Abstract
Aim of the study. To develop a new method of tension-free inguinal hernioplasty in elderly patients, which will expand the arsenal of effective open methods of surgical treatment of inguinal hernias and improve the results of their treatment. Material and methods. A total of 172 elderly patients with inguinal hernias were treated. Hernioplasty according to the Lichtenstein method was performed in 83 patients, and according to the developed method – in 89 patients. The testicular volume and blood flow in a.testicularis were determined by ultrasound before surgery, in the early postoperative period, and 1 year after surgery. Results. The developed method of hernioplasty has the following advantages: 1) it permits to reduce significantly the contact area of the elements of the spermatic cord with a mesh implant; 2) the back wall of the inguinal canal is strengthened not only by the mesh implant, but the aponeurosis of the oblique abdominal muscle; 3) a window in a mesh implant corresponds to the diameter of the elements of the spermatic cord, 4) no decrease in testicular volume at the site of the operative intervention is observed in the late postoperative period. Conclusion. The proposed method of hernioplasty is simple to use and surpasses the well-known Lichtenstein method in a number of parameters.
Highlights
Hernioplasty according to the Lichtenstein method was performed in
The testicular volume and blood flow in a.testicularis were determined by ultrasound before surgery
no decrease in testicular volume at the site of the operative intervention is observed in the late postoperative period
Summary
9. Ambulatory inguinal hernia repair with prolene hernia system (PHS) / M. Клиническое сравнение предлагаемой методики герниопластики и метода Лихтенштейна представлены в таблице 3. Предлагаемый метод герниопластики прост в исполнении и по ряду параметров превосходит известный метод Лихтенштейна: а) позволяет существенно снизить площадь контакта элементов семенного канатика с сетчатым эндопротезом; б) не вызывает уменьшения объема яичка на стороне оперативного вмешательства в отдаленном послеоперационном периоде; в) укрепляет не только разрушенные структуры задней стенки пахового канала и поперечной фасции, но и сохраняет клапанную функцию структур, образующих паховый промежуток, так как сетчатый эндопротез не фиксируется к мышечным структурам пахового промежутка. Е. О влиянии паховой грыжи и ее оперативного лечения традиционными способами на репродуктивную функцию мужчин / В.
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