The Internet Journal of Surgery™ ISSN: 1528-8242

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Simple maneuver to place the skin incision for inguinal hernia

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Naguib NN
Department of Surgery
Prince Charles Hospital

Citation: N. NN : Simple maneuver to place the skin incision for inguinal hernia. The Internet Journal of Surgery. 2009 Volume 21 Number 2

Technique
Correspondence to

Abstract

I describe a simple maneuver to place the skin incision for the inguinal hernia repair. All the open operative techniques for inguinal hernia repair use a transversely oriented slight curvilinear skin incision of 6-8cm positioned one to two fingerbreadths above the inguinal ligament¹. Classically the incision is made between the anterior superior iliac spine and the pubic tubercle². Technically it may be difficult to identify these two landmarks. Hence, the exposure can be very difficult especially in obese patients³.

Technique

Simply, the external inguinal ring can be identified through the skin by the external ring test which was previously used to differentiate between the diagnosis of the direct and indirect hernia, Fig. 1. The examining finger is introduced in the inguinal canal to delineate it and the incision is placed directly on the inguinal canal starting from the site of the external inguinal ring, Fig. 2. Dissecting the subcutaneous tissues directly goes down to the external oblique fibers, Fig. 3.

Fig. 1: Identification of the external ring through the skin.

Fig. 2: The incision is placed directly over the inguinal canal.

Fig. 3: The dissection deepened leading directly to the external oblique fibers (opened) at the level of the external ring.

Correspondence to

Mr. N. Naguib
Prince Charles Hospital
Merthyr Tydfil CF479DT
Email; nadernaguib71@yahoo.com

References

1. Maingot R, Zinner MJ and Ashley SW. Maingot’s abdominal operations, 11th Edition. Published by McGraw-Hill Professional, 2007; 108. (s)

2. Schwartz SI, Brunicardi FC and Andersen DK. Schwartz's Manual of Surgery, 8th edition. Published by McGraw-Hill Professional, 2006; 930. (s)

3. Morrey MC, Relevant Surgical Exposures: Relevant Surgical Exposures, illustrated edition. Published by Lippincott Williams & Wilkins, 2007; 129. (s)

This article was last modified on Tue, 29 Dec 09 21:50:37 -0600

This page was generated on Sat, 20 Mar 10 18:29:45 -0500, and may be cached.


	The Internet Journal of Surgery™ ISSN: 1528-8242 \| Home \| Editors \| Current Issue \| Archives \| Instructions for Authors \| Disclaimer \| Share with others \| Simple maneuver to place the skin incision for inguinal hernia Read printer friendly Subscribe in a reader Share with others Naguib NN Department of Surgery Prince Charles Hospital Citation: N. NN : Simple maneuver to place the skin incision for inguinal hernia. The Internet Journal of Surgery. 2009 Volume 21 Number 2 Table of Contents Technique Correspondence to Abstract I describe a simple maneuver to place the skin incision for the inguinal hernia repair. All the open operative techniques for inguinal hernia repair use a transversely oriented slight curvilinear skin incision of 6-8cm positioned one to two fingerbreadths above the inguinal ligament¹. Classically the incision is made between the anterior superior iliac spine and the pubic tubercle². Technically it may be difficult to identify these two landmarks. Hence, the exposure can be very difficult especially in obese patients³. Technique Simply, the external inguinal ring can be identified through the skin by the external ring test which was previously used to differentiate between the diagnosis of the direct and indirect hernia, Fig. 1. The examining finger is introduced in the inguinal canal to delineate it and the incision is placed directly on the inguinal canal starting from the site of the external inguinal ring, Fig. 2. Dissecting the subcutaneous tissues directly goes down to the external oblique fibers, Fig. 3. Fig. 1: Identification of the external ring through the skin. Fig. 2: The incision is placed directly over the inguinal canal. Fig. 3: The dissection deepened leading directly to the external oblique fibers (opened) at the level of the external ring. Correspondence to Mr. N. Naguib Prince Charles Hospital Merthyr Tydfil CF479DT Email; nadernaguib71@yahoo.com References 1. Maingot R, Zinner MJ and Ashley SW. Maingot’s abdominal operations, 11th Edition. Published by McGraw-Hill Professional, 2007; 108. (s) 2. Schwartz SI, Brunicardi FC and Andersen DK. Schwartz's Manual of Surgery, 8th edition. Published by McGraw-Hill Professional, 2006; 930. (s) 3. Morrey MC, Relevant Surgical Exposures: Relevant Surgical Exposures, illustrated edition. Published by Lippincott Williams & Wilkins, 2007; 129. (s) This article was last modified on Tue, 29 Dec 09 21:50:37 -0600 This page was generated on Sat, 20 Mar 10 18:29:45 -0500, and may be cached.
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