局麻下疝修补术01.pptVIP

The superficial epigastric vessels were identified, isolated, ligated and divided. It is easy to miss these vessels when using cautery. The vessels are elastic and retract into the fat where they can later start bleeding and cause a hematoma.  Five cc of local was injected beneath external oblique aponeurosis to anesthetize the ilioinguinal nerve and to separate the aponeurosis fromthe nerve and canal contents. A nick was made in external oblique aponeurosis.  A Metzenbaum scissors was inserted in the opening with the points up. Keeping the points pushed tightly up against the underside