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Rutkow plug repair in inguinal hernia - general and visceral surgery
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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
Division of the external oblique aponeurosis
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
Preparation of the hernia sac
Hernia sac management
Closure of the external oblique aponeurosis
End of procedure