Surface and deep inguinal ring. Symptoms and treatment of tensile ligaments and muscles in groin

Inkhan canal It is called the gap between the wide muscles of the abdomen over the medial half of the groove bundle. Recall that the term "groove bundle", adopted in surgery, implies two ligament formations: a true inguinal ligament and going in parallel, but more deeply (rear) iliac-pubic tract. Both of these formations are closely adjacent to each other, but there is a very narrow slot between them.

Packing canal He has an oblique direction: from top to bottom, outside inside and back in advance. Its length in men - 4-5 cm; In women, it is somewhat longer, but compared to male more narrow.

Walls in the inguinal canal

In the inguinal canal 4 walls and 2 rings are isolated.

The front wall of the inguinal canal Educated by aponeurosis of the outer oblique muscle.

Patch Channel Rear Wall Formed by transverse fascia. In the medial part, it is strengthened by a groin sickle, Falx Inginalis ( bunch of Genla ), connected by aponeurosis of the inner oblique and transverse abdominal muscles.

The lateral edge of the straight muscle of the stomach sickle is arcuently bends down the book and attaches at the pubic tubercle, connecting with the iliac-pubic tract.

On the site between the medial and lateral inguinal patchs, the transverse fascia (rear wall of the channel) is reinforced by the interlarded ligament, Lig. Interfoveolare.

Part rear wall of the inguinal canal Knutrice from a. ET V. Inferiores epigastriters are called triangle of Hesselbakha .

Its borders are below - pach bunch (iliac-pubic tract), lateral - lower superstub vessels, medial - outer edge of the straight abdominal muscle. Through this triangle, direct inguinal hernias come out.

Thus, patch Channel Rear Wall It really consists of transverse fascia, but this is not such a thin plate as it looks in other sections of the abdominal wall. It is sealed and strengthened by tendon elements, although the main edge of the inner abdominal muscle is played in its strengthening.

Top Wall of the Inguinal Channel It is formed by the lower free edges of the inner oblique and transverse abdominal muscles. The lower edge of the inner oblique muscle is usually located slightly below the transverse one. From this, as already mentioned, the height of the inguinal gap dependes and, accordingly, the height of the rear wall of the inguinal canal.

The bottom wall of the inguinal canal There are a groove bunch and a iliac-pubic tract.

Surface inguinal ring

Surface inguinal ring, Anulus Inginalis Superficialis, formed by two divergent legs of the aponeurosis, the outer oblique muscle of the abdomen, the medial of which is attached near the symphiza, and the outer-to the pubic tubercle. The outer part of the ring is supported by arcuately walking internally fibers, Fibrae Intercrules.

Sometimes there is a third, rear, leg - it is caught bunch, Lig. Reflexum, which goes into the fibers of the outer oblique muscle of the opposite side. The surface ring has the kind of incorrect oval, its longitudinal size is 2-3 cm, transverse - 1-2 cm. In an external study through the skin, the surface ring passes the end of the maiden. In women sizes surface Ring twice smaller.

Packing canal, canalis inguinalis It has the appearance of the slit in the bottom of the abdominal wall. It contains in men seed rope, FUNICULUS SPERMATICUS, in women - a round bunch of uterus. Lig. Teres Uteri.

The canal has an oblique direction. From the surface inguinal ring, located above the front section of the upper branch of the pubic bone, the channel is directed to the cosos laterally up and a month ago to a deep inguinal ring, which is 1.0-1.5 cm above the middle of the groove bunch; Channel length 4-5 cm.


The walls of the inguinal canal are: a) the front - aponeurosis of the outer oblique muscle; b) rear - transverse belly fascia; c) lower - gutter groove; d) the upper - the lower edges of the inner oblique and the transverse muscles of the abdomen.

Surface inguinal rings,anulus. iN.­ guinalis. superficial iS.. located above the pubic bone, it has the form of an oval hole (2.5-3.0 x 1.0-2.5 cm). On top and bottom limit it, respectively medial and lateral feet of groin bale,crus me.­ dIATE. el. crus lalerale, lateral - intercase beamsfibrae. intercrules, medial and Book - bindinglig. reflexium. .


Hole is available to research; When piercing the midges of the scrotum skin, you can take up the login to the groin canal. Normally, he passes only the end of the maiden; At large sizes, its condition is assessed as an expansion of the surface inguinal ring.

Deep inguinal ring,anulus. inguinalis pROFUNDUS., represents a funnel-shaped deepening of the transverse fascination of the abdomen; Medially limits it interlarded bunchlig.

interfoveolaRe. . Knutrice from this bundle The rear wall of the inguinal canal is backed by the fibers of the lower edge of the aponeurosis of the transverse muscle of the abdomen, which, bending down, attach to the tuberculosis and the crest of the pubic bone, forming packing sickle (connecting tendon),fatx inguinalis (tendo. conjunctivus.) . The medial is a deep inguinal ring, the vessels occur - the lower left artery and veins, a. et w Epigastricae Inferiores, which pass in the lateral umbilical fold. What is important to consider when dissection of a deep inguinal ring in cases of infringement of hernia.

The groin canal is in the abdominal wall in the groin area. It is the oblique gap. He has:

• the upper wall, which is limited by the edges of the transverse and oblique abdominal muscles;
• lower wall, fenced in a groin bunch;
• rear and front walls.

Description of the inguinal canal

The groin canal has rings that are wider in men than women. All due to the fact that the seed rope takes a greater volume than a bunch of uterus. In addition, the strong half of the population is lowered by the testicle, so the structure of the inguinal channel is slightly different. Because of this, men are more common in congenital hernia in this area.

The upper wall is separated by the oblique and transverse muscle of the abdomen, but men still have a small muscular beam, with which the testicles can rise. This muscle comes to them through the groin canal.

The rear wall separates the transverse fascism of the abdomen, which goes into the inguinal bunch. Also the groin canal contains a ring on the surface. It is located above the ligament, the tendons are diverged here, which limit it. They are divided into such legs:

• medial, which is attached to the symphysus;
• lateral, grows to the pubic tubercle.

The groin canal is vulnerable to the appearance of hernia, as it is considered a weak zone, due to this, the organs can be succumbed.

Weak places that are on the abdominal wall

There are such weaknesses on the abdominal wall:

1. Packing canal, as well as his pits. There are inguinal hernias from these pits.
2. A forefront, which is located between the puretes of the peritoneum near the navel (left and right), which are located above the bladder. Here can be observed, except for inguinal, sliding hernia.
3. Inner femur ring. In this case, femuric hernias appear in the groin bale and fold.
4. Channel.
5. Basic ring. Here manifested the bubble hernia.
6. White line in which the defects of the aponeurosis appear.

Deep and Surface Inguinal Ring

The walls of the inguinal canal have a deep inguinal ring. If we consider it from the abdominal cavity, it is a deepening in the middle of the groove. It is located opposite the girlfriend.

But the surface ring is located above the pubic bone, limited to the legs of the abdominal muscle, which is located outside. There is a medial edge from above, and the bottom is lateral.

Violations that are observed in the inkhan channel

The anatomy of the inguinal channel develops in such a way that this part of the body is not insured against violations. Some organs can begin through this channel, and the phenomenon of groin hernia is called. No need to forget that both women, and men here are important organs, such as a bunch of uterus and seed rod, respectively.

The groove channel is protected from all sides of the muscle. Sometimes in the abdominal part can begin to increase the pressure, the internal organs are put on each other, begin to be pushed, after which they find a weak place and begin to go out.

Manifestation of hernia

When the groin hernia appears, the groin area begins to be crowned. This can be seen in calm condition, as well as at certain loads. For instance:

• lifting heavy things;
• when the prostate adenoma appears;
• constipation;
• coughing.

In addition to visual changes, the groove hernia carries a stupid pain in the groin zone. It can manifest itself constantly, and can periodically disturb the person.

Inspection at the Patch Channel

To inspence the inguinal channel, special procedures are not required. The doctor inspects the patient, then recognizes the exact complaints of it, after which it will be able to diagnose, identify the presence of deviations. In some cases, the presence of hernia is visually visible.

In order to conclude about the state of human health, the doctor examines the groin canal. The scheme is as follows: it introduces the little finger in the outer ring. If this organ is in order, only the tip of the finger can plunge there. When the little finger is located inside the ring, the doctor can spend a cough sample. This allows him to feel the shock.

Sometimes, in order to study the inguinal hernia more detail, the patient will need to pass an ultrasound. Basically, do without it. Apply this study only in complicated cases.

Patch channel operations

Operational intervention is carried out in the inguinal channel, when other methods did not get rid of hernia. Make this procedure under the anesthesia of this place. But sometimes general anesthesia is used, when the patient is a child or a person with a psyche disturbed.

Stages of operation:

1. At first, the doctor makes an incision that runs parallel to the groin bond.
2. Subsequently, he receives a naked ink channel, after which the hernia search occurs, as there are situations where it is not so easy. In this case, the doctor may be needed so that the patient does not fit. It is for this reason that an operation is performed only under local anesthesia.
3. When the doctor finds the goal, he dissects it.
4. After a specialist assesses the overall condition of all internal organs.
5. If after inspection the doctor does not see any deviations, then all the organs that came out are immersed in the belly.
6. Then there is a bandaging and cutting off the hernia.
7. After that, the doctor is faced with a task: to carry out plastic in the inguinal canal. There are many methods, but they are very similar to each other. Mainly crossing muscles and fascia. Sometimes a specialist can be asked to the inguinal channel a special grid that does not harm the authorities.
8. The last stage of the operation is the final seam.

So, the groin canal is a simple organ, but any violations can lead to the appearance of hernia. The main thing is to begin timely treatment in case of such a problem.

Packing canal (Canalis Inginalis) pair, represents a 4-5 cm skiing slot located in the Regio Inginalis Dextra Et Sinistra above the groove bundle.

The men's groan canal and its rings are wider, as it passes a more massive seed rope (Fig. 171), in women - a round bunch of uterus. Men in the groin canal is more widely and because on the ix of the intrauterine development through the groin canal from the abdominal cavity in the scrotum, the testicle is lowered. Therefore, boys are more likely congenital inguinal hernias than girls.

The groin canal has four walls and two holes (Fig. 172).

171. The superficial ring of the masculine inkhan canal and the outer hole of the femoral canal.
1 - Linea Alba; 2 - m. Obliquus abdominis externus; 3 - CRUS Mediale; 4 - Lig. Reflexum; 5 - CRUS LATERALE; 6 - FUNICULUS SPERMATICUS; 7 - m. Cremaster; 8 - v. Saphena Magna; 9 - Cornu Inferius (Margo Falciformis); 10 - v. femoralis; 11 - Margo Falciformis (Cornu Superius).

172. Surface (A) and deep (b) inguinal rings (scheme).
1 - Fibrae Intercrules; 2 - Lig. Reflexum; 3 - Lig. lacunare; 4 - CRUS Mediale; 5 - CRUS LATERALE; 6 - Symphysis Ossis Pubis; 7 - r. Superior Ossis Pubis; 8 - m. Rectus abdominis; 9 - Lig. interfoveolare; 10 - Lig. Inguinale; 11 - Ductus Defferens.



The lower wall of the inguinal canal is formed by a groove bundle, which represents the exposed edge of the outer oblique abdominal muscle, connecting with the transverse fascia of the abdomen.

The front wall is limited by aponeurosis of the outer oblique muscle, sometimes representing not compact, and the mesh plate.

The upper wall is represented by the lower edges of the inner oblique muscle and the transverse muscle of the abdomen. In men from the lower edge of the inner oblique muscle, a slight muscular beam is separated, which forms the muscle - the lift of the egg (m. Cremaster), which comes out of the inguinal channel through the outer hole and reaches the egg.

The rear wall is formed by the transverse fascia of the abdomen. It grows with the rear edge of the groove bundle.

The surface groove ring (Anulus Inginalis Superficialis) is above the groin bond and is limited due to the discrepancy of the tendon (aponeurosis) of the outer braid abdominal muscle for two legs: medial (Crus Mediale) and lateral (Crus Laterale). The medial leg is attached to the symphysus; At the same time, the left is the Kepende from the right, and the lateral grows to the pubic tuberculosis. Consequently, the farther the Tuberculum Pubicum from the Symphyse, the wider there will be a hole in the inguinal canal. On this basis, it is possible to somehow establish a predisposition to the emergence of inguinal hernia, which is easily determined by x-ray. The gap from the lateral side is strengthened by interchangeable connective tissue fibers (Fibra Intercrules) separated from the tendon of the outer oblique abdominal muscle. The hole in the norm should skip the makeup of the maiden.

The deep inguinal ring (Anulus Inginalis profundus) is above the middle of the groove bundle on 1 -1.5 cm. It does not exist in the form of a free opening, since it contains an invalid transverse belly fascia, which surrounds the seed rope or a round bunch of uterus. A deep inguinal ring corresponds to the lateral groin yam (Fossa Inginalis Lateralis), limited from the medial side a. ET V. Epigastricae Inferiores; It is connected to a bundle of fibers, removed from the lower edge of the transverse muscle, forming m. INTERFOOLARIS (Fig. 173).

173. The inner surface of the front wall of the abdomen and pelvis.
1 - LIG. Umbilicale Medianum; 2 - Lig. Umbilicale Laterale; 3 - Vagina m. Recti abdominis; 4 - m. Rectus abdominis; 5 - Anulus Inginalis Profundus; 6 - Lig. interfoveolare; 7 - Ductus defferens; 8 - Ureter; 9 - vesica urinaria; 10 - vesica seminalis; 11 - Fossa SupraveSicalis; 12 - Fossa Inginalis Medialis; 13 - Fossa Inginalis Lateralis; 14 - Plica Umbilicalis Lateralis; 15 - Plica Umbilicalis Mediana.

The main focus of bodybuilders during sports is usually done on the development of muscles of the hands, legs, press and chest. Many even ignore the muscles of the groove zone, exposing themselves to serious injury, such as stretching and even a groin hernia. Underwakened groin muscles can also contribute to sexual dysfunction, problems with a prostate and urica system.

In the article, I will not consider tedious, detailed anatomical schemes. Where which muscle is located, as it is correctly called - I do not know how you, and me from such a material is clone in sleep.

I will only consider the most highlights of the muscles of the groin, their training and this will be quite enough for you, believe me. So, let's begin.

What is the inguinal muscles?

Before proceeding with the exercises, you need at least in general terms know where the inguinal muscles are located and that they represent.

Inguinal muscles in men consist of several layers of muscle fibers and are on the inside of the thigh, in the deepening between the hips and the abdominal cavity. It is these muscles that are responsible for the reduction and breeding of legs, have a huge number of nerve endings and blood vessels. This includes the thrust muscles of the thigh, the thin muscles of the thigh (gracilis), tailoring muscle.

The muscles of the groin area in men also include the zone at the bottom of the abdomen in the form of a regular rectangular triangle adjacent to the thigh. In this area also passes the groin canal, and in it there is a seed rope in men.

The groin canal consists of several walls:

• The upper wall - consists of muscle abdominal fibers.
• Lower - looks like a shallow chute.
• The front - it is formed by the external and internal oblique muscles of the abdomen.
• Rear wall - it forms thickened muscle shells.

The absence of stretching and flexibility of inguinal muscles can lead to very painful injuries, and rehabilitation can last for months. Diagnose the tear of muscle fibers can a doctor, but a man most often feels that the muscles hurt in the groin area, it is difficult for him to walk, swelling and bruises may appear.

How to pump inguinal muscles?

The coolest and effective exercise for pumping the muscles of the groin is the mixing of the legs in the simulator. The only minus is that here without a special simulator can not do - so you need to go to the gym.

Upon information, the muscles that are called adductors are involved. This is a big, short and long leading muscles, as well as the comb muscle.

So if you want to be cool to pump your groin, first of all deal with this exercise. It is difficult to find it more efficient. But it is not the main, basic exercise. Excellent can be combined with breeding legs to the sides.

VERY IMPORTANT! Before performing this exercise, it is necessary to warm the muscles of the inner surface of the thigh very well, to stretch them well. This will increase the amplitude of movements during the exercise itself, you are better pursuing the muscles. Recommended initial load, which you can install on the simulator -KG for men. No sharp movements!

Exercises Below will help you prepare inguinal muscles for a more serious workout and at the same time heat them to stretch them.

Exercises for inguinal muscles for men:

1. Side attacks - step by left foot to the side, and transfer all your weight to it. Run down, holding the left knee perpendicular to the floor. Transfer the weight on the right foot and further by the order. Repeat 10 lows for each leg in three approaches.
2. Stretching. In a sitting position on the floor, not bending your back, put the legs bent in the knees to the floor, and the feet are connected. Make tilts forward, while lining your knees by pressing their elbows. Close for 40 seconds and start again all first.
3. Bringing hips. To perform the exercise you will need a chair. Lie on the floor on the side. Place the upper leg on the chair, and the bottom slowly lift up and delay for a few seconds. Return to the starting position. Make 10 repeats and turn over the other side and make similar manipulations with the second leg.
4. The initial position is lying on the back. If you feel easier to perform this exercise, you can put the palms under the tailbone. Raise up straight legs with unfounded footsteps. Bend the legs in the knees, while collecting them on the parties and pressing the feet as close as possible to the inside of the thigh. You need to do slowly, 10 times three approaches.
5. Stretching № 2. Sit on the floor, do not bend your back, feet together. Divide your knees to the sides, detaining the feet in the original position. Before the legs, put the elbows and try to pull the pelvis as close as possible to the footsteps. At the same time you will feel the tension of the muscles.
6. And again an exercise with a chair. Lie on the back. Place one leg on the chair, the second lines up, perpendicular to the floor. Raise the pelvis from the floor for several centimeters and delay until you feel the strong tension of the muscles.
7. Take the position as for classic pushups lying. Then make a jump forward, pushing at the same time with two legs at the same time. Your feet should be as close as possible to the hands. Keep your head straight, perform the exercise slowly up to 20 times in 2 approaches.
8. The exercise is similar to the previous one, only the attacks need to make legs in order. Take the initial position and jump, with the power of pushing the right foot, take the position to push up and repeat with the other foot. Repeat 15 times. Try to keep the straight angle of the leading leg to the floor and put it on the minimum distance to the palms.
9. Stretching № 3. Sit on the floor, legs to spread to the sides, connect the feet. Press elbows to dilute knees trying to press them into the floor.
10. For the next exercise, you will need an elastic bandage and support. Tie one end of the bandage to the non-moving object, but the other to the ankle. Take the foot to the side to the maximum height and hold for a few seconds. Repeat with the other foot. At the very beginning of the workout, use a support for your equilibrium, but gradually try to cope without it. The second variation of this exercise may be the output of the leg forward to the highest point without bending in the knee.

Taking training, always highlight the time for the groove zone, it will help not only avoid injury and stretching, but also increase your male strength.

Today, all guys. I think that this small information is enough for you to put your groin in order. Be in shape in all parts of your body. Bye Bye!

P .s Subscribe to update the blog to miss anything!

How to download inguinal muscles?

How to download inguinal muscles? These muscles lead to the thigh. Under Pat, it is implied to the deepening existing between the hips and the abdomen area. Inguinal muscles are located on the inside of the thigh, which can be attracted inside. It must be said that the groin muscles are necessary to prevent stretching muscle data. It is recommended to start training with exercises that do not require considerable muscle tension, after which it is necessary to gradually increase the amplitude of the movement. Thanks to regular training, you can significantly strengthen the muscles of the groin.

How to download inguinal muscles with the help of Kegel's exercise? Rules of implementation.

Inguinal muscles are weakened under the influence of numerous factors. For example, their weakening can have a negative impact of various diseases as diabetes. Sometimes inguinal muscles become weak after removal of the prostate gland. With the help of the exercise of Kegel, men can prevent, cure or avoid some problems provoked by the weakening of the muscles of the pelvic diaphragm. In addition, these exercises will be useful to men suffering from incontinence of Cala and urine.

Among other things, training muscle groin will help men cope with erectile dysfunction. Performing the exercise of Kegel needs to show effort and perseverance. With it, you can feel the pelvic muscles, essentially develop them and even learn them to manage. To achieve the best results, you should concentrate attention directly at the work of pelvic muscles. In addition, you must try not to include the abdominal muscles, hips and buttocks. Do not be detained breathing, but on the contrary, it is necessary to breathe deeply and freely.

Kegel exercise is preferably preferably after each urination. It is necessary to teach yourself to regularly strain the inguinal muscles, only there will be to achieve the desired effect. With constant exercise, a positive result will appear after a few weeks.

Exercises that will help work out and pump the muscles of groin in men.

1. Classic hip bringing. This exercise must be performed in the position lying on the side. Put one leg on the chair. The bottom leg should be slowly raised up, delay it for one to three seconds, after which it slowly return to the initial position. The number of repetitions is not less than 12. Then a little rest and recruit approach is only for the second leg (that is, you need to roll over on the other side). If it is initially hard to perform this exercise, then 5 - 6 repetitions are enough. The main thing over time is gradually increasing their number.

2. The second exercise is performed from the position - lying on the back. For the convenience of the palm can be put under the tailbone. Straight legs need to raise up. Holding the feet together, bend your knees, while divert them. The footsteps need to close as much as possible to the area of \u200b\u200bthe groin. At a slow pace, this movement should be repeated 12 times. After a small rest - the next approach to the same number of repetitions.

3. Classic Stretch inguinal muscles. This exercise is suitable for beginners. It is necessary to sit down, lay down together, and knees to dilute. Without bending your back, make a tilt forward, put the elbows before the legs and attract the pelvis to the heels. At the same time, a good muscle stretching should be felt.

4. Raise the pelvis lying on the back. At the same time you need to put one leg, and the second straightened up. The further pelvis should be cut off for several centimeters until a strong tension is feeling. Then drop and repeat the movement at least 16 times. Then repeat the approach for the second leg.

Plastic in the inguinal canal. Part 1

As already noted, the initial place of formation of oblique gentle hernia is a deep inguinal ring. Hence the first priority need to strengthen the most responsible in the pathogenetic attitude of the site. To this end, to the present, it is proposed to use the gradation of the deep hole in the inguinal channel using the synthetic "plug" or a junk bag. However, it is doubtful that the "cork method" itself significantly strengthened the rear wall of the inguinal canal. Only the narrowing of a deep inguinal ring allows reliably to protect this "weak place." This is usually achieved by the embedding of the medial part of the deep inguinal ring with a nodal or continuous seam to sizes sufficient only to pass the seed rope. With destroyed transverse fascia, there is a need for plastic synthetic plate. This, of course, the rational technique should be recognized as one of the fundamental and mandatory moments of operation in oblique gnewing.

Method of bassini

• each jolf needles passed at a distance of 2-5 mm from the free edge of the groin bond, and the rods are 3-4 mm lateral of the ins.
• each seam took place by 2-3 mm lateral or more than the previous seam;
• the needle's edge when conducting it under the bundle should be seen through the fibers of the ligament.

The seams are tied in turn, starting from the medial angle of the wound. In case the deep inguinal ring remains an unplanned inner abdominal muscle, impose an additional seam laterally seed rope. Thus, the seed rope falls between two seams.

This lifting incision allows with less tension to reduce the lower edge of the inner oblique and transverse abdominal muscles to the groove bundle. The cut, produced in order to weaken the tension of the seams, is then covered by the medal leaflet of the aponeurosis outer oblique muscle.

Ways to strengthen the front wall of the inguinal canal

Girard method. After removing the hernial bag and stitching its deep hole, the inner oblique and the transverse muscles on all over the inguinal channel over the seed canopa are sewn to the groove wall. Then impose a second series of seams between the medial flap of the dissected aponeurosis and the groove bundle. After that, the lateral flap of the aponeurosis in the form of duplication is laid to the medial third number of seams. When the seams are applied near the Lonny tubercle, it is necessary to ensure that the newly formed outer opening of the inguinal canal passed the misma tip. The suturing of seed rope seams creates a risk of egg nutrition. The disadvantage of the Girard method is the multi-row of seams that greatly injure the inguinal ligament and wave it.

Method of Spaskukotsky. This method is a modification of the method of Girar. It is distinguished by the fact that the muscles and the medial flap of the aponeurosis are sewn to the groin bond with one seam. In this method, the groin bunch is injured to a lesser extent.

Shov Kimbarovsky. With this modification, the principle of connecting homogeneous tissues is implemented. The first seam is imposed so that the upper flap of the aponeurosis of the outer oblique abdominal muscle enveloped the lower edges of the inner oblique and transverse muscles. To do this, the first pall needles make, retreating 1-1.5 cm up from the edge of the aponeurosis section. The needle passes through the entire thickness of the muscles subject to the muscles and returns to the front surface of the medial flap of the aponeurosis in the very edge. Then the same needle capture inguinal ligament. The remaining seams are imposed in the same way. As a result, in front of the seed cord, the hanging edges of the muscles shrouded with aponeurosis are laid. The lateral flap of the aponeurosis of the outer oblique muscle is placed on top medially and fixed to it nodal lavsanine seams.

Ways to strengthen the posterior wall of the inguinal canal. Bassini method. This clinical way to strengthen the posterior wall of the inguinal canal, which has many modifications. In its original form, it is performed as follows. Under seed cords are superimposed by deep seams:

1) between the edges of the direct muscle and its vagina and the perception of the LONA BUGGORK; here are enough 1-2 seams;

2) between the inner oblique and transverse muscles, as well as the transverse fascia on the one hand and the groin bundle on the other. These seams completely eliminate the inguinal gap. Thus, the rear wall of the inguinal canal is strengthened with transverse fascia and muscles. The edge of the aponeurosis of the outer oblique muscle is stitched on top of it.

Method of Kukuchanova. It is proposed mainly for direct and complex forms of inguinal hernia: large obliquely with direct channel, recurrent. After removing the hernial bag and the embossing of a deep inguinal ring, the seams are applied: a) between the vagina of the straight muscle of the abdomen and the Kuper bundle. To do this, use a small round sling needle and synthetic threads. The seams (3-4) are superimposed for 3 cm from the LONA BUGGORK to the fascial case of the iliac vessels, protecting them with the spatula and not squeezing. In the case of an outlined tension before the tie of the seams in the medal department of the vagina, the direct muscles make a slightly oblique-cutting cut with a length of 2-2.5 cm. Stitching tension should be considered a rough technical error. The described point of operation is of great importance, creating a strong bottom of the inguinal channel; b) between the connected tendon, as well as the upper edge of the dissected fascia and the lower edge of the transverse fascia and the groove bunch. The very last seam is imposed from the medial edge of the deep opening of the inguinal channel. The operation is completed by creating a duplication of the aponeurosis of the outer oblique muscle of the abdomen.

Treatment of hernia in groin in men with exercise

The groin hernia refers to diseases that in the early stages of development can be corrected using the right lifestyle and muscle strengthening with physical exercises. The treatment of groin hernia in men by physical exercises gives excellent results, rarely causes complications and is an excellent method of strengthening the patient's health as a whole.

A few words about the disease

The hernia is a pathological process of departing a certain body beyond its location. The groove hernia is a filling and loop of the small intestine through the groin canal.

Most often, the disease develops in men. Symptoms of pathology are extremely rare in women, the disease is predominantly congenital.

There is a disease in the form of education in the groin area of \u200b\u200bbulge, which can independently come out and disturb the patient only at the stress of the abdominal muscles. In the early stages, pathology concerns little patients, discomfort is felt only with intensive physical exertion and lifting severity. At the later stages of hernia provokes the risk of infringement of internal organs and the development of other hazardous consequences.

Objectives of therapeutic physical education

The fallout of the internal organs into the inguinal ring is due to the loss of the muscular tone or stretching the inguinal hole under the influence of increased intra-abdominal pressure, heavy physical exertion and other things. To restore the muscular corset and strengthening the hole in the bundles of the inguinal region, experts recommend using a complex of specially designed exercises.

The common goals of gymnastics should be attributed:

• increase muscle tone;
• reducing the hernial gate (holes through which protrusion occurs);
• general strengthening of the patient's well-being.

Before performing the gymnastics, each patient needs to receive a consultation of a specialist, therapeutic physical culture with inguinal hernias has its own contraindications.

Indications and Contraindications for exercise

Exercises used to treat hernia universal. Gymnastics for gymnastic hernia in men can engage in healthy patients in order to prevent and people with small amounts of protrusion to prevent complications. The physical education and people who have moved operational treatment on the plastic of the hernia hole are shown.

Indications for physical education are:

Among the contraindications allocate the following aspects:

1. Various complications of hernia, infringement of organs.
2. Recent transfer of operation, unexplored seams.
3. The appearance of pain and discomfort when charging.
4. Brush injuries.

All exercises are selected by a specialist. It takes into account the size of the protrusion, the features of the pathology, the overall health of the patient, the likelihood of the development of complications.

What you need to consider when performing gymnastics

To achieve the best effect, therapeutic physical education should be performed in compliance with uncomplicated rules. The first classes need to be carried out using minor loads. The patient should not have pain and discomfort. Increase the load is allowed gradually. Every day the number of exercises increases by 2-3 repetitions.

If the whole complex is moved well, with the exception of several exercises, you can refuse them. During charging, it is not recommended to do sharp movements. This will help to avoid muscle injury and will exclude infringement and other complications.

When performing physical education, the patient must follow his well-being. With the development of pain, a feeling of burning, discomfort, exercises must be stopped and consult with the attending physician.

During the execution of gymnastics, you need to adhere to the right nutrition. The diet should be saturated with a large number of cereals, vitamins, minerals. It is important to abandon bad habits.

Complex to strengthen the abdominal muscles

Effective exercises will be only in the event that you can dedicate lessons at least 3-4 hours per week. Physical culture must be performed regularly in compliance with all prescriptions.

To perform some exercises, you may need an elastic bandage, dumbbells, a bag with a peak, a ball. The complex consists of exercises:

1. Source position (Next SP) lying, hands along the body, legs are straight. On the abdomen you need to put a bag with sand. The patient is inhaling, straining the abdominal muscles, then slow exhalation.
2. Ip lying on the stomach, rely on the bent elbows and fingers of the legs, with breath slowly raise the pelvis above the floor, stay 5-10 seconds, with exhale return to the IP.
3. Ip lying, hands along the body, legs to lift over a floor at 45 degrees, perform movements of legs in the form of crossing, imitating the work of scissors.
4. Ip lying on the back, hold the ball between smooth legs (held by footsteps), lift it above the floor for 5-10 seconds, slowly lower the legs on the floor.
5. Stool exercise. Sitting face to the back, make a slow slope to the left side, stay 5-10 seconds, return to the SP, make a repetition to the other side.
6. Sitting on a chair, leaving his palms on his back, perform a lift pelvis, while climbing on the socks, fix for 10 seconds, return to the IP.

The regular execution of the complex will contribute to the strengthening of the muscles, will allow you to get rid of excess weight, it will establish blood circulation in the organs of the small pelvis, will increase immunity.

Rehabilitation complex after surgery

After the operation, the performance of physical exercises with groin hernia is allowed only after full healing of operating seams and the exceptions of other contraindications. During this period, it should be abandoned by force exercises that can provoke complications.

To strengthen muscle tone, exercises are used:

1. Ip lying on the back, easy to reach the right knee to the left elbow, carrying out twisting. Repeat the exercise in the opposite direction.
2. In the lying position, raise the stretched leg, perform several circular movements, as if out of the circle in the air, change your leg, repeat the exercise.
3. Lying on the back, raise your legs, perform movements imitating riding a bike. The lower the angle of tilt legs, the hardest exercise.
4. Ip lying, hands along the body, when inhaling, slowly raise the pelvis, the blades do not come off from the floor, lock on 5 seconds, return to the floor.
5. In the sitting position, strain the muscles of the abdomen, delay the breath, make a slow exhalation, relaxing the belly.
6. Ip lying, raise smooth legs above the floor, try to stay for 5-10 seconds, omit legs.

All exercises are repeated slowly, the patient must follow his breathing, when shorting, you can relax. In the initial stages, the number of repetitions from 3 to 5 times, in the future the load increases depending on the well-being and abilities of the patient.

Exercises must be performed not only regularly, but also correctly. The back during charging should be smooth, breathing calm, measured. It is important to avoid jerks and sharp movements.

Regular sports will provide not only the strengthening of the muscular corset, but also contribute to the normalization of weight, to strengthen the immunity, the establishment of metabolic processes and maintain excellent well-being.

Exercises for strengthening inguinal rings

Hello! Are there any exercises to strengthen the inguinal rings. The fact is that I consulted with doctors: they argue that this happened because of the expansion of the ingun rings and that they are weak. One doctor offered me an operation to strengthen them, because Subsequently, it can grow into a groin hernia, another says that there is no need for operation yet, but it is necessary to occur periodically. Pains are not constant and not strong, rather discomfort, appear only after serious physical exertion. Please tell me how to solve this problem, I really do not want to make an operation. Thank you in advance!

Hello. Our department is engaged in this problem. To recommend something, you need to make sure of the diagnosis. You can come to us, although you will be far from Yerevan)) I recommend contacting the sports trauma to the department of sports injury in your country, because The problem is quite specific and not all traumatologists with it are generally familiar.

GoodBye Visitor!

Thanks for Visiting US!

Some Additional Text Here. Lorem IPSUM.

Packing hernia prevention: Gymnastic treatment

The development of hernia in the groin canal area occurs on the background of the weakness of the muscular wall, because the main prevention of the disease is the strengthening of the muscles and increase their tone. Specialists propose to apply a special medical and prophylactic course of gymnastics for the treatment of the initial stage of hernia protrusion and in order to prevent it. The main task of exercises during hernia is to strengthen the front wall of the abdomen. Reliable muscular protection can prevent the formation of any kind of hernia, including inguinal protrusion in women, men and young children.

Preventive exercises in groin hernia can perform all people, only the exacerbation of hernia and its complication, sharp pain in the implementation of physical work and traumatic damage in the area of \u200b\u200bgroin and abdomen. The correct execution of gymnastics can improve local blood circulation in the defect area, thereby warning the ischemic complication and necrosis of tissues. In addition to stimulating blood circulation, gymnastics trains all the abdominal muscles, forming a natural corset that supports internal organs in its place.

Gymnastics in hernia: testimony and contraindications

After consulting the abdominal surgeon and detecting hernia or predisposition to it, the specialist will offer effective exercises for the abdominal muscles that will help withdraw the symptoms of the disease, and warn relapse. Therapeutic and preventive exercises are universal and can be performed, both healthy people and patients after radical elimination of hernia protrusion and conducting plastic.

When need to do gymnastics

• The weakness of the abdominal wall, the initial stage of obesity.
• Blood circulation disorder associated with blood stagnation against hypodynamia.
• Formation of a small dupile in the area of \u200b\u200bthe groin, the diagnosis of hernia.
• The postoperative period for removing hernia in the inguinal channel, exercises are performed after the full healing of scars.
• The period of pregnancy and the inclination towards the formation of hernia protrusion.
• Congenital deviations in children associated with the weakness of the muscles.

Important! Gymnastics for children is carried out by their parents after the detection of groin hernia. This is a mandatory stage of preventing hernia complications and the possibility of its self-treatment for up to 5 years.

Contraindications for gymnastics for the prevention of hernia:

• Complication of hernia, its pinching, tissue ischemia.
• The presence of a purulent process, an infectious lesion of local tissues in the hernia area after surgery.
• Pronounced pain when performing exercises.
• Traumatic damage to the abdominal and chest cavity.

Important! You can not independently choose exercises in hernia, since even the usual morning charging is contraindicated patient with hernias. Exercises eliminate sharp turns, squats, slopes, as this can lead to complications.

Preparation for exercises

Before proceeding with the main tasks, it is necessary to focus on sensations, and if there is discomfort in the area of \u200b\u200bthe groin or peritoneum, it is better to postpone the gymnastics and come to the doctor's examination. All exercises are performed in the lying position or on sitting. The first stage is the normalization of breathing and warm-up, after which the main course begins.

Gymnastics will be effective prevention only with regular performance and followed by all safety measures. Gymnastics takes at least three hours a week half an hour after eating. Each exercise is repeated 3-4 times, depending on sensations.

Gymnastic complex

Exercises in position lying.

1. Feet lie straight, hands stretched parallel to the body. You need to take a bag with sand (1kg) and put on the center of the abdomen. Slowly inhale, druiting the stomach and pulling.
2. The exercise is repeated with a bag on the top of the peritoneum and the bottom.
3. Legs are a bit bent and placed, hands bent, rest about the floor on the elbows. During the exhalation, lift the pelvis, leaning on the hands and feet. Exercise do slowly and smoothly.
4. The legs are divorced, hands parallel to the body. Slightly lifting the legs, cross them alternately.
5. Legs wider shoulders, hands parallel to the body. Footsuits need to raise the ball, holding it at a height of 30 cm from the floor of about 10 seconds.

Exercises sitting on a chair.

1. The legs are coated together, hands parallel to the body. On a deep breath, one hand straightens up, and a slow slope to the left and right is performed on a smooth exhale.
2. Legs together, holding hands for the seat of the chair. On the breath you need to raise the pelvis, leaning on your feet and palms.
3. Legs are located wide, hands put on the belt. On the deep breath, a smooth inclination of the body is performed, the fingers of the hands get socks, on the exhale return to its original position.
4. Legs are located together, hands relaxed parallel to the body. On the exhalation, lift the knees to the stomach alternately.

Regularly performing the presented exercises, it is possible to prevent the hernia not only in the groin canal, but also organs of the peritoneum. It is important to remember that in the process of performing the exercises of hernia, it may be damaged, depending on the correctness of the execution, in this case you need to lie down, call a doctor and wait for its arrival without making any measures.

Emergency Medicine

Treatment of groin hernia surgical. The main goal of the operation about the inguinal hernia - plastic in the inguinal canal. The operation is carried out in stages. The first stage is access to the inguinal channel, in the groin area, the oblique section is parallel to the groove bunch and above 2 cm from it, from the front axle of the ileal bone to the symphima. Dissection of the aponeurosis of the outer oblique abdominal muscle along the move / fibers. Upper flap aponeurosis is separated from the inner oblique and transverse muscles. The lower flap of the aponeurosis is separated from the seed edge, exposing the gutter in the groove bunch to the lane tubercle.

The second stage is the selection and removal of the junk bag. The third stage is the embedding of a deep inguinal rings to normal sizes (in diameter 0.6-0.8 cm). If a deep inguinal ring is not stitched, there are anatomical prerequisites for the occurrence of hernia recurrence! With oblique gneeze, a deep inguinal ring is always expanded. Strengthening the rear wall of the inguinal channel by embeding to the normal size of the internal inguinal ring should be the mandatory step of the operation with all the forms of inguinal hernia.

Fourth stage - plastic in the inguinal canal. When choosing the method of the inguinal channel plastic, it is necessary to take into account that the main cause of the formation of inguinal hernia is the weakness of the rear wall of the inguinal channel.

Strengthening the front wall of the inguinal channel with the obligatory stamping of a deep inguinal ring to normal sizes can be applied in young men with small oblique teaching hernias.

With direct hernias and complex shapes of inguinal hernia (oblique with a straightened channel, sliding hernias, recurrent), the rear wall of the inguinal canal should be made. There are several methods of the inguinal channel plastic.

Ways to perform transactions about groin hernia

The method of Girarch provides strengthening the front wall of the inguinal channel. The edge of the inner oblique and transverse abdominal muscles is sewed over the seed cord, and then separate seams - the upper flap of the aponeurosis of the outer oblique muscle. The lower flap of the aponeurosis fixes the seams on the upper flap of the aponeurosis, thus forming a duplication of the aponeurosis flap by the outer oblique muscle of the abdomen.

The method of sprinkling is a modification of the method of Girarch and differs from it only by the fact that the muscles of the internal oblique and transverse together with the top flap of the aponeurosis with the outer oblique muscle of the abdomen are simultaneously laminated. In this method, the smelting bunch is less injured.

Kimbarovsky's seam provides a compound of the same tissue of the same name. With the help of this seam, the edge of the outer oblique muscle is enveloped by the edges of the inner oblique and transverse muscles. The first introduction of the needle is carried out at a distance of 1 cm from the edge of the uprooder's top flap of the outer oblique muscle, then having spent the needle through the edges of the muscles, flashes again by the edge itself. The same thread is stitching in the inguinal ligament. The result is a comparison of the tissues of the same name.

The bassini method ensures the strengthening of the rear wall of the inguinal channel (Fig. 92). After high removal of the hernial bag, the seed edge is moved to the side and the inner oblique and transverse muscles are laid under it along with the transverse fascia of the belly to the groove. In the medial corner of the wounds heed the edge of the vagina's vagina's direct abdominal muscle to the supervisor of the Lonatic bone in the region of the Lona Budrock. The seed rope is laid on the formed muscular wall. Thanks to the overlay of deep seams, the weakened rear wall of the inguinal channel and the narrowing of the inner opening of it is restored. The edges of the aponeurosis of the outer oblique muscle of the abdomen are stitched over the edge edge edge into the edge. Thus, the front wall of the inguinal canal and the outdoor groove ring are reconstructed.

Fig. 92. Patch channel plastic according to the bassini method. a - bugging of the inner oblique, transverse and direct abdominal muscles to the groove bunch behind the seed rope; B - crosslinking of the internal and external flap of the aponeurosis of the outer oblique muscle of the abdomen over the seed rope.

In some cases, especially with a high groin triangle, after stitching internal oblique and transverse muscles, a significant tension of the seams occurs with a tippack bundle, which contributes to their cutting and the recurrence of hernia. In such cases, it is advisable to conduct a lifting section of the vagina's straight muscle of the abdomen (Operation of Mac-Veya - Wenglovsky).

Method of Kukuchanova. Proposed for direct and complex forms of inguinal hernia. After the breath of a deep inguinal ring, the seams are applied between the vagina of the straight muscles of the abdomen and a ligament of the cooper, from the Lona Bugork to the fascial case of iliac vessels. In the case of an outlined tension before the tie of the seams in the medial department of the vagina, the direct muscles make a slanting incision with a length of 2-2.5 cm. Then the connected tendon of the internal oblique and transverse muscles together with the upper and lower edges of the dissected transverse fascia are laid to the groove bundle. The very last seam is imposed from the medial edge of the deep opening of the inguinal channel.

The seed rope is placed on the formed rear wall of the inguinal canal. The operation is completed by creating a duplication of the aponeurosis of the outer oblique muscle of the abdomen and the formation of the outdoor opening of the inguinal channel.

MAK-VEY - WEDGLOVSKY METHOD. Pretty close to the method of Kukuchanov. Its essence consists in the narrowing of the inner opening of the inguinal channel and the reconstruction of the rear wall of the inguinal canal. A deep inguinal ring is formed by embedding transverse fascia. On the vagina, the straight muscles of the abdomen make a large liner with a length of 4-5 cm to improve the mobility of the stuffed fabrics. The transverse fascia, together with the connected tendon of the inner oblique and transverse muscles, sews are sewn to the LONA (Cooper) bundle (from the hivebnock bundle to the femoral vessels). The seed edge is placed and in the form of duplicates, the aponeurosis of the outer oblique muscle, forming the outer opening of the inguinal canal.

Method of Pumpkin is to complete the liquidation of the inguinal channel, the inguinal gap and in the creation of a groin canal with a completely new direction. The seed rope is receparparovy, they are as far as possible in the lateral direction, the medial side of the rope is narrowing the inner inguinal ring. Sometimes to move the seed cord, the inner oblique and transverse muscles are more laterally disseminated, a family channel is placed in the resulting gap in the upper-bearers. The muscles are sewed under seed cord so that they fit tightly to him, but did not squeeze it. Next, strengthen the wall in the scam channel. The edge of the vagina direct muscles together with the connected tendon of the inner oblique and the transverse muscles is laid to the Lonnaya (Cooper) bundle. Further, the upper flap of the aponeurosis together with the inner oblique and transverse muscles is labeled to the pubic-iliac chips and to the groin bond. These seams must move the seed edge into the lateral side to the limit (if the muscles have not been crossed). The lower flap of the aponeurosis of the outer oblique muscle, carried out under the seed cord, is fixed on top of the top flap of the aponeurosis. The newly formed "ink channel" with seed codes should pass through the muscular-aponeurotic layer in the oblique direction of the back in advance and from the inside the dust so that its inner and outer holes are not opposite each other. The seed rope is placed on the aponeurosis and layers the subcutaneous fiber and the skin above it. If it is possible, it is advisable to arrange a seed cable between the aponeurosis flap by the outer oblique abdominal muscle.

Handbook of Clinical Surgery, edited by V.A. Sakharov