Year 2012 Vol. 20 No 3




ME City clinical emergency hospital, Grodno 1,
EE Grodno State Medical University 2,
The Republic f Belarus

Objectives. To work out a new method of the combined atensional hernioplasty at inguinal hernias and to evaluate its immediate results.
Methods. A new atensional method of the inguinal canal plasty at the external abdominal hernias has been designed. The proposed method provides the inguinal canal posterior wall strengthening with the aponeurosis flap of the external oblique abdominal muscle and the anterior wall is formed from the meshy endoprosthesis. The method was applied in 25 patients. The control group included 25 patients who had been operated on using Bassini method. All patients were subjected to ultrasound scanning of both inguinal-scrotal areas the day before the operation and 5 days after it. During the whole postoperative period the intensiveness of the pain syndrome was being evaluated in the patients.
Results. It has been found out that the patients with inguinal hernias have hemodynamics disturbances in the testicle parenchyma. Decrease of the maximal systolic and diastolic speed of the blood flow has been registered. The most evident decrease of the blood flow was in the patients with the direct inguinal hernias. In the postoperative period the increase of the intratesticular blood flow speed was noted in the patients with the oblique and direct inguinal hernias. These parameters were significantly higher in the patients of the main group than the control one. At the same time in the control group of patients the resistance index increased considerably that testifies to the compression of the spermatic cord elements in deep inguinal ring forming. The designed atensional hernioplasty eliminates the present intratesticular hemodynamic disturbances. But the pain syndrome intensiveness is considerably higher at the atensional hernioplasty than at the Bassini tension plasty.
Conclusions. The combined atensional hernioplasty method permits to level the detected blood supply disturbances in the testicle, typical for the Bassini tension plasty and thus to improve the immediate treatment results.

Keywords: inguinal hernias, atensional plasty, intratesticular blood flow, pain syndrome
p. 9 15 of the original issue

1. Shliakhovskii IA, Chekmazov IA. Sovremennye aspekty khirurgicheskogo lecheniia gryzh briushnoi stenki [Current aspects of surgical treatment of abdominal wall hernias]. Abdomin Khirurgiia. 2002:4(7):4447.
2. Kharnas SS, Samokhvalov LI, Ippolitov AV. Gryzhi perednei briushnoi stenki (klinika, diagnostika, lechenie): ucheb posobie. [Hernias of the anterior abdominal wall (clinical picture, diagnosis, treatment): textbook]. Moscow, RF: Russkii vrach; 2009. 84 p.
3. Bekoev VD. Retsidiv pakhovoi gryzhi (problema i puti vozmozhnogo resheniia. [Recurrence of inguinal hernia (the problem and possible ways of solving]. Khirurgiia. 2003:(2):4547.
4. Timoshin AD, Iurasov AV, Shestakov AL, Fedorov DA. Sovremennye metodiki khirurgicheskogo lecheniia pakhovykh gryzh: metod. rekomendatsii [Modern methods of surgical treatment of inguinal hernia: a guideline]. Moscow, RF; 2002. 36 p.
5. Volod'kin VV. Voprosy patogeneza i lecheniia pakhovykh gryzh [Some aspects of pathogenesis and treatment of inguinal hernia]. Novosti Khirurgii. 2007;15(2):11220.
6. Egiev VN, Chizhov DV, Rudakova MN, Egiev VN. Plastika po Likhtenshteinu pri pakhovykh gryzhakh [Plasticity in the of Liechtenstein with inguinal hernias]. Khirurgiia. 2000;(1):1922.
7. Kuzin NM, Dalgatov KD. Sovremennye metody lecheniia pakhovykh gryzh [Modern methods of treatment of inguinal hernias]. Vestn Khirurgii. 2002; 161(5):10710.
8. Protasov AV. Reproduktivnaia funktsiia muzhchin posle pakhovogo gryzhesecheniia [Reproductive function after inguinal herniotomy]. Urologiia i Nefrologiia. 1999;(2):4648.
9. Vizgalov SA, Smotrin SM. Sposob kombinirovannoi atenzionnoi gernioplastiki. [The method of combined tension-free hernioplasty: pat.N14259 Resp. Belarus' ; zaiavitel' Grodn. gos. med. un-t. a 20081392; publ. 30.04.11. Afitsyiny Biul. Nats Tsentr intelektual ulasnastsi. 2011;(2):50.
10. Breivik H. Assessment of pain. Br J Anaes. 2008;101(1):1724.

Address for correspondence:
230009, Respublika Belarus', g. Grodno, ul. Gor'kogo, d. 80, UO Grodnenskii gosudarstvennyi meditsinskii universitet, kafedra khirurgicheskikh boleznei 2 s kursom urologii,
Vizgalov Sergey Aleksandrovich
Information about the authors:
Vizgalov S.A., a Surgeon of the Surgical Department of ME Grodno City Clinical Emergency Hospital.
Smotrin S.M., Doctor of Medical Sciences, Professor of the Surgical Diseases Chair 2 with the Course of Urology of EE Grodno StateMedical University.
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