RU2793669C1 - Method for fixing the testicles and spermatic cord in case of cryptorchism - Google Patents

Abstract

FIELD: medicine; urology.

SUBSTANCE: invention can be used in the surgical treatment of cryptorchidism. From an oblique incision in the inguinal region, the scrotum is straightened with a finger and turned into the wound, along the anterior wall of the scrotum. From the base to the bottom, semi-purse-string sutures with an interval of 5–6 mm form a bed for the testicle and a channel for the spermatic cord. The testicle is immersed in the bottom of the scrotum, stitches are alternately tied from the bottom to the base of the scrotum, returning the scrotum to its normal position.

EFFECT: method allows to physiologically position the testis and spermatic cord, fixing them stably in the scrotum.

1 cl, 1 ex, 2 dwg

Description

The invention relates to medicine, namely to urology, can be used in the surgical treatment of cryptorchidism.

There are various ways of fixing the testicle and spermatic cord in cryptorchidism (ES Shahbazyan. Cryptorchidism and its treatment. M.; Medgiz, 1957).

Recently, the method of fixing the testicle and spermatic cord according to the Petrevalsky-Shemacher method (E.S. Shakhbazyan. Cryptorchidism and its treatment. M .; Medgiz, 1957, p. 88) is more often used, after the mobilization of the spermatic cord and testicle, the formation of the channel in the scrotum, the skin of the bottom of the scrotum is cut to tunica dartos 2-4 cm long. In a blunt way, tunica dartos is separated from the skin, the testicular bed is formed. The tunica dartos is dissected and the testicle is brought out through the holes in it in a bed under the skin. The tunica dartos wound is closed with two sutures. The skin wound is sutured over the testicle.

Shoemaker testicular fixation technique: after mobilization of the testicle, the index finger is inserted through the wound to the bottom of the scrotum and a small incision is made in the skin of the scrotum, a pocket is formed between the fleshy membrane and the skin of the scrotum, the fleshy membrane is dissected and the testicle is placed in the prepared sac, sutures on the fleshy membrane and skin ( Operative Urology Clinic of Innovation L.G. Managadze et al Guidelines for Physicians Moscow Meditsina 2003 p. 321)

The disadvantage of this method is the translation of cryptorchidism into testicular ectopia.

The closest method of fixing the testicle and spermatic cord in the scrotum in cryptorchidism (RU 2371110 C1 Tolkachev V.K.), because it allows you to physiologically position the testicle and firmly fix it in the scrotum.

The incision, often inguinal, mobilization of the testicle is carried out according to the generally accepted method. Then a linear incision is made from the base to the bottom of the scrotum through all layers. In the corners of the wound, the central fiber is bluntly bred to the size of the testicle, at the base to the inguinal canal, and at the bottom of the scrotum for the testicular bed. The testicle is brought down in the bed, sutured in layers on the wound of the scrotum, while in the center of the fleshy shell a bulb-shaped case is formed for the testicle and spermatic cord.

The disadvantage of this method is two incisions, the care of the wound of the scrotum is complicated due to physiological functions and pain during manipulation.

The objective of the invention: the physiological location of the testis and spermatic cord, their stable fixation in the scrotum from an oblique incision in the inguinal region.

The result is achieved by the fact that from an oblique incision in the inguinal region, mobilization of the testicle and spermatic cord, the scrotum is straightened through the wound with a finger, then it is turned into the wound, hemostasis, semi-purse-string sutures with an interval of 5-6 mm form a bed for the testicle and a channel for spermatic cord, returning the scrotum to its normal position. Stitches on the wound.

The result of this method is - the whole operation from an oblique incision in the inguinal region, the physiological location of the testicle and spermatic cord, their stable fixation in the scrotum.

Clinical example: Misha K., 5 years old, diagnosis: Cryptorchidism on the right. Operation: Bringing down and fixing the testicle.

From an oblique incision in the right inguinal region, the testicle and spermatic cord were mobilized, the scrotum was straightened through the wound with a finger, then it was everted into the wound, hemostasis. Three semi-purse-string sutures were placed along the anterior wall of the scrotum from the base to the bottom with an interval of 5-6 mm. The testicle is immersed with the bottom of the scrotum, sutures are tied alternately from the bottom to the base of the scrotum; testis, spermatic cord and scrotum in physiological position. Stitches on the wound.

The operation is shown schematically.

Fig. 1

Stage of operation with everted scrotum.

Fig. 2

End of operation.

Designation:

1. Testicle.

2. The spermatic cord.

3. Scrotum.

4. Semi purse-string sutures

5. The edges of the surgical wound.

Claims (1)

A method of fixing the testicle and spermatic cord in the scrotum with cryptorchidism, characterized in that the scrotum is straightened from an oblique incision in the inguinal region with a finger and turned into the wound, along the anterior wall of the scrotum, from the base to the bottom, with semi-purse-string sutures with an interval of 5-6 mm , form a bed for the testicle and a channel for the spermatic cord, the testicle is immersed in the bottom of the scrotum, sutures are alternately tied from the bottom to the base of the scrotum, returning the scrotum to its normal position.

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