METHOD FOR PROSTHETIC PLASTIC REPAIR IN INGUINAL HERNIAS

FIELD: medicine.SUBSTANCE: method involves an anterior inguinal approach, dissecting aponeurosis of abdominal external oblique muscle, separating a space under the aponeurosis for placing a synthetic mesh, separating a femoral arch and a spermatic cord. A hernia sac is separated and processed. The synthetic mesh is used to repair a posterior wall of inguinal canal. Flaps of the aponeurosis of the abdominal external oblique muscle are sutured in the medial direction under the spermatic cord with single sutures at intervals 0.5-1 cm, and in the lateral portion - above the spermatic cord. The most lateral suture is applied so as to underrun the synthetic mesh. The most medial suture is applied so as to underrun fibrous tissue within pubic spine. In the recurrent inguinal hernia in the medial portion of the inguinal space after Liechtenstein's repair of hernia, plastic repair of the posterior wall of the inguinal canal is produced with the use of a portion of the mounted synthetic mesh to be sutured to the tissues along the perimeter of the inguinal defect, whereas the flaps of the aponeurosis of the abdominal external oblique muscle in the medial portion are sutured above the eliminated hernia defect. The flaps of the aponeurosis are sutured so as to involve the synthetic mesh into the suture. In the recurrent inguinal hernia in the medial portion of the inguinal space after Liechtenstein's repair of hernia, if the mounted synthetic mesh is not sufficient enough to eliminate the hernia defect, plastic repair of the posterior wall of the inguinal canal is produced so as to cover a portion of the hernia defect with the mounted synthetic mesh. The remained hernia defect is closed with a rigid mesh prosthesis to be fixed to tissues along the periphery, whereas the flaps of the aponeurosis of the abdominal external oblique muscle in the medial portion are sutured above the specified rigid mesh prosthesis. The most lateral suture is applied so as to involve the mounted synthetic mesh.EFFECT: effectiveness of the prosthetic plastic repair of inguinal hernias ensured by suturing the flaps of the aponeurosis of the abdominal external oblique muscle in the medial portion under the spermatic cord, and in the lateral portion - above the spermatic cord.9 cl, 4 dwg, 3 ex Изобретение относится к медицине, а именно к герниологии. Способ включает передний паховый доступ, рассечение апоневроза наружной косой мышцы живота, выделение пространства под апоневрозом для размещения с