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Acta
Medica Medianae
Vol. 45
No 4, October, 2006
UDK 61
YU ISSN 0365-4478
Contact:
Miodrag Radunovic
Surgical Clinic of Clinical Center
81000
Podgorica,
Montenegro
Phone: 081/ 243-952,
E-mail:
bobo_radunovic@yahoo.com
Copyright 2006
by Faculty of Medicine, University of Nis
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ANATOMICAL FEATURES AND MEASURING OF THE APPROXIMATE
MUSCLE TENSION IN THE COURSE OF SELECTION OF A METHOD OF INGUINAL HERNIAS
REPAIR
Miodrag Radunovic 1
and Miroslav Radunović 2
Surgical
Clinic of Clinical Center in Podgorica1
Institute of Anatomy of Faculty of Medicine in Podgorica2
Hernia repair
represents the most frequent surgical operation.
The objective of the research is determination of anatomical features of
the inguinal canal and measuring of the approximate muscle tension as well
as justification of the relaxing incision application in the process of
the hernia repair in this region.
The research is based on the prospective study including 120 patients, who
underwent the operation in the General Hospital in Berane. 60 of them went
through measuring of the inguinal canal length, referential angle (α),
overlapping of musculoaponeurotic arch with m.rectus abdominis (H),
distance between the arch and inguinal ligament (L) as well as measuring
of the surface of myopectineal orifice (P1) and deep opening of the
inguinal canal (P2).
Approximate muscle tension was also measured before and after the relaxing
incision.
Control group was treated using conventional methods without previous
measurements. Percentage of relapse was 6,6% in that group.
The measured values were correlated. Inguinal canal length was in the
range from 4,5 to 5,5 cm (64%). The average value of appendage (H) was
0,52 cm ± 0,34. Referential angle was 116,26 ± 1,68. The average value
P1 was 9,75 cm2 ± 2,66. Surface of the deep opening P2 was
1,71 cm2 ± 1,07. The average values of approximate tension (N)
before relaxing incision were I=19,9; II=22,4; III=21,7; IV=20,7; V=18,0,
and after the relaxing incision the average values were I=15,7; II=17,6;
III=16,7; IV=15,5; V=13,2.
Referential angle (α) and distance of the musculoaponeurotic arch (L) from
the inguinal ligament were measuring parameters, which indicated presence
of tissue tension in the course of suture material placement.
Approximate tension decreased after the relaxing incision and it reached
maximum at the farthest distance L.
Relaxing incision was obligatory.
Local anesthesia was a matter of choice.
Acta Medica Medianae 2006:45(4):15-22.
Key words:
hernia,
approximate tension, relaxing incision, fascia transversalis, reparation
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