| Objective1.To analyze the incidence and location changes of living corona mortis,analyze its correlation with different sexes and left and right sides of the human body,and explore the clinical value of corona mortis in laparoscopic inguinal hernia repair.2 To explore the anatomical range of myopectineal orifice in laparoscopic inguinal hernia repair and its clinical value in laparoscopic inguinal hernia repair.Methods:Retrospective analysis was made on 207 cases of laparoscopic inguinal hernia repair operation data of hernia and abdominal wall surgery in Yanan hospital affiliated to Kunming medical university from January 2015 to February 2018.Through anatomical analysis of high-definition laparoscopic surgery video,the occurrence frequency and position changes of living corona mortis were counted,and the distance from corona mortis to pubic bone was measured.Statistical analyzed of its correlation with different sexes and human left/right side.Measure the major and minor diameters of the myopectineal orifice during surgery to obtain the anatomical range of the myopectineal orifice,and measure the distance from the myopectineal orifice upper limit to the direct inguinal hernia triangle edge and the distance from the outer edge of the myopectineal orifice to the outer edge of the inner ring mouth and the lower boundary of the myopectineal orifice to the aortico-pulmonary lower boundary.All videos analyzed were recorded by the STORZ laparoscopic system,and all data were analyzed by SPSS 20.0 statistical software.Results:1.The proportion of corona mortis was 39.1%;The corona mortis in male and female patients was 39.7%and 34.50%,respectively;The corona mortis in the left and right sides of the human body were:36.8%,40.9%.There was no statistical difference in the presence of corona mortis between different genders and human left/right sides.Arterial corona mortis accounted for 16.8%,venous corona mortis accounted for 20.6%and arteriovenous mixed accounted for:1.6%;One side exists in the pubic symphysis,and the rest exists in the suprapubic branch and near the aortico-pulmonary.Among them,62.1%of corona mortis originated from the inferior-epigastric vessels.Origin and external vascular vessels accounted for 24.2%,originated in the obturator veins accounted for 13.7%.2.The average distance between the corona mortis and the pubic symphysis was 3.05±0.48cm and the range was 2.01-3.86cm,where the mean distance in men was 2.99±0.45cm,and the range was 2.01-3.62cm,the mean distance in women was 3.54±0.37cm,and the range was:2.3 l-0.38cm,the mean value of the distance from the left side of the human body is 3.04±0.47 cm,and the average distance from the right side of the human body is 3.06±0.49 cm.There was a statistically significant difference in sex for this distance,and there was no statistical difference between the left/right sides of the human body.3.The average long diameter of the myopectineal orifice was 7.5±0.6 cm,and the average minor diameter was 4.3 cm±0.7 cm.The mean distance from the myopectineal orifice to the direct inguinal hernia triangle edge is 0.9±0.2cm;the mean distance from the outer edge of the myopectineal orifice to the inner margin is 2.8±0.7cm;the mean distance from the lower boundary of myopectineal orifice to aortico-pulmonary is 1.0±0.3cm.Select 12.*9cm patches to fully cover the myopectineal orifice.Conclusion(s):1.The incidence of corona mortis in living subjects was 39.1%,corona mortis appeared within the range of pubic bifurcation pubic symphysis 2.01cm-3.86cm,and laparoscopic inguinal hernia repair should avoid damage to corona mortis within this range.2.Compared with men,corona mortis in women is closer to the surgical field,and care should be taken to avoid corona mortis injury in female laparoscopic inguinal hernia repair.3.Based on the measurement of myopectineal orifice,it is suggested that in the laparoscopic inguinal hernia repair,selecting a patch not smaller than 12*9 cm to achieve adequate coverage of the myopectineal orifice(over 2 cm at the edge). |
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