| 摘要 |
A method for transabdominal preperitoneal endovideohernioplasty in the inguinal and femoral hernias with the aid of the implant provides for pneumoperitoneum of 12- Hg, the insertion of paraumbilical trocar and laparoscope with the tapered optics of 30°. Two additional trocars are inserted in both iliac areas of abdomen. The area of the parietal peritoneum over medial and lateral fossae is cut with the aid of the coagulation hook from the anterior-superior spine of the iliac bone to the pubic symphysis. The hernial sac is invaginated to the abdominal cavity and separated from the elements of the spermatic cord. The polypropylene mesh is partially cut horizontally with its lower part passed beneath the spermatic cord, and the lateral edge is fixed with herniostapler to the oblique muscles of abdomen, while the medial edge is fixed to the pubic bone and Cooper ligament. The previously separated parietal peritoneum is fixed above with herniostapler. The hernial sac is cut in such a way that its fragment attached to the elements of the spermatic cord being left on the spermatic cord itself. The polypropylene implant is fixed over the fragment of the hernial sac left on the spermatic cord and over the areas where the generation of femoral, direct, and oblique hernias are suspected. The area of the parietal peritoneum that was separated earlier and the free area of the hernial sac are attached above. |
