(外科学课件）（参考翻译）腹外疝课件修改稿.ppt

* Ferguson ① ② ③ ④ Ferguson 精 索 To strengthen or repair the posterior wall of the inguinal canal ＊ Bassini :是把精索提起，在其后方把腹内斜肌下缘和联合健缝至腹股沟韧带上，置精索于腹内斜肌与腹外斜肌腱膜之间。 Bassini Bassini repair : lower edge of internal oblique muscle and the conjoined tendon are sutured 缝合 to inguinal ligament. It is widely used. Bassini ① ② ③ ④ Halsted external oblique fasciae spermatic cord Halsted Repair : like the Bassini repair, but the spermatic cord is superficial to external oblique aponeurosis 位于腹外斜肌腱膜表面 McVay Coopers ligement Inguinal ligament McVay repair : lower edge of internal oblique muscle and the conjoined tendon are sutured to Cooper’s ligament direct. it is popular for direct hernias, large indirect hernias, recurrent hernias 复发性疝, and femoral hernias 股疝. Shouldice Shouldice repair : the posterior wall of the inguinal canal is repaired by dividing the transversalis fascia 腹横筋膜 from the pubis 耻骨 to adjacent 临近 to the inferior epigastric vessel 腹壁下血管, then imbricate 覆瓦状 sutures 缝合 The development of inguinal hernia repair Since 1884, Bassini had completed of the first cases of hernia repair. Strengthen the posterior wall of the inguinal canal to cure inguinal hernia. Although there are many surgical methods to repair the posterior wall of the inguinal canal, however, hernia recurrence 复发 is a serious problem. Domestic 国内 statistics (Huang) ※ Recurrence rate of indirect hernia HUANGTINGYAN（1984） 17～22% ※ Recurrence rate of direct hernia WANGHAINIAN（1988） 20～40% Major problems 1. Higher recurrence rate 10% 2. Large hernia, treatment of multiple recurrent hernia 3. Severe local pain after hernia repair, restore normal activities and work need a long time. Tension-Free 无张力 Herniorrhaphy Lichtenstein 1987 has proposed 提议, “tension-free hernia repair” (Tension-Free Herniorrhaphy) theory, namely the use of permanent artificial materials do not absorb the polymer 聚合物 repair defects, the hernia repair without disruption 破坏 of nor