Inguinal Hernia Repair

Inguinal Hernia

Objective

Repair of hernial defect in case of:

•   All indirect hernias

•   Symptomatic and large direct hernia.

Position

Supine.

Anesthesia

General/regional/local.

Incision

Two cm above the medial two-third of the inguinal ligament.

Procedure

1.  Incise external oblique aponeurosis.

2.  Mobilize indirect sac from within the cord; excise the cremaster.

3.  Transfer indirect sac at the internal ring and excise the redundant portion.

4.  For direct hernias separate cord structures from the sac and then reduce sac.

5.  Divide transversalis fascia all along the canal floor.

6.  Approximate the conjoint tendon and transversalis fascia (upper leaf) to the lower leaf of transversalis fascia and inguinal ligament using interrupted nylon or prolene sutures

7.  If the defect is large or tissues are weak a mesh can be fixed between inguinal ligament and conjoint tendon

8.  Replace cord in the new floor

9.  Close the wound in the layers.

Instrument

Hernia set.

Any questions be sent to drmmkapur@gmail.com

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