Inguinal, umbilical, femoral hernia, hernia of linea alba, postoperative hernia

Researching history of inguinal hernia First information about hernia was founded in papyruses of ancient Egypt, dated at 1500 years b.c. First anatomic researches of inguinal area was performed by Halenus (II century a.d.) Celsus was the first, used word “hernios” for meaning of hernia (25 b.c. ). Exactly Celsus was the first, who treated hernias surgically.

Klaudius Halenus

the first exactly describing of inguinal hernia was done by Guy de Chauliac in 1363. Historic break in gerniology is connected with the name of Italian surgeon Bassini, founded union conception in surgical treatment of inguinal hernia. He performed his first operation in 1884. He separated out 3 more important stages in his report in 1887.

Francesco Graziani Constance Nantieur-Didieur Aquille de Bassini.

In 1959 F.Usher for the first time used a synthetic material – polypropylene – to support back wall of inguinal ring. In 1982 R.Ger for the first time was performed laparoscopic hernioplastic.

Plastic of inguinal canal with using synthetic prothesis (Lichtenstein operation)

Researching history of femoral hernia First information about hernia was founded in papyruses of ancient Egypt, dated at 1500 years b.c. Celsus was the first, used word “hernios” for meaning of hernia (25 b.c. ). Exactly Celsus was the first, who treated hernias surgically.

Ancient method of reducing of hernia

Preventing of hernia in ancient time

Researching history of umbilical hernia First information about hernia was founded in papyruses of ancient Egypt, dated at 1500 years b.c. Celsus was the first, used word “hernios” for meaning of hernia (25 b.c. ). Exactly Celsus was the first, who treated hernias surgically.

Avl Cornelius Celsus

In 1891 L.Tait offered laparotomic approach for the treatment of umbilical hernia.

Researching history of hernia of white line of abdomen First information about hernia was founded in papyruses of ancient Egypt, dated at 1500 years b.c. Celsus was the first, used word “hernios” for meaning of hernia (25 b.c. ). Exactly Celsus was the first, who treated hernias surgically.

Topography of the inguinal triangle Aponeurosis of the external oblique muscle Spermatic cord Internal oblique muscle Transverse muscle

Inside view of the bottom of the anterior abdominal wall 1 — m. rectus abdominis; 2 — lig. interfoveolare; 3 — anulus inguinalis profundus; 4 — lig. inguinale; 5 — a. et v. epigastrica inferior; 8 — a. et v. iliaca externa; 10 — n. obturatorius; 13 — ductus deferens; 14 — vesica urinaria;

Oblique inguinal hernia

Direct inguinal hernia

Presentation of obliqual inguinal hernias by Krimov A.P. In the canal beginning Hernia of funicullus spermaticus Inguinal - scrotal

Presentation of direct inguinal hernias by Kukudzhanov N.I. innitial interstitional Inguinal - scrotal

Congenital and acquired inguinal hernia Hernial sac ovary

Distinctive features of congenital and acquired inguinal hernias Congenital inguinal hernia Is more common in young More common in older Often one-sided Often both sided Descends into the scrotum Rarely falls into the scrotum Pear-shaped Round shape Cough symptom is determined from the outside of the internal inguinal ring Symptom cough shock is determined by the opposite internal inguinal ring Hernial sac is located outside of the spermatic cord Hernial sac is located inside of the spermatic cord

Incision for inguinal hernias

Plastic of the front wall of the inguinal canal (Girard way)

Plastic of the front wall of the inguinal canal (Spasukukockiy method)

Plastic of the front wall of the inguinal canal (Girard-Spasukukocky method with seams Kimborovsky)

Plastic of the rear wall of the inguinal canal Bassini method

A method for performing operations in congenital inguinal hernias

Topography of the femoral triangle

Type of femoral hernia

Operational methods for femoral hernias Operations through the inguinal access Method of Rudzhi Method of Rudzhi-Parlavechio Method of Reich Method of Praksin Operations through the femoral access Method of Lockwood Method of Lockwood-Bassini Method of Lockwood-Krymov Method of Abrazhanov

Incisions for the femoral hernias

Rudgy’s method

Reith’s method

Praksin’s method

Method of Lockwood

Method of Lockwood-Bassini

Method of Abrajanov

Surgical anatomy of umbilical hernias 1 — skin; 2 — subcutaneous fat; 3 — the contents of the hernia; 4 — m. rectus abdominis; 5 — fascia transversalis; 6 — peritoneum; 7 — hernial sac

Incisions for the umbilical hernias 1- Sapezhko’s method 2- Mayo’s method 3- Lexer ‘s method

Plastic by Lexer

Plastic by Sapezhko

Plastic by Mayo

Development of the hernia of the white line of abdomen 1 – preperitoneal lipoma 2 – beginning the swelling of the peritoneum 3 – formed hernial sac

Plastic of the abdominal wall by Voznesensky

Plastic of the abdominal wall by Shampioner

Duties of the general practitioner in hernias - Provision of primary health and social care; - Health education (promoting healthy lifestyles); - Preventive work (timely detection of early and latent forms of the disease, risk groups); - Dynamic monitoring; - Emergency assistance in case of emergency and acute conditions; - Timely consultation and hospitalization in the prescribed manner; - Medical and rehabilitation work in accordance with the qualifying characteristic; - An examination of temporary disability; - The organization of medical and social care and household together with the bodies of social protection and services of mercy alone, the elderly, the disabled, the chronically ill; - Maintaining the approved forms of records and reports.