The skin incision Central high hernia sac ligation -

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The skin incision ring ligation surgery in children 698 cases of hernia sac

698 cases of pediatric patients with inguinal hernia incision through the subcutaneous ring high ligation of hernia sac, the effect is satisfactory, the experience of the surgical operation is simple, less postoperative complications, recurrence rate, reported as follows. 1 General clinical data: The group of men and 655 cases (93.8%), 43 females f62%), male to female ratio of 152:1; ages 6 months to 7 years old, an average of 2 years and 9 months. 294 patients with left inguinal hernia (421%), 334 cases of right inguinal hernia (479%), double commission oblique hernia 70 patients (10:0%), including 13 cases of recurrent hernia. Duration of up to 7 years and the shortest 15d. Hernia contents reach the scrotum and labia majora 549 cases (78.7%). All cases are reusable oblique hernia. 2. Surgical methods of operation and points: (1) patients who by right or left index finger ipsilateral Tang Yin Ming bag or large mouth after touching the outer ring, directly on the outer surface to make a population of about 10-15em incision, parallel with the inguinal ligament . (2) skin incision the subcutaneous tissue, the vascular clamp for blunt dissection aimed at outer mouth. Prolapse of the hernia contents repeatedly, 'male cremaster muscle was significantly thicker in children can be pink cremaster muscle fibers easily filed, x', YR direct mention of the hernia sac in children. Difficulties mentioned above, that is not mentioned in cremaster muscle tissue or hernia sac should be put down to re-look, do not clamp blind date, so as not to damage nerves, blood vessels (3) stripping to the hernia sac ring wall above or procure the extraperitoneal adipose tissue After pulling out the hernia sac wall, to maintain a certain tension, high ligation of the hernia sac through a simple increase (to avoid ligation of the surrounding tissue.) After the removal of the hernia sac wall bleeding wound, with vascular clamp gently stump anyone to cut deep, so that part of retraction to the song ring ligation of the deep surface in order to avoid artificial vaginalis. Testicular cord back to normal position. no matter what the size of the outer ring, not in any way to make marriage miserable. cremaster muscle repair, suturing the skin 3. Results: A total of 652 cases were followed up rate of 93.4%, up from 6 A 12-year-month postoperative hernia recurrence in 5 cases (0.77%), concurrent inguinal cryptorchidism in 2 cases (0.31%), no other complications. discuss indirect inguinal hernia in children is due to defects in fetal development, the sheath-like conflict is not closed or regurgitation, increased abdominal pressure caused by the Most children with no obvious weak abdominal muscles, it is simple for high ligation of hernia sac that is able to obtain satisfactory results. Inguinal canal is shorter in children, especially children's inguinal canal through the abdominal wall is almost vertical. Repeated because of hernia contents coupled with extrusion, the inner and outer ring increases, basically in the overlapping state, so the skin incision resistance ring, no dissection of the inguinal canal, which can be seen in the outer port for high ligation of hernia sac and. The surgical incision is small, surgical approach is simple, without dissection of the inguinal canal, without any means of repair, surgical trauma, shorten the operation time, the general 515min that is able to complete the operation. More because they do not destroy the original structure of the inguinal canal, spermatic cord difficult to damage nerve and blood vessels to prevent recurrence of hernia is important. Postoperative inguinal cryptorchidism in this group 2 cases, 2 cases were in the early surgery patients in our hospital, within 2 months after surgery found. May be due to the small incision, intraoperative dissection unnecessary when the testis sac incision made, the end of surgery is also satisfied that the normal bundle to testicular position, or fibrous tissue scar contraction I pull, is not valid for 6 months after the second operation, see the spermatic cord surgery adhesions in the groin was buckling shape, releasing adhesions, testicular descent line of fixation, postoperative recovery was normal. Accordingly, we feel patients should try not to testicular make incisions, the surgery should be completed within the normal scrotal testes back into position to prevent distortion or down incomplete. gubernaculum absent testicle, testicles free traders, and for testicular fixation, to prevent postoperative adhesions retraction.

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