[Reconstruction of the inguinal ligament with fascia lata sling. First reported case in Hungary]
Gábor Bognár1, Loránd Barabás1, Enikő Tóth1
1II. Sz. Sebészeti Klinika, Semmelweis Egyetem 1125 Budapest, Kútvölgyi út 4.
Introduction:
A technique of reconstructing the inguinal ligament using pedicled fascia lata flap is described.
Presentation Of Case:
A 66-year-old woman was referred with massive incarcerated left inguinal hernia, following acute surgery on a femoral vein leasion and numerous attempts at repair and subsequent recurrences. There was complete absence of the left inguinal ligament. The inguinal ligament was reconstructed using a strip of fascia lata, pedicled on the anterior superior iliac spine. This was transposed to cover the external iliac vessels, and sutured to the pubic tubercle. The musculoaponeurotic abdominal wall was reconstructed with 15×13 cm sheet of polypropylene mesh, placed preperitoneal and sutured to the remaining abdominal wall muscles and to the neo-Pouoart ligament.
Discussion:
Complete destruction of the inguinal ligament is rare but can occur following multiple operative procedures or trauma. Published reports of inguinal ligament reconstruction have been performed using synthetic mesh. The use of autologous tissue should reduce the risk of erosion into the neurovascular bundle, seroma formation, and enhance integration into surrounding tissues.
Conclusion:
This new technique for autologous reconstruction of the inguinal ligament provides a safe alternative to the use of synthetic mesh in the operative armamentarium of plastic and general surgeons. This is the first reported case in Hungary.
