tratamento das hernias
TRANSCRIPT
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Tratamento das Hérnias
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Tratamento das Hérnias
• Conceito– Protrusão anormal do tecido intra-abdominal através de
um defeito da fáscia na parede abdominal
• Tipos– Inguinal
• Direta• Indireta
– Femoral– Umbilical– Incisional– Outros
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Tratamento das Hérnias
• Anatomia
Ligamento InguinalLigamento Gimbernat
Ligamento Cooper
Cremaster
Oblíquo Interno
Oblíquo Externo
Aponeurose Oblíquo Externo
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Tratamento das Hérnias
• Anatomia
Arcada do mm transverso
Tendão conjunto
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Tratamento das Hérnias
• Anatomia
Ligamento Pectíneo (Cooper)
Ligamento Lacunar (Gimbernat)
Anel Femoral
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Tratamento das Hérnias
• Anatomia
Ligamento Inguinal
Triângulo de Hesselbach
Vasos epigástricos inferioresLigamento Pectíneo (Cooper)
Ligamento Lacunar (Gimbernat)
Anel FemoralAnel inguinal interno
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Tratamento das Hérnias
• Anatomia
Úraco
Artéria umbilical obliterada
Vasos epigástricos inferiores
Fosseta inguinal lateralFosseta inguinal média
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Hérnia Inguinal
• Técnicas Operatórias– Bassini– McVay– Lichtenstein– Laparoscópica
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Hérnia Inguinal – Técnica de Bassini
• Característica Técnica– Sutura da fáscia transversalis ao ligamento
inguinal
• Índice de Recidiva: até 15%
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Hérnia Inguinal e FemoralTécnica de McVay
• Característica Técnica– Sutura do músculo (tendão) conjunto e fáscia
femoral ao ligamento de Cooper .
• Recorrência: 3%
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Hérnia Inguinal - Lichtenstein
• Característica Técnica:– Reparo sem tensão com tela sintética. Técnica
simples
• Recorrência: 1%
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Laparoscópica
• Característica Técnica– Laparoscopia
• Recorrência: 1,6%
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Hérnia Umbilical
• Conceito– Protrusão tecidual através do anel umbilical
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Hérnia Incisional (ventral)
• Conceito: – Ocorrem após tratamentos cirúrgicos com
incidência média de 10%.
• Etiologia– Má técnica– Infecção– Debilidade– Obesidade etc
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