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Strangulated Femoral Hernia Images

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Bulge shows femoral hernia beneath skin.
VID 29, frame 1

herP4110

 

Pubis and pectineal ridge.
VID 29, frame 2

herG4111

 

Pectineus muscle.
VID 29, frame 2

herG4112

 

Femoral artery and vein.
VID 29, frame 2

herG4113

 

Transversalis fascia.
VID 29, frame 2

herG4114

 

Femoral canal, tansveralis fascia and femoral sheath.
VID 29, frame 2

herG4115

 

Femoral canal, tansveralis fascia and femoral sheath (labeled).
VID 29, frame 2

herL4115

 

Femoral hernia protruding into femoral canal.
VID 29, frame 3

herG4116

 

Hernia sac exposed beneath incision.
VID 29, frame 4

herP4117

 

Hernia sac mobilized.
VID 29, frame 5

herP4118

 

Hernia sac elevated and fold of peritoneum felt.
VID 29, frame 6

herP4119

 

Sac containing watery fluid signifying dead bowel.
VID 29, frame 7

herP4120

 

Knuckle of dead bowel visualized.
VID 29, frame 8

herG4121

 

Right-angle clamp inserted through neck of sac and over lacunar ligament.
VID 29, frame 9

herG4122

 

Lacunar ligament opened medially.
VID 29, frame 9

herG4123

 

Additional small bowel on either side of dead segment is delivered into the hernia defect.
VID 29, frame 10

herP4124

 

Small bowel mesentery divided between the points of viable bowel chosen for resection.
VID 29, frame 11

herP4125

 

Borders of normal bowel tacked together and compromised segment resected with a linear stapler.
VID 29, frame 12

herP4126

 

Compromised bowel specimen.
VID 29, frame 12

herP4127

 

Antemesenteric corner of each bowel limb cut off to allow insertion of the linear stapler.
VID 29, frame 13

herP4128

 

Stapler fired along the common antemesenteric walls.
VID 29, frame 14

herP4129

 

Open end of anastomosis closed using linear stapler.
VID 29, frame 15

herP4130

 

Functional end-to-end anastomosis is gently reduced through the hernia defect.
VID 29, frame 16

herP4131

 

Redundant hernia sac is trimmed off.
VID 29, frame 17

herP4132

 

Remaining peritoneum closed with continuous 4-0 absorbable suture.
VID 29, frame 18

herP4133

 

Four sutures of 2-0 prolene are placed from below inguinal ligament.
VID 29, frame 19

herG4134

 

Inguinal ligament and iliopubic tract sutured to pectineus fascia directly posteriorly, closing the femoral canal.
VID 29, frame 19

herG4135

 

Completed repair shown.
VID 29, frame 20

herP4136

 

Skin incision closed.
VID 29, frame 21

herP4137

 

Alternative "McVay repair" for femoral hernia.
VID 29, frame 22

herG4138

 

This page was last modified on 12/9/1999.
 

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