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Sliding Inguinal Hernia Images

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Incision sites marked.
VID 41, frame 1

herP4139

Incision sites marked (labeled).
VID 41, frame 1

herL4139

Subcutaneous tissue opened with blend current down to the level of Scarpa's fascia.
VID 41, frame 2

herP4140

External oblique aponeurosis and superficial inguinal ring exposed.
VID 41, frame 3

herP4141

External oblique aponeurosis and superficial inguinal ring exposed (labeled).
VID 41, frame 3

herL4141

Nick made in external oblique aponeurosis above the superficial ring.
VID 41, frame 4

herP4142

Metzenbaum scissors inserted in nick with points directed up against underside of fascia.
VID 41, frame 5

herP4143

Scissors pushed toward ring.
VID 41, frame 6

herP4144

Fascia partially opened.
VID 41, frame 7

herP4145

External oblique opened laterally exposing full length of inguinal canal.
VID 41, frame 8

herP4146

Cord swept off lateral and medial crura of superficial ring using a moist sponge.
VID 41, frame 9

herP4147

Ilioinguinal nerve identified.
VID 41, frame 10

herP4148

Nerve gently elevated and freed from cremaster.
VID 41, frame 11

herP4149

Mobilized nerve protected outside medial flap of external oblique.
VID 41, frame 12

herP4150

Cord elevated at pubic tubercle by grasping cremaster.
VID 41, frame 13

herP4151

Penrose drain passed under cord for retraction.
VID 41, frame 14

herP4152

Cremaster opened using cautery.
VID 41, frame 15

herP4153

Cremaster detached from inguinal floor using cautery.
VID 41, frame 16

herP4154

Flaps of cremaster clamped, excised and ligated.
VID 41, frame 17

herP4155

Internal spermatic fascia opened to reveal cord structures.
VID 41, frame 18

herP4156

Hernia sac identified on anteromedial surface of cord and sharply separated from cord structures.
VID 41, frame 19

herP4157

Dissection continued with cautery.
VID 41, frame 20

herP4158

Sac mobilized toward deep inguinal ring.
VID 41, frame 21

herP4159

Sac opened on anteromedial side, sigmoid mobilized, sliding hernia identified, and hernia sac freed at its junction with sigmoid.
VID 41, frame 22

herP4160

Sac opened on anteromedial side, sigmoid mobilized, sliding hernia identified, and hernia sac freed at its junction with sigmoid (labeled).
VID 41, frame 22

herL4160

Defect in sac wall closed with running 2-0 silk.
VID 41, frame 23

herP4161

Closure of sac wall recreates a complete sac.
VID 41, frame 24

herP4162

Neck of sac closed in standard fashion.
VID 41, frame 25

herP4163

Patch for tension-free polypropylene mesh repair.
VID 41, frame 26

herP4164

Deep ring narrowed by suturing tails of mesh lateral to ring.
VID 41, frame 27

herP4165

Ilioinguinal nerve replaced in its anatomical position.
VID 41, frame 28

herP4166

External oblique closed loosely with 4-0 absorbable suture. Scarpas approximated with same material and skin stapled.
VID 41, frame 29

herP4167

This page was last modified on 2/4/2000.
 

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