Generally speaking, the incidence of indirect inguinal hernia in men is very high, and when treating indirect inguinal hernia, it is also necessary to choose an appropriate way. So, how should we treat indirect inguinal hernia?
1. High ligation:
The operation exposed the neck of the oblique hernia sac at the inner ring, and high ligation or through suture was performed at the root of the neck with thick silk thread, and then the hernia sac was cut off. This operation does not repair the weak area of the groin area, so it is only applicable to infants, because the growing abdominal muscles can strengthen the abdominal wall; But for adults, recurrence cannot be prevented. The hernia sac resection and high ligation is also applicable to the cases of intestinal necrosis caused by strangulation of oblique hernia with severe local infection. At that time, herniorrhaphy could not be performed.
2. Hernia repair:
It is the most common operation for indirect inguinal hernia. The repair was carried out on the basis of high cutting and ligation of the hernia sac neck. The repair should include two main links: inner ring repair and inguinal tube wall repair. The inner ring repair is only applicable to cases with enlarged and loose inner ring; After the high ligation of the hernia sac neck, the abdominal transverse fascia at the inner ring is intermittently stitched or an "8" suture is made to strengthen the loose and enlarged inner ring due to the frequent passage of hernia contents. This is an important step in hernia repair, which can reduce the recurrence of hernia after surgery; However, it is unnecessary for patients with insignificant defects in the inner ring area. Strengthening or repairing the inguinal wall is the main procedure of most inguinal hernia operations. But up to now, there is no one operation that can be applied to all kinds of situations, so there are many methods. Usually, there are two kinds of operations: strengthening the anterior and posterior inguinal wall. (The various operations are named after the creator who advocates how to repair them).
The method of strengthening the anterior wall of groin is Ferguson method. After cutting off the neck of the hernia sac for high ligation, without releasing the spermatic cord, sew the lower edge of the internal oblique muscle and the transverse aponeurosis arch (or joint tendon) in front of the spermatic cord to the inguinal ligament, in order to eliminate the gap between the above two weak areas. This is a repair to strengthen the anterior wall of the inguinal canal. This method is applicable to small indirect hernia in children and young people who have no obvious defect in the transverse aponeurosis arch and the posterior wall of the inguinal canal is still tendinous.
