Bülent Ü. ARIKAN, Fatih M. AVŞAR, Mustafa ŞAHİN, Salim DEMİRCİ, Erdal ANADOL, Alaittin ELHAN

Alt karın kesilerinde n.ilioinguinalis ve n.iliohypogastricus'un zedelenme olasılıkları

Amaç: N.ilioinguinalis ve N.iliohypogastricus'un Mc Burney ve paramedyan kesilere olan uzaklarını belirlemek. Yöntem: Çalışma 12 erişkin kadavra üzerinde yapıldı. Kadavraların sağ ve sol inguinal bölgeleri klasik inguinal kesi ile diseke edilerek açıldı. Sinirlerin kasları deldikleri noktalar belirlendi ve bu noktaların Sipina iliaca anterior, superior ve Umbilicus'a olan uzaklıkları ölçüldü. Bu mesafeler bir şema üzerinde işaretlendi ve sinirlerin aynı şema da gösterilen Mc Burney ve Paramedyen kesilere uzaklıkları ölçüldü. Bulgular:İlioinguinal sinir Mc Burney kesisinde sağda 0,2-6,1 cm, solda 1,8-7,5 cm, iliohipogastrik sinirde sağda 4,6-10 cm, solda 6,4-11,2 cm, iliohipogastrik sinirde sağda 5-11,2, solda 7,4-11,6 cm idi. Sonuç: Bulgularımıza göre paramedyan kesi daha güvenlidir. Alt karın bölgesinde yaılan kesiler ilioinguinal ve iliohipogastrik sinirlerin yaralanması riskini taşımaktadır. Bu sinirlerin korunmasının inguinal fıtık gelişimin azaltacağı kanaatindeyiz.

Anahtar Kelimeler:

Kadavra, Fıtık, kasık, Risk faktörleri, Cerrahi işlemler, operatif

The possibility of ilioinguinal and iliohypogatric nerves injury in lower abdominal incisions

Aim: To investigate the distances of ilioinguinal and iliohypogastric nerves from McBurney and paramedian incisions: Methods: Right and left inguinal regions of 12 adult cadavers were dissected with inguinal incision. The perforating points of the nerves on the muscles were detected and the distances of these points from spina iliaca anterior superior and umbilicus were measured marked on diagram. McBurney and paramedian incisions wrew drawn on this diagram and the distances of the perforating points of the nerves from these incisions were measured. Results: The distances of the nerves from McBurney incisions were 0,2-6,1 cm in the right, 1,8-7,5 cm in the left fo ilioinguinal nerve, and 2,2-6,9 cm inthe right, 2,9-6,2 cm in the for iliohypodastric nerve. The distances of 11,2 cm in the right, 7,4-11,6 cm in the left for iliohypogastric nerve. Conclusions: The paramedian incision is safer than the McBurney incison for nerve injury according to the distances. The lower abdominal incisions may cause nerve injury. We believe that the protection of these nerves from injury will lessen inguinal hernia occurence after appendectomy operations.

Keywords:

Cadaver, Hernia, Inguinal, Risk Factors, Surgical Procedures, Operative,

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