Page 255 - Manual of Equine Field Surgery

Umbilical Herniorrhaphy 251

..

A

B

Figure 45-1 A, Sharp dissection of skin from hernial sac. B, The l1ernial sac a11d overlying skin are held before

removal of skin from sac.

-

Figure 45-2 After removal of skin from the hernial

sac and before closure, the sac is inverted into the

abdomen.

-z::;,,~C,..;R:".____

Figure 45-4 The hernial sac is inverted into the

abdomen and the thickened fibrous ring (arrow) is

closed.

the potential for incorporation of intestine in the

suture line, and, in large hernial sacs (larger than

a tennis ball), the potential for ischemic necrosis

of the hernial sac and subsequent aseptic peri-

tonitis. The closed technique is indicated for

repair of most uncomplicated hernias.

-i::;,__e,-,.,,.iC:..J:~
Open Herniorrhaphy

Figure 45-3 The first bite of closure inserts the

needle into the edge of the fibrous hernial ring and The approach for the open technique is similar

inverted hernial sac. to the closed technique until the hernial sac is