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A D V E R T I S E M E N T
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A D V E R T I S E M E N T | |||||
Strangulated Femoral Hernia Images | ||||||
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Bulge shows femoral hernia beneath skin. |
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Pubis and pectineal ridge. |
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Pectineus muscle. |
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Femoral artery and vein. |
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Transversalis fascia. |
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Femoral canal, tansveralis fascia and femoral sheath. |
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Femoral canal, tansveralis fascia and femoral sheath (labeled). |
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Femoral hernia protruding into femoral canal. |
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Hernia sac exposed beneath incision. |
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Hernia sac mobilized. |
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Hernia sac elevated and fold of peritoneum felt. |
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Sac containing watery fluid signifying dead bowel. |
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Knuckle of dead bowel visualized. |
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Right-angle clamp inserted through neck of sac and over lacunar ligament. |
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Lacunar ligament opened medially. |
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Additional small bowel on either side of dead segment is delivered into the hernia defect. |
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Small bowel mesentery divided between the points of viable bowel chosen for resection. |
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Borders of normal bowel tacked together and compromised segment resected with a linear stapler. |
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Compromised bowel specimen. |
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Antemesenteric corner of each bowel limb cut off to allow insertion of the linear stapler. |
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Stapler fired along the common antemesenteric walls. |
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Open end of anastomosis closed using linear stapler. |
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Functional end-to-end anastomosis is gently reduced through the hernia defect. |
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Redundant hernia sac is trimmed off. |
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Remaining peritoneum closed with continuous 4-0 absorbable suture. |
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Four sutures of 2-0 prolene are placed from below inguinal ligament. |
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Inguinal ligament and iliopubic tract sutured to pectineus fascia directly posteriorly, closing the femoral canal. |
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Completed repair shown. |
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Skin incision closed. |
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Alternative "McVay repair" for femoral hernia. |
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This page was last modified on 12/9/1999. A D V E R T I S E M E N T
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