Я никогда не слыхал...
Он её оперировал с тампонированием вот такой штукой...
No 1
From: SURGINET: General Surgery Discussion List [mailto:SURGINET@listserv.utoronto.ca] On Behalf Of Moshe Schein
Sent: 10 September 2013 07:06 PM
To: SURGINET@listserv.utoronto.ca
Subject: Velpeau hernia:
Members,
Today I repaired my first case of a Velpeau hernia.
Should I elaborate ?
M
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No 2
• Velpeau hernia: a hernia in the groin in front of the femoral blood vessels ? ? ?
Moshe, can you, please, ask Dan to draw it, please...
Slava
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From: "Dr. Nenad Bijelic" <nenad.bijelic@KC.T-COM.HR>
Date: 10 September 2013 10:57:00 PM SAST
To:
Subject: Re: Velpeau hernia:
Slava
Nenad
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No 3
Slava,
No need for a drawing.
Patient 30 years old, male, thin and tall. Manual worker.
Presented with a painful groin hernia.
On examination a bulge and a "thrill" pointing UNDER the inguinal ligament....just lateral to the femoral pulse.
"Atypically lateral to where the usual femoral hernia should be ", I thought...
Today, under local anesthesia and sedation I placed a 4 cm incision above the inguinal ligament. Opened the external oblique fascia to expose the conjoint tendon, inguinal ligament and cord.
Lifted up the cord....did not find any indirect hernia.
Next I split the fascia transversalis and found a large hernia sac pointing down behind the inguinal ligament and anterior to the pubic bone and femoral vessels. I reduced the hernia....the defect admitted 2.5 fingers. I never saw a hernia in this specific location before --
Next I took a plug made out of light mesh (Proloop, Atrium) extra -large size..very soft (see attached image) and inserted it into the defect. I sutured it with 20 vicryl to the abdominal wall muscles to the internal ring, laterally; the conjoint tendon above; the pubic tubercle medially; and public bone below--taking care to avoid the femoral vessels.
Next I placed a patch of the same soft mesh anterior to the plug and behind the cord...fixing it all around as usual with 20 vicryl...
Finally I reapproximated the aponeurosis anterior to the cord with 20 vicryl.
The subcut fascia with vicryl 30...the skin with subcuticular monocryl.
Patient went back to his room and walked to his car after 3 hours.
My first Velpeau hernia!
Cheers,
Moshe
http://i.ebayimg.com/t/Atrium-Proloop-M ... ~60_35.JPG
