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: 61

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

   

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The 3x6 mesh is trimmed to a bullet shape at the pubic tubercle end. The medial end of the mesh is placed over the pubic tubercle with a 1-cm overlap and a slit 1/3 the distance from the bottom of the mesh is cut to the measured site of the deep inguinal ring. A Y is cut to start the ring opening, which is completed to a diamond shape. The ilioinguinal nerve is replaced with the spermatic cord.    

Notes:

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Hernia Technique Master Class: 62

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

   

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The medial end of the mesh is sutured to the fascia over the pubic tubercle (not into periosteum) with 2-0 prolene and tied. The tails are trimmed, placed around the cord at the deep ring, and tucked under the external oblique lateral to the ring. The first suture is run along iliopubic tract and inguinal ligament past the deep ring and left long with the needle attached. The tip of the needle is shielded in the jaws of the needle driver. A second suture is anchored at the pubic tubercle and is run on the cephalad side of the mesh. The last bite unites the two tails lateral to the deep ring and the ends of the two sutures are tied.   

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Hernia Technique Master Class: 63

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

   

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One of the suture ends is used to place a figure-of-eight suture between the tails lateral to the deep ring to tailor a 1-cm deep ring.     

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