Medial umbilical ligament in the prevention of recurrence of indirect inguinal hernia with large sac by laparoscopic treatment in children / 中国基层医药

Objective To study medial umbilical ligament in the prevention of recurrence of indirect inguinal hernia with large sac by laparoscopic treatment in children.Methods The clinical data of 178 cases of indirect inguihal hernia with large sacs in children were retrospectively analyzed.After high suture ligation of the internal ring with pediatric laparoscopy,all of the internal tings were covered with the same side of medial umbilical ligament to further strengthen.Results All cases were discharged from hospital 1～2 days after surgery.No recurrence and no any other complications could be found after following up 3～18 months.Conclusion Pediatric laparoscopic application of medial umbilical ligament to further cover the internal ring could significantly reduce the rate of recurrence for indirect inguinal hernia with large sac.This method of operation waft safe and feasible.It Was worth promoting.

Morphologic Variations of the Umbilical Ring, Umbilical Ligaments and Ligamentum Teres Hepatis

PURPOSE: The varied morphology of the umbilical ring and its surrounding structures, such as the ligamentum teres hepatis, and the median and medial umbilical ligaments, has not been thoroughly investigated. Hence, this study was undertaken to clarify the morphologic variations of these structures. MATERIALS AND METHODS: The anterior abdominal walls were removed en bloc from 57 adult cadavers and dissected under a surgical microscope. RESULTS: One case of umbilical hernia was observed, and the remaining 56 umbilical rings were classified into 3 types: oval or round in 33 cases (Type A, 59.0%), obliterated or slitted in 12 cases (Type B, 21.4%), and completely covered by a connecting band between the ligamentum teres hepatis and umbilical ligaments in 11 cases (Type C, 19.6%). The median and medial umbilical ligaments were classified into four types based on their interrelationships. The most common type was the median umbilical ligament terminated by joining one or both medial umbilical ligaments (Type II, 41.1%). The ligamentum teres hepatis frequently ended by dividing into several branches in the area cranial to the umbilical ring, some of which crossed the umbilical ring. The umbilical fascia covered the umbilical ring in 50.0% of cases, and the rest either not covering the ring or not existing. CONCLUSION: These results are expected to improve our understanding of the anatomy of the umbilical area, and further improve treatments of the umbilical hernia.