Method of Strengthening the Posterior Wall of the Inguinal Canal with Direct Inguinal Hernias, the Transverse Fascia is Superimposed Endo-loop

Abstract


Purpose of the study is to determine the effectiveness of our proposed method of strengthening the posterior wall of the inguinal canal with direct inguinal hernias. Further complications such as hemostasis and seroma in early postoperative period after laparoscopic hernia repair on direct inguinal hernias due to the fact that nonliquidated cavity is formed between the mesh endoprosthesis, and the transverse fascia. Our proposed method is as follows: while performing a laporoscopic hernia repair on a direct inguinal hernia, after dissection of tissues in the periperitoneal space, elements of the inguinal gap are distinguished. We find stretched prolapses in 
the transverse fascia of the inguinal gap, in the projection of the medial inguinal fossa. Then, by an endoscopic clamp we grab the bottom of the stretched transverse fascia, pulling it in rotational movements in the periperitoneal space. On the basis of the formed cone elongated in the periperitoneal space, the transverse fascia is superimposed endo-loop and tightened, thereby eliminated prolapsed of the transverse fascia which in turn strengthens the posterior wall of the inguinal canal. The next step is setting up and fixing the mesh prosthesis with its subsequent peritonization. 
Conclusion Publication experience in this study confirms that the proposed method can be used in the treatment of direct inguinal hernias. 

State Education of Ryazan Medical University, Ryazan st. Visokovoltnaya-9, Russian Federation

Author for correspondence.
Email: omen@mail.ryazan.ru
Ph.D., Professor, Head. Department of Hospital Surgery Medical University RyazGMU

State Education of Ryazan Medical University, Ryazan st. Visokovoltnaya-9, Russian Federation

Email: ozaitsev@rambler.ru
Ph.D., Associate Professor, Department of Hospital Surgery Medical University RyazGMU

State Education of Ryazan Medical University, Ryazan st. Visokovoltnaya-9, Russian Federation

Email: mail@vestnik-surgery.com
MD, PhD, Department of Hospital Surgery Medical University RyazGMU 

State Education of Ryazan Medical University, Ryazan st. Visokovoltnaya-9, Russian Federation

Email: Shamil.akhmedov.1983@mail.ru
post-graduate student of the Department of Hospital Surgery Medical University RyazGMU

State Education of Ryazan Medical University, Ryazan st. Visokovoltnaya-9, Russian Federation

Email: mail@vestnik-surgery.com
Assistant of the Department of Hospital Surgery Medical University RyazGMU

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