CAUSES OF INGUINAL HERNIAS RECURRENCE DURING THE LIECHTENSTEIN OPERATION

Numerous methods of plastic surgery inguinal hernias with own tissues, which were developed by surgeons, gave relapses up to 35%. A large number in the treatment tension forced surgeons look for new ways solve this problem.
 Without pathological changes deep ring, a hernia cannot occur, and leads conclusion that all existing methods, are aimed at strengthening only front wall canal, pathogenetically unfounded often recurrence can be expected.
 Therefore, justified operation various types is ring back canal.
 Changing concept approach should minimizing trauma take into account pathogenetic features development hernias.
 The reason expansion, destruction, functional insufficiency openings: medial lateral.
 canal does not have protective function when intraperitoneal pressure increases resist formation. At same time, its weakening, destruction contribute increase internal opening. Although we did come across any publication an example exiting directly through Based on our clinical experience, as well processing literary sources, offer modified type Lichtenstein's following interpretation: typical incision skin subcutaneous tissue opening aponeurosis external oblique abdominal muscle; mobilization spermatic cord; sac, opening, stitching base removal. With direct hernia, if bag small, there no need remove it. Revision case and, necessary, sewing it required size (the tip little finger pass between cord ring).
 suturing "tightly" over hernial protrusion.
 Prepare mesh implant so dimensions cover both holes, dissect according proposed method. Fix net using described Sew lower part overlap 1-1.5 cm pubic bone, fix lateral edge ligament wrapping suture or knotted single sutures.
 Above cord, legs dissected sewn together muscle abdomen from below.
 manner above.
 middle fixed separate stitches. We lay mesh, sew abdomen, skin.
 In opinion, method us most optimal, minimally traumatic, best meets modern requirements pathogenesis disease. But even ideal needs constant improvement.