消化系统腹外疝英陈以宽.ppt

Anterior wall repair of inguinal canal Ferguson repair In front of spermatic cord, suturing the transversus abdominis and internal oblique musculoaponeurotic arches or conjoined tendon to the inguinal ligament. Mainly for young adult. Posterior wall repair of inguinal canal Bassini:Under spermatic cord, suturing the transversus abdominis and internal oblique musculoaponeurotic arches or conjoined tendon to the inguinal ligament . Halsted：after Bassini repair, the external oblique aponeuroses was sutured under spermatic cord. Mc Vay：has traditionally been popular for the correction of direct inguinal hernias, large indirect hernias, recurrent hernias, and femoral hernias. Interrupted, nonabsorbable sutures are used to approximate the edge of the transversus abdominis aponeurosis to Coopers ligament. particularly suited for strangulated femoral hernias. Shouldice:the posterior wall of the inguinal canal was dissected. The initial suture of the transversus abdominis aponeurotic arch to the iliopubic tract. Next, the internal oblique and transversus abdominis muscles and aponeuroses are sutured to the inguinal ligament. a low recurrence rate and a high degree of patient satisfaction in highly selected patients. The tension-free repair has become the dominant method of inguinal hernia repair. Recognizing that tension in a repair is the principal cause of recurrence, current practices in hernia management employ a synthetic mesh prosthesis to bridge the defect, a concept first popularized by Lichtenstein. Tension-free hernioplasty The site of Mesh: Intraperitoneal Onlay Preperitoneal space Aponeurosis Material：膨化聚四氟乙烯（ e-PTFE, Expanded-Polytetrafluoroethylene） , 聚丙烯（prolene），聚酯（ polyester ） * * There are several options for placement of mesh during anterior inguinal herniorrhaphy:Lichtenstein approachPlug-and-patch technique, Rutkowthe sandwich technique with both an anterior and preperitoneal piece of mesh, (Gilbert) UHS, PHS (P