News Feed Discussions 4 months out and still the same Reply To: 4 months out and still the same

  • Bob

    November 20, 2022 at 10:39 am

    Operative findings..Direct and indirect right inguinal hernia…An ultrasound guided ilioinguinal block was preformed with 7ml of 0.5 roprivacaine. An oblique incision was made over the right inguinal canal and deepened down to the external oblique fascia, which was opened in direction of its fibers. The cremasteric muscle fibers were split longitudinally and a long,indirect sac was dissected away from the cord structures and from the cremaster muscles and from the inguinal floor and dissected into the internal ring. The inguinal floor was also herniated and the posterior wall was opened in the usual fashion useing metzenbaum scissors opening it from the level of the epigastric vessels to the pubis and dissecting the posterior preperitoneal fat away from the posterior surface of the transversalis, which was attenuated . Next,the first layer of the shouldice repair was begun using the lateral transversalis suturing it to the rectus tendon with 0 proline suture and running this toward the internal ring,closing it off and running it back using shelving edge of the inguinal ligament to the internal oblique muscle and tying it at the pubis.A 3rd and 4th row of 2-0 prolene was used to reflect the external oblique overhead inguinal floor. Next,the lateral external oblique was closedwith running 2-0 vicryl suture. Scarpas fascia was closed with running 3-0 vicryl suture. The skin was closed with running subcuticular 4-0 monocryl suture dermabond was applied