Etiopathogenesis of oblique inguinal hernia, new concept of its surgical treatment, postoperative complications and their correction

Objective. To study the results of applying a new conceptual approach to the surgical treatment of oblique inguinal hernia in order to reduce the frequency of its recurrence and preserve the function of the male reproductive system. Materials and methods. The study is based on the results of topographic and anatomical examination of 50 unfixed male cadavers on the 1st day after death. As clinical material, 144 patients who were inpatients in the surgical department were involved in the study. Results. Patients of the main group (n=71) underwent hernioplasty according to the developed method. The control group included 73 patients operated on by the Lichtenstein method. The etiopathogenetic basis of oblique inguinal hernia and the causes of its recurrence, the frequency of which after open and laparoscopic use of mesh implants is 5 – 15%, were studied. It is after the use of these implants in the Lichtenstein operation that a complication no less important than recurrence occurs, which is a decrease or even loss of male reproductive function. Conceptually, the new approach is to eliminate the deep inguinal ring, move the spermatic cord under the transverse fascia, and create a new inguinal ring. Conclusions. The proposed method of hernioplasty has significant advantages over the Lichtenstein method of surgery, which are to prevent recurrence of the disease and preserve male reproductive function.