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Results of surgical treatment of large scrotal hernias using the peduncled fascial flap with the hernial sac left in place
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Abstract
Material and methods: Between 10.07.1998 and 03.12.2004, sixty patients underwent indirect scrotal hernia repairs. The inguinal canal was reconstructed with the peduncled fascial flap taken from the medial crus of the aponeurosis of the external oblique abdominal muscle. The second basic element of surgery involved leaving the funicular part of the hernial sac in place having been drained using Redon’s method with hypotension. The drain was removed between the 2nd and 4th postoperative day, depending on any persisting leakage. The average time of removal was 48 hours.
Results: During the postoperative period the following complications developed: 3 recurrences, 13 cases of transient testis oedema, 6 cases of hypoasthesia in the operation wound area, 2 cases of epidydimitis, 1 scrotal hydrolece in the hernial sac, 1 purulent testitis requiring amputation of the testis together with the spermatic cord.
Conclusions: The operative technique used strengthens the inguinal canal without causing tension, effectively preventing recurrences of inguinal as well as femoral hernias. Leaving the peripheral hernial sac in place eliminates possible intraoperatrive damage to the spermatic cord while Redon’s drainage method provides good conditions for the accretion of the walls of the sac and its later atrophy.
Abstract
Material and methods: Between 10.07.1998 and 03.12.2004, sixty patients underwent indirect scrotal hernia repairs. The inguinal canal was reconstructed with the peduncled fascial flap taken from the medial crus of the aponeurosis of the external oblique abdominal muscle. The second basic element of surgery involved leaving the funicular part of the hernial sac in place having been drained using Redon’s method with hypotension. The drain was removed between the 2nd and 4th postoperative day, depending on any persisting leakage. The average time of removal was 48 hours.
Results: During the postoperative period the following complications developed: 3 recurrences, 13 cases of transient testis oedema, 6 cases of hypoasthesia in the operation wound area, 2 cases of epidydimitis, 1 scrotal hydrolece in the hernial sac, 1 purulent testitis requiring amputation of the testis together with the spermatic cord.
Conclusions: The operative technique used strengthens the inguinal canal without causing tension, effectively preventing recurrences of inguinal as well as femoral hernias. Leaving the peripheral hernial sac in place eliminates possible intraoperatrive damage to the spermatic cord while Redon’s drainage method provides good conditions for the accretion of the walls of the sac and its later atrophy.
Keywords
scrotal hernia; aponeurosis; hernial sac; new technique


Title
Results of surgical treatment of large scrotal hernias using the peduncled fascial flap with the hernial sac left in place
Journal
Chirurgia Polska (Polish Surgery)
Issue
Pages
31-42
Published online
2005-05-06
Page views
794
Article views/downloads
1895
Bibliographic record
Chirurgia Polska 2005;7(1):31-42.
Keywords
scrotal hernia
aponeurosis
hernial sac
new technique
Authors
Roman Kuśnierczyk
Adam Wójcik