Inguinal Hernias. Dorothy Sparks, PGY-1c. Historical Hernias. Hernias have been documented throughout history with varying success at either reduction or repair. Trusses & Techniques. Anatomic Considerations.
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Dorothy Sparks, PGY-1c
Hernias have been documented throughout history with varying success at either reduction or repair.
Both the ilioinguinal nerve and the genitofemoral nerve traverse the usual hernia-repair operative field. The femoral vein also runs just deep to the inguinal floor laterally.
The MPO is bordered:
Rectus abdominis muscle medially,
Internal inguinal ring dilated but posterior inguinal wall intact (inferior deep epigastric vessels not displaced)
The hernia sac passes outside the boundaries of Hesselbach's triangle and follows the course of the spermatic cord.
The hernia sac passes directly through Hesselbach's triangle and may disrupt the floor of the inguinal canal.
This repair reconstructs the inguinal canal without using a mesh prosthesis.
AKA: Tension-Free Repair
One of the most commonly performed procedures
A mesh patch is sutured over the defect with a slit to allow passage of the spermatic cord
Open mesh repair. Mesh is used to reconstruct the inguinal canal. Minimal tension is used to bring tissue together.
Viewed from inside the pelvis toward the direct and indirect sites. A broad portion of mesh is stapled to span both hernia defects. Staples are not used in proximity to neurovascular structures.