Lichtenstein

Licthenstein Inguinal hernia repair
with? prolene/vycril mesh

"Tension free" techniques for the treatment of inguinal and crural hernias let us doing surgical procedures by local anesthesia and allow hospital stay laughs at little hours. Polipropilene? meshes in mono or double layer, presahaped or to conform on the operating field, reduced until almost to zero the percentage of recurrences for primitive inguinal hernias. Nevertheless the thickness and the outside quantity of material that we introduce in the organism seems oversized? respect to the tensions that it should supports.

The new prolene and vycril mesh Vypro II associates to a high softness, the great advantage? of the reabsorption? of the vycril fraction, obtaining a just relation between material introduced and necessity of capacity.

The surgical procedure can be performed in local anesthesia by progressive infiltration.

Hhernia is visible in lower part, likely a direct one.

anesthesia. jpg

We proceed to the anesthesia of the superficial layers with Xilocaina 2% 25 cc, sol. fisiologica 20 cc and Na Bicarbonato 5 cc

We start the procedure. Incision of the cute and of the sottocute. This last can be carried out with electric scalpel.

We perform the anesthesia under? the external oblique fascia.

It is continued anesthetizing towards the pube.

The fascia of the external oblique quite freed.

It is opened the external oblique fascia.

It is isolated the ileoinguinal nerve? that comes saved.

It is isolated the cord on a soft drainage.

The direct ernia comes sunk and maintained in position to allow the folding of the fascia trasversalis.

The folding is finished and the? level surface for the prosthesis is regular.

WE cut the prolene and vycril mesh. It? appears soft, light and strong.

We fix the mesh with a first point on the pube.

We use not riassorbibile material like the prolene.

We are going on ?fixing performing a continuous suture? in prolene between the mesh and the margin of the inguinal ligament , till the internal inguinal ring.

We cut the mesh to model the tails on the measure of the internal inguinal ring.

We close themselves? the tails of the mesh around the spermayic cord at the level of the internal inguinal ring by a point.

The tails come fixed between them rear and ancorate to the inguinal ligament .

We fix the mesh?? with three points on the joined tendon .

Mesh ?fixed with the three points indicated from the arrows.

We close the external oblique fascia? with riassorbibile material . The cord? is under the same, rebuilding the anatomy of the inguinal channel .

Some points in the subcutaneous.....

And the procedure is finished!

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Copyright © 2003 Herniasurgery. All? rights? reserved. Last update: 09-09-03.

Copyright © 2003 Herniasurgery. All? rights? reserved.
Last update: 09-09-03.