OV08 TREATMENT OF THE INGUINAL HERNIA USING THE SHOULDICE REPAIR

Abstract

Abstract Aim The Shouldice procedure is a layered reconstruction of the posterior wall in inguinal hernia repair and currently the preferred method if the layers of the abdominal wall are of good quality, the wish of the patient for a non-mesh repair and if a mesh method is not possible or available. The correct performance of the reconstruction of the posterior wall is essential part of the operation. Material and Methods A life educational video was made with the four-layer reconstruction in detail. The first layer of the reconstruction starts at the medial corner and the conjoint tendon is sutured to the caudal flap of the transversalis fascia using a continuous non resorbable suture. The second layer of the reconstruction is made by approximating the cranial flap of the transversalis fascia and the posterior part of the inguinal ligament. The third layer starts at the level of the deep internal inguinal ring and approximates the lower border of the internal oblique muscle with the inguinal ligament. The fourth and final layer approximates the internal oblique muscle again with the inguinal ligament. Results The four-layer reconstruction after splitting the transversalis fascia is shown in detail since treatment of the hernia sac is like the other techniques. Conclusions The instructional video can be used for the resident training as a start in a hernia course followed by the execution on a model before the actual execution on a patient.