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Vol 7, No 1 (2005)
Published online: 2005-05-06
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Results of surgical treatment of large scrotal hernias using the peduncled fascial flap with the hernial sac left in place

Roman Kuśnierczyk, Adam Wójcik
Chirurgia Polska 2005;7(1):31-42.

open access

Vol 7, No 1 (2005)
Published online: 2005-05-06

Abstract

Background: This paper presents the results of surgical treatment of patients with large scrotal hernias with the hernial sac left and drained using Redon’s method.
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

Background: This paper presents the results of surgical treatment of patients with large scrotal hernias with the hernial sac left and drained using Redon’s method.
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.
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Keywords

scrotal hernia; aponeurosis; hernial sac; new technique

About this article
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

Vol 7, No 1 (2005)

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

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