In the 1970s, Lichtenstein in California devised the tension-free repair using a mesh barrier. The repair is suitable for both direct and indirect hernias, and has become the gold standard for open hernia repairs for large defects and older people. The strength of the repair derives from fibrous ingrowth into the interstices of the mesh. Various types of mesh and modifications adding mesh plugs are available. A basic oval patch with a keyhole and two tails is the common standard. The ilioinguinal nerve may be replaced to accompany the cord through the keyhole or left entirely outside the mesh. The mesh is tacked down to the deep lamina of the rectus sheath and internal oblique muscle above, and to iliopubic tract and inguinal ligament below.
Link to this frame from your Personal Thumbnails page?
Click the "Update" button to save your Notes and Personal Thumbnails.