Acetabular Fracture, Bleeding, Inguinal Hernia, Pelvic Fracture
Conditions
Keywords
Corona Mortis, TEP, Inguinal Hernia, Laparoscopic Surgery, Anatomy, Inguinal region anatomy, Bleeding
Brief summary
This study aim to describe the presence, type and size of Corona mortis (CMOR) in patients undergoing total extraperitoneal (TEP) inguinal hernia repair procedures. This study also aim to describe the preperitoneal vascular anatomy of inguinal area and provide in vivo knowledge about CMOR.
Detailed description
Corona mortis is classically defined as the arterial and/or venous vascular anastomosis between the obturator artery and external iliac artery (most commonly the inferior epigastric artery) that crosses the posterior aspect of the superior ramus of the symphysis pubis. It runs along the posterior aspect of the superior pubic ramus and its laceration can prove life threatening in trauma cases or in scheduled operations. CMOR is clinically important due to the potential risk of bleeding in pelvic fractures, pelvic and acetabular operations, surgery for urinary incontinence, oncologycal pelvic dissections and laparoscopic hernia repair. It requires special interests from different surgical branches, such as orthopedics, oncologic surgery, urogynecology and general surgery. Vascular anatomy of retropubic area, especially CMOR, should be kept in mind by surgeons performing laparoscopic surgery for hernia repair. In literature, the anatomical data have usually been come from studies performed on cadavers. The aim of this study was to provide in vivo knowledge about the presence, type (venous and/or arterial) and size of CMOR in patients who underwent TEP repair. 300 patients will undergo TEP procedure for unilateral or bilateral inguinal hernias. TEP procedures will be performed with three ports and one or three skin incisions. The presence and type of CMOR will be evaluated, and picture will be made. The size of the CMOR will be defined with ruler inserted true the 10 mm port.
Interventions
PROCEDURETEP
Total extraperitoneal laparoendoscopic hernia repair with one or three skin incisions.
Sponsors
Sofia Med Hospital
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosed primary or recurrence unilateral or bilateral inguinal hernia * Age between 18 and 90;
Exclusion criteria
* Patients who prefer other surgical approach than TEP
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Presence of CMOR | Intraoperative | Evaluation of presence of Corona mortis in each hemipelvis examined. For unilateral hernias - one hemipelvis, in bilateral - two hemipelvices. |
| Type CMOR | Intraoperative | Evaluation of the type of Corona Mortis - Arterial, Venous or both types, in each hemipelvis |
| Size of CMOR | Intraoperative | Evaluation of size of Corona Mortis in mm., measured with ruler. |
Countries
Bulgaria
Outcome results
None listed