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 Repair under Local Anesthesia: 4

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

   
 

The subcutaneous tissue was opened with cautery (blend current) using quick sketching strokes to avoid thermal injury. The tissue is opened carefully to the level of Scarpa's fascia to expose but not injure the superficial epigastric vessels that invariably cross the middle of the incision.      

Notes:

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Hernia Repair under Local Anesthesia: 5

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

   
 

The superficial epigastric vessels were identified, isolated, ligated and divided. It is easy to miss these vessels when using cautery. The vessels are elastic and retract into the fat where they can later start bleeding and cause a hematoma.       

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Hernia Repair under Local Anesthesia: 6

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

   
 

Five cc of local was injected beneath external oblique aponeurosis to anesthetize the ilioinguinal nerve and to separate the aponeurosis from the nerve and canal contents.       

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This page was last modified on 8/24/2000.