What are the steps of hydrocele surgery?

For hydrocele of the spermatic cord, you must pay attention to the correct treatment method. Surgery can be said to be a more common method, but many people do not understand surgical treatment. It is recommended that surgical treatment be performed scientifically, and correct care is also required after the operation to avoid infection.

1. Anesthesia and body position

1. Anesthesia was ketamine combined anesthesia.

2. The body position is a flat lying position with the head down and the feet up 150 degrees.

(II) Surgical operation

1. Incisions and artificial pneumoperitoneum: A 0.4 cm incision was made on the umbilical fold, and after the pneumoperitoneum needle was inserted and inflated, a hole was made to insert the micro-laparoscope. Another 0.3 cm incision was made 3 cm beside the left umbilical cord, and a hole was made to insert the operating forceps.

2. There are three types of internal ring openings of hydrocele observed under the scope.

(1) 57% of the internal ring opening is ￠0.3-0.7 cm (equivalent to the internal ring opening of a small indirect hernia): Squeeze the scrotal and spermatic cord masses, and it can be seen that all the accumulated fluid flows back into the abdominal cavity from the internal ring opening. The scrotal and spermatic cord masses can disappear completely.

(2) 38% of the internal ring openings are ￠0.2-0.4 cm and are in the shape of a fish mouth. When squeezing the scrotal and spermatic cord masses, the accumulated fluid can be seen flowing back into the abdominal cavity from the fish mouth in the form of dripping water, and the scrotal and spermatic cord masses may disappear completely or partially.

(3) 4% of the cases have a small depression at the inner ring opening: when squeezing the scrotal and spermatic cord masses, a cystic object can be seen protruding into the depression, but no accumulated fluid flows back into the abdominal cavity, and the scrotal and spermatic cord masses do not shrink or disappear.

3. Suturing the internal ring opening: At the projection of the internal ring opening on the affected side, make a 0.15 cm small incision in the skin, insert a suture needle from this point, suture the inner half circle of the internal ring opening, bring the suture into the abdominal cavity, withdraw the suture needle from the abdominal cavity, and then insert a hook needle from this incision to suture the outer half circle of the internal ring opening, hook the abdominal suture and bring it out of the abdominal cavity. At this time, the internal ring opening becomes a purse suture, pull the thread tight and tie a knot, tie it under the skin, the internal ring opening is closed, the pneumoperitoneum is relieved, and the operation is ended. The incision does not need to be sutured.

4. For patients who still have fluid accumulation in the scrotum and spermatic cord, puncture can be used to extract the fluid and then inject 20 mg of prednisolone acetate.

(III) Surgery precautions

1. Work closely with the anesthesiologist to maintain a certain depth of anesthesia, relax the abdominal muscles of the patient, expose the abdominal cavity well, and clearly show the internal ring opening.

2. Completely suture the internal ring opening, taking care not to damage the spermatic cord and vas deferens.

3. Puncture the avascular area of ​​the cyst to extract fluid and inject medicine.

4. Postoperative treatment

After the operation, the patient will be sent to the anesthesia recovery room and returned to the ward after waking up. The patient will not get out of bed or eat any liquid food on the first day, but can get out of bed and resume normal diet the next day.