Inguinal Hernia Surgery by Giampiero Campanelli

Author:Giampiero Campanelli
Language: eng
Format: epub
Publisher: Springer Milan, Milano

Fig. 11.12Genitofemoral nerve on the left

Fig. 11.13Dissection of indirect sac on the left side

Fig. 11.14Cord lipoma on the left side

11.3.3 11.3.3 Mesh Placement

Once the correct extent of the landing zone is achieved and hemostasis is secured an adequate mesh is inserted. According to the EHS [10] and the IEHS guidelines [7], today “adequate” means: a 15 × 10 cm or larger, macroporous flat mesh. The former criterion of weight per m2 was substituted by the term “effective porosity”, indicating the extent and quality of the tissue ingrowth. The mesh should be placed wrinkle- and fold-free (Figs. 11.15 and 11.16) respecting the well-defined anatomic landmarks. Especially the inferior mesh margin has to show a safety distance from the lowest lateral dissection area of the “landing zone” in order to prevent its lifting-up when closing the peritoneum (Fig. 11.17).

Fig. 11.15Two separate meshes overlapping the symphysis pubis, left view

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