Improvement of results of surgical treatment of giant hernias of inguinofemoral region by choice of method of hernioplasty (clinical case)

Aim. Description of a clinical case pf patient K., 71 years old, as an illustration of the possibility to improve treatment of giant hernias in the inguinofemoral region. The patient was hospitalized with the diagnosis: bilateral giant irreducible inguinoscrotal hernia. The specificity of this case was implementation of the operation of hernioectomy from preperitoneal access with prosthetics of the posterior surface of the anterior abdominal wall with polypropylene (prolene) mesh on both sides. In a month after discharge from hospital the condition remained satisfactory, postoperative scar was normotrophic, testicles painless to palpation with a small amount of fluid in the dartos, skin of scrotum contracted.

Conclusion. Hernioectomy from preperitoneal access with prosthetics of the posterior surface of the anterior abdominal wall with polypropylene (prolene) mesh in patients with giant, irreducible and recurrent hernias possesses a number of peculiarities in comparison with traditional methods, since it permits: 1) to fix endoprosthesis to permanent anatomical structures with simultaneous repair of all the defects of the transverse fascia; 2) to operate outside the zone of scar tissue in recurrent hernias; 3) to perform an adequate revision of the organs of the hernial sack in irreducible hernias; 4) to perform operations on patients with distinct comorbid pathology and contraindications to general anesthesia.