Rutkow plug repair in inguinal hernia - general and visceral surgery

You have not purchased a license - paywall is active: to the product selection
date of publication: 18.09.2009
  • Chirurgische Praxis

    Moser

Single Access

Access to this lecture
for 3 days

€4.99 inclusive VAT

payment

webop-Account Single

full access to all lectures
price per month

for the modul: vascular surgery

from 8,17 €

hospitals & libraries

for the modul: vascular surgery

from 390,00 euros

  • Principle

    • 26-6

    In the Rutkow plug repair for inguinal hernia a cone-shaped shell (plug) is inserted into the local defect posterior to the transversalis fascia. A second flat mesh, the onlay patch (resembling the Lichtenstein prosthesis) is placed anterior to the plug.

  • Inguinal skin incision

    Video
    • 26-7

    Make the skin incision, measuring about 4 cm, in the line of the inguinal canal 2 fingers medial to it (solid line), or make a transverse incision 2 fingers superior to the pubic bone. Then divide the subcutaneous tissue down to the external oblique aponeurosis.

  • Division of the external oblique aponeurosis

    Video
    • 26-8

    Now longitudinally divide the fibers of the external oblique, including the superficial inguinal ring. After clamping the aponeurotic flaps and retracting them upward, free the aponeurosis from the internal oblique and cremaster by blunt dissection.

    Caution: The iliohypogastric nerve courses immediately below the aponeurosis!

  • Mobilization and taping of the spermatic cord

    Paid content (video)
    • Paid content (image)
    Paid content (text)
  • Preparation of the hernia sac

    Paid content (video)
    • Paid content (image)
    Paid content (text)
  • Hernia sac management

    Paid content (video)
    • Paid content (image)
    Paid content (text)
  • Plug insertion

    Paid content (video)
    • Paid content (image)
    Paid content (text)
  • Plug buttressing

    Paid content (video)
    • Paid content (image)
    Paid content (text)
  • Closure of the external oblique aponeurosis

    Paid content (video)
    • Paid content (image)
    Paid content (text)
  • End of procedure

    Paid content (video)
    • Paid content (image)
    Paid content (text)