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Outcome of femoral hernia repair with a pediculated fascial flap
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Abstract
Material and methods: Between 3.04.98 and 14.12.2004, 35 patients underwent femoral hernia repair using a transinguinal access. The hernia ring was secured with a pediculated flap taken from the medial crus of the aponeurosis of the external oblique abdominal muscle; the inguinal canal was strengthened by duplication of the transverse fascia and lateral crus of the aponeurosis.
Results: During the postoperative period, neither femoral nor inguinal hernia recurrences were found; the wounds were healed by first intention. In only 3 patients was transient hypoaesthesia within the fossa ovalis skin observed, which subsided spontaneously. No other complications developed.
Conclusions: A transinguinal access provides good conditions for repair of the femoral hernia sac and for intraoperative diagnosis of multiple hernias as it is safe in the preparation of femoral foramen structures. The operative technique proposed strengthens the myopectoneal hiatus without causing tension, effectively preventing recurrences of femoral and inguinal hernias. The use of the patient’s own fascial tissue (pediculated fascial flap) in the vicinity of the femoral vein and deep lymphatic system of the lower limb is safe and creates no risk of thrombosis or lymphorrhagia.
Abstract
Material and methods: Between 3.04.98 and 14.12.2004, 35 patients underwent femoral hernia repair using a transinguinal access. The hernia ring was secured with a pediculated flap taken from the medial crus of the aponeurosis of the external oblique abdominal muscle; the inguinal canal was strengthened by duplication of the transverse fascia and lateral crus of the aponeurosis.
Results: During the postoperative period, neither femoral nor inguinal hernia recurrences were found; the wounds were healed by first intention. In only 3 patients was transient hypoaesthesia within the fossa ovalis skin observed, which subsided spontaneously. No other complications developed.
Conclusions: A transinguinal access provides good conditions for repair of the femoral hernia sac and for intraoperative diagnosis of multiple hernias as it is safe in the preparation of femoral foramen structures. The operative technique proposed strengthens the myopectoneal hiatus without causing tension, effectively preventing recurrences of femoral and inguinal hernias. The use of the patient’s own fascial tissue (pediculated fascial flap) in the vicinity of the femoral vein and deep lymphatic system of the lower limb is safe and creates no risk of thrombosis or lymphorrhagia.
Keywords
femoral hernia; aponeurosis; fascial flap; new technique


Title
Outcome of femoral hernia repair with a pediculated fascial flap
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
85-94
Published online
2005-09-06
Page views
703
Article views/downloads
1813
Bibliographic record
Chirurgia Polska 2005;7(2):85-94.
Keywords
femoral hernia
aponeurosis
fascial flap
new technique
Authors
Roman Kuśnierczyk
Wiesław Piątkowski