腹外疝课件修改稿演示文稿.ppt

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 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, and femoral hernias. Shouldice法 Shouldice repair : the posterior wall of the inguinal canal is repaired by dividing the transversalis fascia from the pubis to adjacent to the inferior epigastric vessel, then imbricate sutures The development of inguinal hernia repair Since 1884, Bassini began to do the first cases of hernia repair. Strengthen the posterior wall of the inguinal canal to cure inguinal hernia surgery inguinal hernia is a great progress. Although there were many surgical methods to repair the posterior wall of the inguinal canal, however, recurrence remains a serious problem. Domestic statistics (Mr.Huang) ※ Recurrent rate of indirect hernia HUANGTINGYAN（1984） 17～22% ※ Recurrent rate of direct hernia WANGHAINIAN（1988） 20～40% Major problems 1. Higher recurrent rate 10% 2. Large hernia, treatment of multiple recurrent hernia 3. Severe local pain after hernia repair, restore normal activities and work required for a long time. Tension-Free Herniorrhaphy Lichtenstein in 1987 has proposed, tension-free hernia repair (Tension-Free Herniorrhaphy) theory, namely the use of permanent artificial materials do not absorb the polymer repair defects, the hernia repair without disruption of normal anatomical structures and to achieve a tension-free state.  Tension-Free Herniorrhaphy Plain film tension-free hernia repair surgery (Lichtenstein )--Use a considerable size of the patch material is placed in the posterior wall of the inguinal canal. RutKow method--(plug+mesh) GPRVS (Giant prosthetic reinfor