The study was aimed at finding new structural features of the rear wall of the inguinal canal, the use of which allow to improving the prevention of inguinal hernias. The study involved 123 corpses of different sex and age. Anatomical and physiological nature of the valve mechanism inguinal canal, the peculiarities of the structure of the back wall in individuals of different sex and age were revealed; the various forms of inguinal gap were studied. Using cluster analysis of transverse fascia thickness abdominal length and height of the deep inguinal ring was one of three variants of the structure back wall of the inguinal canal: a strong, transient and weak. The technique of determining the location of the deep inguinal ring relative to the edge of the internal oblique abdominal muscles is offered. The use of this technique objectively reflects the anatomical and physiological characteristics of the inguinal canal as a whole. In interpreting the results of a valve mechanism of deep inguinal ring should be considered ineffective in the medial or medial edge of the boundary location of the deep inguinal ring relative to the internal oblique abdominal muscles. Functional and anatomical factors that contribute to the formation of inguinal hernias were identified. It is proved that the triangular shape of the inguinal gap causes a high risk of inguinal hernias. In both sexes the transverse abdominal fascia becomes thinner with age, and the deep inguinal ring increases in size. The obtained data will improve the effectiveness of preventive measures.
The purpose of this work is to study surgical anatomy in the patients with inguinal hernias of various kinds. Material. This work is performed on 41 corpses with inguinal hernias. Topographic and anatomical dissection of the inguinal canal with measurement of the linear parameters of anatomical structures, histological examination of specimens of the internal oblique abdominal muscles, the transverse fascia of the abdomen were carried out. Results. The authors have studied the structure of the posterior wall of the inguinal canal in the patients with oblique, direct, supravesical and inguinal-scrotal hernias. At persons with direct and supravesical inguinal hernias, a deformation is observed, mainly, in the medial inguinal fossa and supravesical fossa, showing great value inguinal gap, bland crescent aponeurosis, thinning of the transverse fascia of the abdomen. Increase of deep inguinal rings is observed in persons with oblique inguinal hernias. Dystrophy of abdominal muscles has always with inguinal hernias, and it is pronounced in the patients with inguinal-scrotal hernias. Conclusions. At surgical treatment of patients with direct inguinal hernias it is necessary to carry out correction of a posterior wall of the inguinal canal, in the patients with oblique inguinal hernias the anterior wall of the inguinal canal has to be surely restored. In the application of mesh materials in patients with large inguinal hernias, the results of treatment are doomed to fail, because the endoprosthesis only closes hernial wall that when failure of muscle function will clearly increase.
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