Inguinal Hernia Repair, Sliding (Open) (Lichtenstein)
OPERATION: Open Mesh Repair of Large Sliding Inguinal Hernia
ANAESTHETIC: General anaesthesia
ANTIBIOTICS: Co-amoxiclav at induction
FINDINGS: Large sliding inguinal hernia. Anatomy distorted. Sac containing bowel and omentum.
PROCEDURE:
Incision along medial two-thirds of line joining ASIS with pubic tubercle.
Dissected down to and through external oblique aponeurosis.
Large hernia with distorted anatomy. Sac opened - bowel reduced, omentum adherent to sac.
Difficult dissection to isolate cord structures from sac.
Sliding hernia sac delineated and reduced. Deep ring and posterior wall repaired with Prolene.
Ultrapro mesh applied and secured with 2-0 Prolene. New superficial ring created.
CLOSURE:
Vicryl subcutaneous sutures. Clips to skin.
POST-OPERATIVE INSTRUCTIONS:
Regular observations. Eat and drink as tolerated.
Continue oral antibiotics for 5 days.
Clip removal in 14 days. Avoid excess straining for 2 weeks.