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A D V E R T I S E M E N T

 

Hernia Technique Master Class: 58

A D V E R T I S E M E N T

   

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The placement of the imbrication sutures is shown.     

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Hernia Technique Master Class: 59

A D V E R T I S E M E N T

   

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The completed floor imbrication eliminates the direct bulge.     

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Hernia Technique Master Class: 60

A D V E R T I S E M E N T

   
 

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.    

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This page was last modified on 2/10/2009.