Chapter 86 Inguinal and Umbilical Hernias
Inguinal Hernia
OPERATIVE STEPS
External Oblique Aponeurosis Division
Separation of the Hernia Sac
Damage to the Vas Deferens
• Prevention
When dissecting the hernia sac, the vas must be carefully identified and protected. A clamp should not be applied to the sac before the vas is identified. The vas and vessels should be gently teased away from the sac and never grasped with a forceps. Merely picking up the vas with forceps has been shown to lead to fibrotic luminal occlusion in rats.5,6
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