Method of combined herniolasty in case of big and giant, pararectal, oblique inferior-inguinal postoperative hernias

摘要

The invention refers to medicine, in particular to surgery and may be used for hernioplasty of big and giant, pararectal, oblique inferior-inguinal postoperative hernias.The claimed method is realized in the following way. There are made two semioval longitudinal oblique incisions of the skin and of the adipose cellulocutaneous tissue above the hernial outpouching, it is excised an adipose cellulocutaneous flap, from which it is prepared an autodermic graft. It is mobilized the external oblique muscle aponeurosis and the anterior rectus muscle sheath round the hernial defect. The hernial sac is opened, released from the internal organs, at the base is excised, the peritoneum is sutured. The margins of the pararectal hernial defect are brought in contact under tension by interrupted sutures. At the distance of 1,3…2,0 cm from the earlier applied suture it is made a bounding incision of the external oblique muscle aponeurosis and of the rectus sheath anterior leaf. It is sutured with interrupted sutures the medial margin of the external oblique muscle aponeurosis and the lateral margin of the rectus sheath and is brought in free contact the rectus muscle and the earlier crossed internal oblique and transverse muscles. The autodermic graft is placed oblique-longitudinally above the muscles and is fixed on the inside with interrupted sutures to the external oblique muscle aponeurosis and the rectus sheath. It is carried out suture of the lateral margin of the external oblique muscle aponeurosis and the medial margin of the rectus sheath with interrupted end-to-end sutures above the autodermic graft. The cutaneous-subcutaneous wound is drained and sutured.