Three-dimensional visualization and measurement of myopectineal orifice in non-inguinal hernia patients
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ORIGINAL ARTICLE
Three‑dimensional visualization and measurement of myopectineal orifice in non‑inguinal hernia patients Zhicheng Song1 · Dongchao Yang1 · Yiping Wang2 · Xuemi Bu2 · Jianjun Yang1 · Jugang Wu1 · Xin Nie1 · Heng Song1 · Yan Gu1 Received: 18 January 2020 / Accepted: 31 July 2020 / Published online: 29 September 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose The myopectineal orifice (MPO) is a weak area at lower part of the anterior abdominal wall that directly determines the mesh size required in inguinal hernia repair. However, MPO data have mainly been acquired from measurements of cadavers or anesthetized patients. Furthermore, there are very few reports on the measurement of the MPO in Chinese patients. The present study aimed to use three-dimensional visualization technology to measure the MPO in live non-anesthetized Chinese patients, and to use this information to indicate the appropriate mesh size required for inguinal hernia repair. Methods In this study, we used the parameters of the MPO and the pelvis that were measured in 40 patients with peripheral arterial disease of the lower limb arteries (80 inguinal regions) using Medraw software (Image Medraw Technology Co., Ltd., China). Results The result showed that the average width and height of the MPO were 5.71 ± 0.99 cm and 4.96 ± 0.69 cm, respectively (5.22 ± 0.77 cm and 5.13 ± 0.63 cm in males, and 6.20 ± 0.95 cm and 4.80 ± 0.71 cm in females). The average projected area of the MPO was 16.06 ± 4.37 cm2 on the left, and 15.61 ± 4.10 cm2 on the right (P > 0.05). Conclusion Three-dimensional visualization was used to measure the area, width, and height of the MPO in living nonanesthetized Chinese patients. MPO area was correlated with age, but not with pelvic parameters. Keywords Myopectineal orifice · Inguinal region · Inguinal hernia repair · Three-dimensional visualization · Medraw software
Introduction Inguinal hernia is a common condition, with an incidence of 100–300 per 100,000 people per year [9]. It is estimated that more than 20 million hernias are repaired annually worldwide. The most common repair methods used to be the Bassini and Lichtenstein inguinal hernioplasty techniques. A tension-free hernioplasty was described in 1984, and the Zhicheng Song and Dongchao Yang have contributed equally to this work. * Yan Gu [email protected] 1
Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, Hernia and Abdominal Wall Surgery Center of Shanghai, Jiaotong University, Shanghai, China
Image Medraw Technology, Shanghai, China
2
technique was published in 1989 [12]; The operation is simple, rapid, and enables prompt resumption of unrestricted physical activity [3]. In addition, Rives-Stoppa described the real tension free with coverage of the myopectineal orifice (MPO) [20]. Tension-free hernioplasty can be done via traditional open surgery or laparoscopy, and is accepted by most hernia surgery experts. An increasing number of surgeons are performing laparoscopic
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