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Abstract
The goals of the research are: to improve the results of inguinal hernia treatment, decrease recurrent rate and perform the comparative analysis of the results of hernioplastics, based on 3 groups: pure-tissue, tension-free and laparoscopic groups of operations, clinical testing of Archvadze’s 2nd method on the patients having various types, especially recurrent inguinal hernias and on the patients of various age groups. Clinical material includes 758 case reports of the patients operated on in Clinic ¹1 of TSMU for the inguinal hernias and by the laparoscopic techniques (TAPP) at the Center of Laparoscopic Surgery and Lithotripsy (24 patients). The techniques: The monofilament polypropylene mesh must have adequate size and shape in order to be placed and stitched between the lower edge of internal oblique and inguinal ligament without tension. On the border of upper and middle thirds of the mesh preliminary must be done a hole through which the cord perforates the mesh without any pinching or strangulation. Then, by pulling the cord aside to the upper corner of the wound (lateralization of the spermatic cord) the external oblique aponeurosis must be closed under the chord with non-absorbable sutures without duplicaton. Thompson’s fascia must be stitched by the absorbable (Vicryl) stitches over the spermatic cord . So, the cord makes the knee zigzag at once after it passes through the mesh, follows upper and lateral towards the direction of the upper corner of the wound, comes out between the stitches of the external oblique aponeurosis and lies between it and Thompson’s fascia. So, the cord is separated from the mesh by the external oblique aponeurosis and is totally covered with host tissues.
References
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