Video of tension-free hernia repair surgery

Tension-free hernia repair is one of the commonly used surgical methods for treating hernias, characterized by mild postoperative pain and low recurrence rates. The procedure must be performed at a正规 hospital. The specific steps are as follows:

1. The patient lies supine on the operating table. The anesthesiologist administers general anesthesia. The surgeon performs routine disinfection of the inguinal region and drapes it with sterile towels.

2. After the anesthesia takes effect, the surgeon makes an incision approximately 2 cm above the inguinal ligament. The incision starts at the midpoint of the inguinal ligament, extends slightly obliquely outward, and runs parallel to the ligament, ending just above the pubic tubercle.

3. The skin and subcutaneous tissues are gradually dissected to expose the external oblique aponeurosis and the external ring.

4. Using a toothed clamp, the external oblique aponeurosis is lifted. A curved hemostat is used carefully to separate the deep tissues, pushing aside the ilioinguinal nerve beneath the aponeurosis. A straight scissors is then used to cut the aponeurosis along its fiber direction. The two leaflets of the aponeurosis are subsequently separated and retracted using blunt dissection.

5. A retractor is used to pull back the ilioinguinal nerve, external and internal oblique muscles, transversus abdominis muscle, and their conjoint tendon, fully exposing the cremaster muscle. The cremaster muscle is dissected along its fibers until the hernia sac becomes visible.

6. An assistant uses a toothed forceps in one hand to gently lift the hernia sac, while the other hand lifts another point on the sac about 0.5 cm away. The surgeon then makes an incision between these two points to open the hernia sac.

7. A hemostat is used to grasp the edge of the incised hernia sac. The left hand lifts the sac while placing a finger inside it to support the sac wall. The right hand, wrapped in saline-soaked gauze, uses blunt dissection to separate the hernia sac from surrounding tissues and the spermatic cord.

8. The neck of the hernia sac is completely freed and then cut horizontally at mid-level, dividing the sac into proximal and distal portions. The hemostat is used to pull the sac peripherally, allowing all contents within the sac to be reduced back into the abdominal cavity. Silk sutures are then used to ligate the neck of the hernia sac.

After surgery, patients should avoid straining during bowel movements or coughing for a short period, as this may increase intra-abdominal pressure and impair wound healing.