Open Inguinal Hernia Repair (Lichtenstein) - Direct Hernia
This Open Inguinal Hernia Repair (Lichtenstein) – Direct Hernia course will teach you:
- Open removal of the hernia sac
- Reefing of the transversalis fascia
- Tension free reinforcement of the posterior wall of the inguinal canal using a mesh in a patient with a direct hernia.
- Performing this procedure under local anesthesia, using the enroute anesthesia technique.
Special attention is paid to the following hazards you may encounter during the Open Inguinal Hernia Repair (Lichtenstein) – Direct Hernia:
- Ilioinguinal nerve injury
- Iliohypogastric nerve injury
- Postoperative hemorrhage
- Genital branch of the genitofemoral nerve injury
- Injury to intra-abdominal organs
- Pubic periosteum injury
- Femoral vessels and nerve injury
- Ilioinguinal nerve entrapment
- Inadequate width of prosthetic ring
With the following tips you might perform the Open Inguinal Hernia Repair (Lichtenstein) – Direct Hernia even better:
- Optimal cosmetic results
- Traction during subcutaneous tissue transection
- Scarpa’s fascia in older patients
- Isolation of the cremasteric vein with the spermatic cord
- Iliohypogastric nerve transection
- Alternative reefing using a purse string suture
- Valsalva maneuver
- Lipoma of the spermatic cord resection
- Determination of the internal inguinal ring with the use of the mesh
- Measuring the width of the new deep inguinal ring
The following anatomical variations are described in this Open Inguinal Hernia Repair (Lichtenstein) – Direct Hernia course:
- Iliohypogastric nerve with two nerve branches
After studying this Open Inguinal Hernia Repair (Lichtenstein) – Direct Hernia course you are familiar with the most common complications:
- Recurrence
- Seroma and surgical site infection
- Chronic postoperative ilioinguinal pain
You might also be interested in:
Open Inguinal Hernia Repair (Lichtenstein) – Cadaver
Totally Extraperitoneal (TEP) Repair – Indirect Hernia
TAPP – Bilateral Direct Hernia
Step by step
External oblique aponeurosis exposure
Skin
Mark
Mark the skin over a length of approximately 6 cm, starting 1 to 1,5 cm cranial to the pubic tubercle in a lateral direction towards the anterior superior iliac spine.
Optimal cosmetic results
It is advised to mark and incise the incision in Langer’s lines, for optimal cosmetic results.
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