Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical Surgery2070-478X2409-143XVoronezh State Medical University4810.18499/2070-478X-2015-8-3-310-313UnknownMethod of Strengthening the Posterior Wall of the Inguinal Canal with Direct Inguinal Hernias, the Transverse Fascia is Superimposed Endo-loop<span>Ph.D., Professor, Head. Department </span><span>of Hospital Surgery Medical University RyazGMU</span>omen@mail.ryazan.ru<span>Ph.D., Associate Professor, Department </span><span>of Hospital Surgery Medical University RyazGMU</span>ozaitsev@rambler.ru<span>MD, PhD, Department of </span><span>Hospital Surgery Medical University RyazGMU </span>mail@vestnik-surgery.com<span>post-graduate student of the </span><span>Department of Hospital Surgery Medical University </span><span>RyazGMU</span>Shamil.akhmedov.1983@mail.ru<span>Assistant of the Department of </span><span>Hospital Surgery Medical University RyazGMU</span>mail@vestnik-surgery.comState Education of Ryazan Medical University, Ryazan st. Visokovoltnaya-9, Russian Federation24092015833103132504201625042016Copyright © 2015, ., ., ., ., .2015<div>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 </div><div>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. </div><div><strong>Conclusion</strong> Publication experience in this study confirms that the proposed method can be used in the treatment of direct inguinal hernias. </div>direct inguinal herniaendo-loophernioplastia ТАРР and ТЕР.прямая паховая грыжаэндопетлягерниопластики ТАРР и ТЕР[1.Emel'yanov S.I., Protasov A.V., Rutenburg G.M. EHndohirurgiya pahovyh i bedrennyh gryzh. [Endosurgery inguinal and femoral hernias.] -S-Pb.: Foliant 2000; 176][2.Slavin L.E., Fedorov I.V., Sigal E.I. Oslozhneniya hirurgii gryzh zhivota. [Complications of surgery abdominal hernias.] M:Profil' 2005;175.][3.Ferrarese A., Marola S., Surace A., Borello A., Bindi M., Cumbo J., Solej M, Enrico S., Nano M., Martino V. Fibrin glue versus stapler fixation in laparoscopic transabdominal inguinal hernia repair: a single center 5-year experience and analysis of the results in the elderly. Int J Surg. 2014;12Suppl 2:S94-8. doi: 10.1016/j.ijsu.2014.08.371. Epub 2014 Aug 23]