OpenAccessBelV2, Main, Exploration, bibRecord, 001834

Surgical anatomy of the inguinal region : Implications during inguinal laparoscopic herniorrhaphy

Identifieur interne : 001834 ( Main/Exploration ); précédent : 001833; suivant : 001835

Surgical anatomy of the inguinal region : Implications during inguinal laparoscopic herniorrhaphy

Auteurs : E. Totte [Belgique] ; R. Van Hee [Belgique] ; G. Kox [Belgique] ; L. Hendrickx [Belgique] ; K. J. Van Zwieten [Belgique]

Source :

European surgical research [ 0014-312X ] ; 2005.

RBID : Pascal:05-0349468

Descripteurs français

Pascal (Inist)
- Chirurgie, Anatomie, Inguinal, Région, Laparoscopie, Herniorraphie, Hernie, Réparation, Endoscopie, Complication, Anesthésie, Médecine, Réanimation, Traitement.
Wicri :
- topic : Chirurgie, Anatomie, Région, Médecine.

English descriptors

KwdEn :
- Anatomy, Anesthesia, Complication, Endoscopy, Hernia, Herniorrhaphy, Inguinal, Laparoscopy, Medicine, Region, Repair, Resuscitation, Surgery, Treatment.

Abstract

Introduction: In laparoscopic inguinal hernia repair the inguinal region is approached and hernia repair performed from the interior side instead of the classical open external access. Exploration and placement of staplers in the internal inguinal region during laparoscopic hernia repair may sever different anatomical structures, or induce specific complications such as nerve entrapment, neuralgia, hematomas or osteitis. The incidence of these complications may be reduced by careful dissection of the preperitoneal tissues and by placing a prosthetic mesh without the use of stapling. As laparoscopic techniques evolved, different sizes of meshes have been used. An exact determination of mesh size was hitherto not investigated. Aim: Cadaver studies of the topography of blood vessels and nerves in the preperitoneal tissue in this region were carried out in order to assess a safe position and adequate size of the prosthetic mesh. Methods: Dissection in 6 preserved human female cadavers was performed to define the actual surface of the internal inguinal region. A physical model was developed to formulate the ideal size of the prosthesis. Specific measurements were used to define the maximal size of the meshes, so as to place them without stapling, and without inducing neurovascular complications. Results: The designed physical formula defines the size of the mesh as a function of the maximum intra-abdominal pressure, the size of the abdominal wall defect and the abdominal wall tension. Conclusion: On mathematical and physical grounds our study points out that the size of the currently used prosthetic mesh (10 x 15 cm) is large enough to be placed without stapling so that with proper placement no recurrences should occur.

Affiliations:

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Le document en format XML

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<term>Herniorrhaphy</term>
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<term>Laparoscopy</term>
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<term>Herniorraphie</term>
<term>Hernie</term>
<term>Réparation</term>
<term>Endoscopie</term>
<term>Complication</term>
<term>Anesthésie</term>
<term>Médecine</term>
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<front><div type="abstract" xml:lang="en">Introduction: In laparoscopic inguinal hernia repair the inguinal region is approached and hernia repair performed from the interior side instead of the classical open external access. Exploration and placement of staplers in the internal inguinal region during laparoscopic hernia repair may sever different anatomical structures, or induce specific complications such as nerve entrapment, neuralgia, hematomas or osteitis. The incidence of these complications may be reduced by careful dissection of the preperitoneal tissues and by placing a prosthetic mesh without the use of stapling. As laparoscopic techniques evolved, different sizes of meshes have been used. An exact determination of mesh size was hitherto not investigated. Aim: Cadaver studies of the topography of blood vessels and nerves in the preperitoneal tissue in this region were carried out in order to assess a safe position and adequate size of the prosthetic mesh. Methods: Dissection in 6 preserved human female cadavers was performed to define the actual surface of the internal inguinal region. A physical model was developed to formulate the ideal size of the prosthesis. Specific measurements were used to define the maximal size of the meshes, so as to place them without stapling, and without inducing neurovascular complications. Results: The designed physical formula defines the size of the mesh as a function of the maximum intra-abdominal pressure, the size of the abdominal wall defect and the abdominal wall tension. Conclusion: On mathematical and physical grounds our study points out that the size of the currently used prosthetic mesh (10 x 15 cm) is large enough to be placed without stapling so that with proper placement no recurrences should occur.</div>
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Surgical anatomy of the inguinal region : Implications during inguinal laparoscopic herniorrhaphy

Surgical anatomy of the inguinal region : Implications during inguinal laparoscopic herniorrhaphy

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri