Ultrasonic and morphometric description of inguinal canal in hernia in young patients
Introduction. The individual approach to the choice of the method of inguinal herniotomy at the stage of pre-operative preparation is an actual task for practical surgery. Purpose of the study. To conduct a comparative analysis of the results of ultrasonic visualization of the topographic-anatomical parameters of the inguinal canal with the data of intraoperative morphometry. Materials and methods. The work is based on the results of examination of 39 young patients with inguinal hernia of the II, IIIа and IIIb type, according to L.Nyhus. Ultrasonic visualization of inguinal canal was conducted before the operative intervention with the help of Sonoase 5500 device with a linear transducer 7.5 Mhz in В-mode. There were measured the height of inguinal interval, combined thickness of the inner oblique and transverse abdominal muscles that form the upper wall of inguinal channel, and also the diameter of deep inguinal ring. The same topographic-anatomical parameters of the inguinal canal were measured intraoperatively with the help of special device. Operative intervention was conducted under spinal anesthesia in all patients. Results and discussion. For young patients with hernia, the height of the inguinal interval depends on the type of inguinal hernia. Substantial distinctions in the height of the inguinal interval, revealed during ultrasonic visualization and intraoperative morphometry, were not observed. Cumulative thickness of muscles that form the upper wall of the inguinal canal did not depend on the type of inguinal hernia. In the II type of inguinal hernia, the results of ultrasound and intraoperative morphometry did not have substantial distinctions. Reliable distinctions in the diameter of deep inguinal ring in hernia of the IIIа and IIIb type were not revealed, regardless of the method of research. Conclusion. Ultrasonic visualization of inguinal canal lets to estimate objectively the basic topographic-anatomical parameters of the inguinal canal in hernia. Its results should be used at the stage of planning of the method of hernioplasty.