nlbarnes
Expert
FINDINGS:
very large, scrotal indirect inguinal hernia, sliding type, with loop of
sigmoid colon in the hernia sac.
(Does colong in hernia sac mean incarcerted?)
Cautery was used to make a 7 cm long oblique incision in the left groin
parallel to the course of the inguinal ligament. The incision was carried
down with the help of Bovie cautery until the external oblique fascia was
identified. The fascia was transected along its fibers with Metzenbaum
scissors and through the external inguinal ring. The cord structures and
the hernia sac were identified, and a Penrose drain was placed around the
cord structures. The vas was clearly identified and preserved. No injury
to the vas was noted.the hernia sac was opened, and sliding hernia,
containing a loop of sigmoid colon with retroperitoneal fat was
identified. The bowel was reduced back into the abdominal cavity. The
decision was made to perform hernia repair with a large mesh.
The mesh was then sutured to the pubic tubercle and to the shelving edge
of the inguinal ligament with a running 2-0 Prolene suture. The superior
portion of the mesh was sutured to the conjoin tendon with another
running 2-0 Prolene suture. The aponeurosis of the external oblique muscle was then repaired with a running 2-0 Vicryl suture. The Scarpa
fascia was approximated with multiple interrupted 3-0 Vicryl sutures, and
very large, scrotal indirect inguinal hernia, sliding type, with loop of
sigmoid colon in the hernia sac.
(Does colong in hernia sac mean incarcerted?)
Cautery was used to make a 7 cm long oblique incision in the left groin
parallel to the course of the inguinal ligament. The incision was carried
down with the help of Bovie cautery until the external oblique fascia was
identified. The fascia was transected along its fibers with Metzenbaum
scissors and through the external inguinal ring. The cord structures and
the hernia sac were identified, and a Penrose drain was placed around the
cord structures. The vas was clearly identified and preserved. No injury
to the vas was noted.the hernia sac was opened, and sliding hernia,
containing a loop of sigmoid colon with retroperitoneal fat was
identified. The bowel was reduced back into the abdominal cavity. The
decision was made to perform hernia repair with a large mesh.
The mesh was then sutured to the pubic tubercle and to the shelving edge
of the inguinal ligament with a running 2-0 Prolene suture. The superior
portion of the mesh was sutured to the conjoin tendon with another
running 2-0 Prolene suture. The aponeurosis of the external oblique muscle was then repaired with a running 2-0 Vicryl suture. The Scarpa
fascia was approximated with multiple interrupted 3-0 Vicryl sutures, and