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Year 2012 Vol. 20 No 3
GENERAL AND SPECIAL SURGERY
S.A. VIZGALOV 1, S.M. SMOTRIN 2
COMBINED ATENSIONAL HERNIOPLASTY AT EXTERNAL INGUINAL HERNIAS
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.
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230009, Respublika Belarus', g. Grodno, ul. Gor'kogo, d. 80, UO “Grodnenskii gosudarstvennyi meditsinskii universitet”, kafedra khirurgicheskikh boleznei ¹2 s kursom urologii,
Vizgalov Sergey Aleksandrovich
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 ¹2 with the Course of Urology of EE “Grodno StateMedical University”.