c l i n i c a l f o l i o s : n a r r a t i v e





A D V E R T I S E M E N T

 

Hernia Technique Master Class: 22

A D V E R T I S E M E N T

   

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The genital branch of the genitofemoral nerve and external spermatic vessels from the inferior epigastrics are located inside the lateral flap lying against transversalis fascia. These structures should be preserved. The point at which the genital branch penetrates the transversalis fascia is variable. It might be near the deep ring or more medial. The cremaster flaps are bluntly separated at their deep attachments and dissected as a strip proximally and distally. The lateral flap is opened superficial to the genitofemoral neurovascular bundle. The ends of the cremaster strips are clamped, the strips excised and the stumps ligated with 4-0 absorbable ligatures.   

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Hernia Technique Master Class: 23

A D V E R T I S E M E N T

   

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The internal spermatic fascia is a very thin layer over the cord structures.     

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Hernia Technique Master Class: 24

A D V E R T I S E M E N T

   

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The internal spermatic fascia is delicately opened proximally and distally. Because the processus vaginalis lay within the transversalis fascia embryologically, and the testis and cord descended posterolateral to the cord, the indirect sac will lie anterolateral on the cord.    

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This page was last modified on 2/10/2009.