernia forms - Google Patents

Abstract

The invention refers to medicine, in particular to surgery, and may be used in the hernioplasty of difficult inguinal hernia forms. The claimed method consists in that it there are made two semioval incisions in the inguinal region, it is excised an adipose cellulocutaneous flap of required dimensions in the form of ellipse. From the cutaneous flap it is prepared an autodermic graft. It is resected the external oblique muscle aponeurosis, it is excised the m. cremaster together with the homonymous vene and the genital branch of genitofemoral nerve. It is excised or invaginated the hernial sac. The transverse fascia on the upper boundary of the inguinal interval is brought down and sutured with interrupted sutures to the iliopubic cord. Then the autodermic graft is placed retrofunicularly and onto the upper extremity there are made 4à5 longitudinal oblique incisions of 2à2,5 cm. Afterwards, it is fixed medially to the pubic tubercle and to the rectus muscle sheath, underneath û to the inguinal ligament, laterally û right up to the superior iliac spine, on the upper extremity û to the internal oblique muscle aponeurosis. At the same time, the autodermic graft in the projection of the internal inguinal ring is resected transversely up to 1 cm and it is formed a "ring" round the spermatic cord. In front of the spermatic cord it is carried out the external oblique muscle aponeurosis plasty in the form of duplication or end-to-end. The cutaneous-subcutaneous wound is drained and sutured.