XX医院腹外疝教学.pptVIP

Traditional Herniorrhaphy 疝修补术 ★ principles : High ligation 结扎 of hernia sac, strengthen or repair inguinal wall ＊ High ligation :exposed neck of hernia sac , high ligation and resect 切除 the hernia sac. ＊ To strengthen or repair the inguinal canal wall: Adults with varying degrees of inguinal hernia(anterior or posterior wall of the weak or defect 缺陷) High ligation High ligation make a small incision 切口 over the hernia put the bulging 膨胀的 tissue back into Ab cavity remove the hernia sac(high ligation) Close and enhance 增强 defect (repair of walls of the inguinal canal) Classic Herniorrhaphy strengthening or repair inguinal canal wall Two types { To strengthen the anterior wall To strengthen the posterior wall To strengthen or repair the anterior wall of the inguinal canalFerguson ＊ Ferguson : Spermatic cord in the lower edge 下缘 of the front of the abdominal oblique muscle 腹斜肌 and joint tendon to the inguinal ligament on the seam 接缝, so as to 以便 eliminate abdominal oblique muscle and the arcuate lower edge 弓状下缘 of the gap between the inguinal ligament. For children and young people were no significant transverse fascia defect 腹横筋膜损伤, the posterior wall of inguinal canal inguinal hernia is still normal and sound 健全的. Ferguson ① ② ③ ④ ⑴ skin ⑵ Superficial fascia 浅筋膜 ⑶ external oblique muscle 腹外斜肌 and aponeurosis 腱膜 ⑷ internal oblique muscle 腹内斜肌 ⑸ Transversus muscle 腹横肌 ⑹ Transversalis fascia 腹横筋膜 ⑺ peritoneum 腹膜 several special structure that a surgeon must to know： Subcutaneous (external 外) inguinal ring 腹股沟皮下环 Inguinal ligament 腹股沟韧带 Lacunar ligament 腔隙韧带 Cooper’s ligament (pectineal ligament 耻骨梳韧带) Conjoined tendon 联合腱 Internal inguinal ring 腹股沟内环 Iliopubic tract 髂耻束 * Some special structure in groin * external (superficial) inguinal ring An ovoid 卵形 opening of the external oblique aponeurosis 腹外斜肌腱膜 that is positioned superior and slightly lateral 侧部 to the pubic tubercle 耻骨结节 * Inguinal ligament and Lacunar ligament Inguinal ligament is the i