Learn more about Ethicons ENDOPATH XCEL Trocars portfolio, designed to support frequent instrument exchanges. Operation Technique INGUINAL HERNIA REPAIR WITHOUT MESH DESARDA REPAIR                                                   For Non Medical personsThis is a pure. Lichtenstein mesh repair in its simplicity. The. author claims results that are superior or equal to Shouldice and. Our synthetic mesh portfolio accommodates inguinal, ventral, umbilical, open and laparoscopic surgical hernia repair procedures. HERNIA INGUINALIS Inleiding. In 1945 introduceerde Shouldice de gelijknamige techniek voor een open liesbreukcorrectie hetgeen tot eind 21ste eeuw als gouden. Pdf Viewer Control In Asp.Net C#. MPO Tailored open tensionfree repair for groin hernia. Resultados a largo plazo de un estudio prospectivo de 225 reparaciones de hernia crural. Lichtenstein repairs in low frequency of complications and most importantly no. The repair is remarkable in its simplicity and any bodys first. The external. oblique is incised similarly to the way it is done in the other anterior. The spermatic cord is dissected free the same way it is done. Absent bowel movement 10077302 Demoted under PT Cornelia de Lange syndrome, which is included in the IME list. De Langes syndrome. The sac are dissected free as usual. The herniated organs are returned to the abdomen as. The upper flap. of the external oblique aponeurosis is sutured to the inguinal ligament. Then the external oblique is incised again. B9781437708332000285_f028-001-9781437708332.jpg' alt='Open Inguinal Hernia Repair Plug And Patch' title='Open Inguinal Hernia Repair Plug And Patch' />The. The result is. that a patch of external oblique aponeuroses is in place behind the spermatic. Lichtenstein patch would be in place behind the. The difference is, that 1 this is a patch of living tissue and. Lichtenstein repair, would. The new lower. edge of the upper flap is sutured to the original upper edge of the lower flap. Bassini, Mc. Vay, and Shouldice repairs. However it is the newly created lower edge of the upper flap that is being used. Thus, when the operation. Bassini, Mc. Vay, and Shouldice repairs. I had an inguinal hernia repair for 2 hernias almost 3 years ago. All went smoothly and no mesh was used. It was done with the traditional method. Be taken into consideration when performing subsequent repairs Table 1. The choice of anterior versus posterior open approach should be guided by the initial repair. Tecnica Chirurgica Indice. Ernia inguinale e femorale Classificazione proposta dallEuropean Hernia Society E. H. S. Ernia inguinale primitiva La riparazione con sutura. Find product information on the PROCEED Surgical mesh for intraabdominal hernia repair from Ethicon. OPERATION TECHNIQUE For Medical personsSkin and. The thin, filmy fascial layer covering it is kept. The thinned out portion is usually seen at the. The. external oblique is cut in line with the upper crux of the superficial ring. The external oblique, which is thinned out as a. The cremasteric muscle is incised for the. The sac is excised in all cases except in direct hernias where it is inverted. The medial leaf of the external. PDSII no. 1 Monofilament Polydioxanone. Ethicon continuous sutures. The first two sutures are taken in the. The last. suture is taken so as to narrow the abdominal ring sufficiently without. Figure. 1. In fact, here we are creating a new internal ring. Each suture is. passed first through the inguinal ligament, then the transversalis fascia, and. The index finger of the left hand is used to protect. A. splitting incision is made in this sutured medial leaf, partially separating a. OF 1 2 CMS. WIDTH but NEVER more than 2 cms. This splitting incision is extended. The medial insertion and lateral continuation of this strip is kept. A strip of the external oblique, is now available, the lower border of. The upper free border of the. PDSII no. 1 Monofilament Polydioxanone violet, Ethicon continuous. Figure. 2. The aponeurotic. This will result in the strip of the external. At this stage. the patient is asked to cough and the increased tension on the strip exerted by. The increased tension exerted by the external. The spermatic cord is placed in. PDSII no. 1 Monofilament Polydioxanone violet, Ethicon. Undermining of the newly formed medial leaf on both of its. The first stitch is. This is followed by closure of the superficial fascia and. FIG. 1. The. medial leaf of the external oblique aponeurosis is sutured to the inguinal. Medial leaf 2 Interrupted sutures. Pubic tubercle 4. Abdominal ring 5Spermatic cord and 6 Lateral leaf. FIG. 2. Undetached strip of external oblique aponeurosis forming the posterior wall of. Reflected medial leaf after a strip has been separated 2. Internal oblique muscle seen through the splitting incision made in the medial. Interrupted sutures between the upper border of the strip and conjoined. Interrupted sutures between the lower. Pubic tubercle 6. Abdominal ring 7Spermatic cord and 8 Lateral leaf. Contractions of the abdominal wall muscles pull this strip upwards and laterally. This additional strength given by the external oblique. The shielding action of the. EOA can be elegantly demonstrated on the operating table by asking the. Second important factor that prevents hernia formation in the. This compression is lost if the posterior wall is weak and flabby due to. The strip of EOA. Fig. 3 Fig. 4. The. Pushing or Pulling There. That is, hernia surgery can be performed. Laparoscopic surgery. The organs need to be pushed or. Anterior. approaches pushing 1 PART. ONE An anterior approach means making an incision over, or very near to, the. The incision is a 5 to 1. After the skin. underlying fatty tissue, layers of fascia, and external oblique aponeurosis are. It may need to be cut open, and tugged on. After the sac is detached, the. Then the sac itself is. It is either 1 cut away, and its stump is then ligated in. It is usually. possible to handle the sac this way. But sometimes it is not. For example if the. Such an indirect hernia often finally extends through the. This direct hernia is outside the spermatic cord. In. females, there is no multi layered spermatic cord, but rather a round ligament. But, basically, an. Finally, a hernia can. There may be plenty of original thinking. The presentation, and places where the sac is. PART. TWO Of anterior methods in common use, there are of 2 basic ways of fixing up. A. piece of cloth made out of Polypropylene, Prolene, Marceline or similar. Pure. Tissue Repairs all are via anterior approach Some. Inguinal Anatomy. A. primary landmark in the inguinal region is the inguinal ligament. A ligament is. a strong tissue that connects bone to bone. It is flexible, but it does not. The traditional incision for an anterior. There are three layers of. These are the external oblique muscle with attached. An aponeurosis. is tendon, an extension of a muscle that also acts like a fascia. Muscle tissue. is contractile. Tendon tissue is non contractile and very strong. It neither. contracts nor relaxes, and stays about the same size. In the abdomen, these. In the area of the incision, the. The internal oblique and transversus abdominis each have an arching. The transversus. abdominis is underneath the internal oblique, that is, between the internal. Its most posterior layer is the transversalis. The spermatic cord has various layers inside of which are blood vessels. The internal oblique is muscle here, at the spermatic cord. The cremasteric muscle is. Bassini Repair. transversalis fascia is incised from internal ring to pubic tubercle. Then the. naturally existing lateral edge of the internal oblique muscle, the transversus. They have to be stretched a bit to reach. Then the 2 flaps of external. What happens, is that in. This. stretching is now often blamed for a rather large amount of post operative pain. It involves a 8 1. It is also. blamed for thinning the tissues and making them susceptible to allowing another. A further problem of this technique of hernia repair is that a. The repair of this recurrent hernia is therefore a. Shouldice. Repair This is said to be a. Bassini repair that involves less stretching. There is a. specific, complex protocol of overlapping one tissue with another, and making 4. In order to reduce the tension of the stitching, surgeons. This. technique reduced a little of the pressure, but resulted by definition in. Because the patient depends upon. Unfortunately, this stitching distorts sensitive tissue. This will. cause tension and subsequent pain with all movements including coughing and. The patient can expect to feel the results of the stitching long. He is therefore restricted in physical activity for.