What should we pay attention to after indirect inguinal hernia repair?

summary

Inguinal hernia is usually classified into indirect inguinal hernia, direct hernia, * sliding hernia. Elderly patients often have benign prostatic hyperplasia and obvious urinary retention. The main surgical treatment, namely inguinal hernia repair, different types of inguinal hernia choose different surgical methods. Let's share my experience with you.

What should we pay attention to after indirect inguinal hernia repair?

Incision of external oblique abdominis aponeurosis: after incision of skin, incision of subcutaneous tissue, pay attention to ligation of superficial abdominal wall arteries and veins and branches of external pudendal arteries and veins, until the external oblique abdominis aponeurosis, exposing the superficial ring of inguinal canal. On the line between the superficial ring and the deep ring of the inguinal canal, the lateral oblique tendon was incised along the direction of the aponeurosis fiber. The incision should be slightly shallow above the ring mouth to avoid injury to the ilioinguinal nerve.

To find and open the hernia sac: clamp up the upper and lower part of the external oblique muscle aponeurosis with two hemostatic forceps, and then separate it bluntly under it, from the upper part to the joint tendon, and from the lower part to the inguinal ligament. Pay attention not to hurt the ilioinguinal nerve when separating the lower segment. The nerve can be separated from the internal oblique muscle. Use hemostatic forceps to pull the aponeurosis from the lower segment to the lower part of the nerve, and then turn the aponeurosis out to cover the nerve with the aponeurosis

Ask the patient to increase the abdominal pressure. The herniated mass can be seen on the anteromedial side of the spermatic cord. Vertically cut the levator muscle and the internal fascia of the spermatic cord. The gray hernia sac can be seen on the anteromedial side of the spermatic cord. Lift the hernia sac with toothed forceps. Vertically cut the hernia sac between the two forceps. Do not damage the contents of the hernia. When the incision was enlarged, the index finger was extended into the hernia sac to explore its contents, most of which were small intestine and omentum.

matters needing attention

1. General treatment: take supine position after operation. In order to reduce the tension of suture and the discomfort and pain of incision, a small pillow was added to the fossa to make the hip flexion. 2. To prevent hematoma, sandbag was used to compress the operation area for 24 hours after operation, and T-belt was used to support scrotum to avoid hematoma. Cold compress can also be used.