腹外疝课件ENGLISH.ppt

* tension-free repair Great tension in a conventional repair is the principal cause of recurrence(10%). Lichtenstein firstly employ a synthetic mesh prosthesis to bridge the defect and release tissue tension tension-free repair has become the dominant method of inguinal hernia repair recurrence decrease( 1%). * The commom patch or mesh * * Inguinal hernias-- Treatment 2. operative therapy 3) laparoscopic repair of inguinal hernia the minimally invasive technique of laparoscopic surgery can be used to repair the most common types of hernias * 1.Indications for manual reduction: 1) duration 3-4 hours, no local tenderness, no abdominal tenderness, no rigidity of abdominal muscle. 2) elderly patients or with other severe diseases, and the intestinal loop is still alive. 2.Usually requires emergency operation if manual reduction is fail. 3. bowels resection is necessary when the incarcerated bowels is gangrene, in this case, only high ligation of the sac can be done,and hernioplasty is not suitable. * 3. management rule of incarcerated and strangulated hernia * procedure * introduction Femoral hernia is a protrusion of peritoneum through the femoral canal. Usually in women 40 years Causes: laxity of groin tissue and elevated intra- abdominal pressure Anatomy of femoral canal Femoral ring – fossa ovalis Anterior: inguinal ligament Posterior: pectineal ligament Medial: lacunar ligament Lateral: femoral vein * Femoral hernia femoral canal Clinical findings and diagnosis Reducible femoral hernia: asymptomatic lump, localized intermittent discomfort Irreducible femoral hernia: constant lump and localized discomfort Strangulated femoral hernia * Femoral hernia Differential diagnosis inguinal hernia groin lymph nodes long saphenous varix iliolumbar tuberculous abscess * Femoral hernia Treatment Not be treated conservatively Rule operation: excision or reduction of the hernial sac, and narrowing of