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The Marsh Modification for Groin Reconstruction

The Marsh Modification for Groin Reconstruction. Gilmore’s Groin updated. Simon Marsh MA MD FRCS Eng FRCS Gen-Surg Surgical Director 108 Harley Street. New and Improved. Rehabilitation Anaesthesia and pain control Surgical technique. Rehabilitation. Traditional 4 week program.

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The Marsh Modification for Groin Reconstruction

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  1. The Marsh Modification forGroin Reconstruction Gilmore’s Groin updated Simon Marsh MA MD FRCS Eng FRCS Gen-Surg Surgical Director 108 Harley Street

  2. New and Improved • Rehabilitation • Anaesthesia and pain control • Surgical technique

  3. Rehabilitation Traditional 4 week program Week 1: walk 4 x day Week 2: jog --- running adductor exercises Week 3: start sprinting cycling Week 4: kicking twist & turn Week 5: play PLAY

  4. Rehabilitation 4 Stages: Summary: Stage 1: Mobility Stage 2: Flexibility Stage 3: Strength Stage 4: Sport Specific Different requirements for amateurs and professionals

  5. Stage 1 Mobility Straight line activities Avoid abdominal straining Treadmill jogging/running Front crawl swimming Cross training

  6. Stage 2 Flexibility Body weight movements Lunges Side lunges Partial squats Hip flexion and extension Begin ball work

  7. Stage 3 Strength Increase intensity of core stability work Change of direction at speed Box drills Cutting drills Figure of eight routines

  8. Stage 4 Sport specific training

  9. Rehabilitation Professional: 3-4 weeks Amateur: 6-8 weeks

  10. Accurate Ultrasound Guided Ilioinguinal nerve block

  11. Pubic bone Stress Injury Aka: Osteitis Pubis

  12. Graph of wound strength against time Wound without sutures

  13. Graph of wound strength against time Wound with Dissolvable sutures Wound without sutures

  14. Graph of wound strength against time Wound with Permanent sutures Wound with Dissolvable sutures Wound without sutures

  15. Surgical Technique • Inguinal ligament tenolysis • Plication of posterior wall • Resuturing conjoint tendon to inguinal ligament • 2/0 prolene darn (permanent) • Closure of Scarpa’s fascia

  16. Marsh Modification Builds on traditional repair Incorporates the best from around the world Includes inguinal ligament tenolysis and less tissue trauma Specific anaesthesia Individualised rehabilitation Traditional repair Based on established anatomical and physiological principles 30 years experience Established success Groin Reconstruction

  17. http://www.108harleystreet.co.uk/

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