MD3884F1

MD3884F1 - Method for inguinal hernia plasty

Info

Publication number: MD3884F1
Application number: MDA20070328A
Authority: MD
Inventors: Alexandr Botezatu
Original assignee: Alexandr Botezatu
Priority date: 2007-11-27
Filing date: 2007-11-27
Publication date: 2009-04-30
Also published as: MD3884G2

Abstract

Inventia se refera la medicina, in special la chirurgie, si poate fi utilizata la plastia urmatoarelor forme de hernii inghinale: hernii directe, indirecte de dimensiuni mari cu canalul indreptat, hernii prin alunecare, hernii combinate si recidivante. Metoda de plastie a herniei inghinale consta in aceea ca se efectueaza doua incizii semiovale in regiunea inghinala, se excizeaza un lambou cutanat cu tesut subcutanat, din care se prepara un transplant autodermic, se incizeaza aponevroza muschiului oblic extern, se deschide canalul inghinal, se excizeaza partea laterala a muschiului cremaster impreuna cu vena cu acelasi nume si ramura genitala a nervului genito-femural, se excizeaza sau se invagineaza sacul herniar, se efectueaza o incizie de relaxare a foitei anterioare a tecii muschiului drept abdominal in sus de la tuberculul pubian pana la granita aponevroticomusculara a muschiului oblic intern. Apoi marginea laterala a tecii excizate a muschiului drept impreuna cu fascia transversala se sutureaza de cordonul iliopubian si ligamentul inghinal pana la inelul inghinal profund, iar tendonul muschiului drept se sutureaza de cordonul iliopubian lateral de osul pubian, dupa care transplantul autodermic pregatit se plaseaza retrofunicular, se fixeaza prin suturi cu fire separate medial de marginea mediala a tecii incizate a muschiului drept, inferior de ligamentul inghinal, in proiectia inelului inghinal profund in transplant se executa o incizie transversala pana la 1 cm si se formeaza „un inel” in jurul cordonului spermatic. Apoi transplantul autodermic se fixeaza cu 2...3 cm lateral de inelul inghinal profund de ligamentul inghinal si de marginea muschiului oblic intern, dupa care se formeaza peretele anterior al canalului inghinal prin suturarea foitelor aponevrozei muschiului oblic extern. Se efectueaza suturarea pe straturi a plagii postoperatorii.The invention relates to medicine, especially to surgery, and can be used in the plastics of the following forms of inguinal hernias: direct, indirect large hernias with the rectal canal, sliding hernias, combined and recurrent hernias. The plastic method of the inguinal hernia consists in the fact that two semi-ovarian incisions are made in the inguinal region, a cutaneous flap with subcutaneous tissue is excised, from which an autodermal transplant is prepared, the aponeurosis of the external oblique muscle is incised, the inguinal canal is opened, the excision is excised the lateral part of the cremaster muscle together with the vein with the same name and the genital branch of the genito-femoral nerve, the hernial sac is excised or invaginal, an incision is made to relax the anterior leaf of the muscle sheath as straight abdominally up from the pubic tubercle up to the aponevroticomuscular border of the internal oblique muscle. Then the lateral edge of the excised sheath of the straight muscle along with the transverse fascia is sutured by the iliopubic cord and the inguinal ligament to the deep groin ring, and the tendon of the right muscle is sutured by the lateral iliopubic cord from the pubic bone, after which the prepared autodermal transplant is placed. it is fixed by sutures with wires separated medially by the medial edge of the incised torso of the right muscle, inferior to the groin ligament, in the projection of the deep groin ring in transplantation, a transverse incision is made up to 1 cm and a "ring" is formed around the spermatic cord. . Then the autodermal transplant is fixed with 2 ... 3 cm lateral of the deep groin ring by the groin ligament and the edge of the internal oblique muscle, after which the anterior wall of the inguinal canal is formed by suturing the aponeurosis of the external oblique muscle. Postoperative wound suturing is performed on layers.