HERNIOPLASTY METHOD

Abstract

Autoplasty of inguinal hernias is accompanied by a high recurrence rate of the disease - 10-12%. Therefore, the main principle of surgical treatment of hernias at the present time is the performance of plastics "without tension" using modern synthetic materials. However, in any type of aloplasty, despite the inertness of the synthetic material, a tissue reaction with a pronounced inflammatory component develops around it, causing a number of specific complications. Among them are seromas, hematomas, foreign body sensation, chronic groin pain syndrome. At the same time, there is an increasing number of reports on the risk of specific complications due to contact of the allograft with the spermatic cord. This study is based on the results of a topographic and anatomical study of 50 unfixed corpses of men on the first day after death at the age of 34 to 65 years, with a height of 160.0 to 190.0 cm. cord into the anterior rectal space and the method of fixing the allograft. The proposed method is used as follows. An oblique incision in the groin area above and in the middle of the groin folds cut through the skin and subcutaneous tissue. The aponeurosis of the external oblique abdominal muscle is isolated and opened. The hernial sac is differentiated and isolated. With an oblique hernia, the latter is stitched at the neck, the remainder is cut off. With a direct hernia, the hernial sac, without opening, is immersed in the anterior urethral space. The transverse fascia is dissected from the inner opening of the inguinal canal to the outer edge of the rectus sheath. After mobilization, the spermatic cord is placed in the anterior ureal space, and the edges of the transverse fascia are sutured with a continuous suture with the elimination of the inner opening of the inguinal canal. A new exit site of the spermatic cord is formed at the lateral edge of the sheath of the rectus abdominis muscle. Plasty of the hernial defect is performed using a mesh implant, along the upper edge of which a notch is formed, the size of which corresponds to the diameter of the spermatic cord. The proposed method prevents the contact of the spermatic cord with the aloprosthesis, thereby preventing the development of specific complications. In addition, suturing the deep inguinal ring, as one of the weakest points of the inguinal canal, prevents the development of hernia recurrence.