WorldWideScience

Sample records for incarcerated inguinal hernias

  1. Bowel Perforation complicating an incarcerated inguinal hernia

    Directory of Open Access Journals (Sweden)

    Adam Sigal

    2017-04-01

    Full Text Available History of present illness: A 51-year-old male presents complaining of increasing right groin pain and an enlarging bulge. Symptoms started as a “bubble” 6 weeks prior to presentation. One week prior to presentation, thinking the bulge was an abscess, the patient attempted to “pop” the bulge with a sewing needle, the needle became lodged in the site and he attempted retrieval with a second sewing needle, which also became lodged. No purulent material was obtained. The patient denied any nausea, vomiting or constipation as well as any fevers or urinary symptoms. His abdomen was soft, non-tender, non-distended with active bowel sounds. The groin exam demonstrated an incarcerated right inguinal hernia and cellulitis of the right hemiscrotum with associated induration and tenderness. Significant findings: The AP and lateral pelvis x-rays revealed two sewing needles, 60 mm in length, within the soft tissue over the anterior right lower hemipelvis. In addition, the AP view showed emphysema involving the right hemiscrotum (arrow, concerning for perforated bowel. Discussion: Groin hernias have a lifetime risk of 27% for men and 3% for women and the incidence increases with age.1 Groin hernias can be either direct or indirect, and inguinal or femoral. The distinction is made during surgery. Femoral hernias make up only 5% of groin hernias but are more common in women.1 Concerning complications include incarceration, in which a hernia cannot be reduced, and strangulation in which vascular compromise occurs.1 Incarcerated hernias often present with a painful, tender mass and are difficult to distinguish from strangulation. Patients with strangulation may present with fevers and peritonitis. The overlying skin may also be red.2 The percentage of patients presenting with strangulation varies by region. Western developed countries report only 1%-3% of patients presenting as surgical emergencies whereas in Africa the percentage can be as high as 26

  2. Prosthetic Mesh Repair for Incarcerated Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Cihad Tatar

    2016-08-01

    Full Text Available Background: Incarcerated inguinal hernia is a commonly encountered urgent surgical condition, and tension-free repair is a well-established method for the treatment of noncomplicated cases. However, due to the risk of prosthetic material-related infections, the use of mesh in the repair of strangulated or incarcerated hernia has often been subject to debate. Recent studies have demonstrated that biomaterials represent suitable materials for performing urgent hernia repair. Certain studies recommend mesh repair only for cases where no bowel resection is required; other studies, however, recommend mesh repair for patients requiring bowel resection as well. Aim: The aim of this study was to compare the outcomes of different surgical techniques performed for strangulated hernia, and to evaluate the effect of mesh use on postoperative complications. Study Design: Retrospective cross-sectional study. Methods: This retrospective study was performed with 151 patients who had been admitted to our hospital’s emergency department to undergo surgery for a diagnosis of incarcerated inguinal hernia. The patients were divided into two groups based on the applied surgical technique. Group 1 consisted of 112 patients treated with mesh-based repair techniques, while Group 2 consisted of 39 patients treated with tissue repair techniques. Patients in Group 1 were further divided into two sub-groups: one consisting of patients undergoing bowel resection (Group 3, and the other consisting of patients not undergoing bowel resection (Group 4. Results: In Group 1, it was observed that eight (7.14% of the patients had wound infections, while two (1.78% had hematomas, four (3.57% had seromas, and one (0.89% had relapse. In Group 2, one (2.56% of the patients had a wound infection, while three (7.69% had hematomas, one (2.56% had seroma, and none had relapses. There were no statistically significant differences between the two groups with respect to wound infection

  3. Incarcerated vermiform appendix in a left-sided inguinal hernia.

    Science.gov (United States)

    Breitenstein, S; Eisenbach, C; Wille, G; Decurtins, M

    2005-03-01

    We report here of a patient with an incarcerated vermiform appendix occurring in a left-sided indirect inguinal hernia. Occasionally, appendices are found in a hernial sac; however, the finding of an incarcerated vermiform appendix in an inguinal hernia on the left side is very unusual and has only been previously described once. The patient suffering this rare entity underwent appendectomy and repair of the hernia and experienced an uneventful postoperative recovery. The possibility of the presence of a situs inversus, or malrotation, as an underlying cause for the observed pathology was excluded by x-ray examination.

  4. A Giant Retroperitoneal Abscess Mimicking Incarcerated Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Naciye Sinem Gezer

    2015-06-01

    Full Text Available An 82-year-old man was admitted to the emergency room with an acute left-sided groin pain and scrotal swelling. He has suffered from a groin hernia for two years. Abdominal x-ray demonstrated air-fluid levels in the left upper quadrant suggesting an intestinal obstruction (Figure 1. Abdominal computed tomography (CT scan was obtained with an initial diagnosis of an incarcerated inguinal hernia. However, it showed multiple perirenal abscesses and a giant-sized retroperitoneal abscess extending from the retroperitoneal space into the scrotum through the inguinal canal (Figure 2 and 3. Retroperitoneal abscesses are most frequently seen in the 3rd to 6th decades of life (1. Gram-negative bacteria, most commonly E. coli, are the cause of infection which usually develops secondary to pyelonephritis, urinary stasis or immune suppression. The onset of clinical manifestations of the infection, including flank, abdomen and groin pain, chills, fever, tachycardia, weakness and anorexia are often insidious (2,3. Laboratory findings include leukocytosis, increased serum creatinine levels and pyuria. The literature emphasizes the possibility of diagnostic delay and postponed treatment of retroperitoneal abscess due to the fact that its prodrome phase may be long.

  5. A laparoscopic high anterior resection for sigmoid cancer with extraction through incarcerated left inguinal hernia repaired with Permacol mesh.

    Science.gov (United States)

    Carr, William Reginald Joseph; O'Dair, Graham

    2012-09-21

    A 65-year-old man presented to the general surgical outpatients with an incarcerated left inguinal hernia. Initial investigations revealed an iron deficiency anaemia that was investigated with a colonoscopy and gastroscopy. This revealed a sigmoid cancer and the staging CT scan confirmed a tumour incarcerated in the sac of the left inguinal hernia. We proceeded with a laparoscopic high anterior resection using the inguinal hernia as the extraction site. The hernia was repaired using Permacol mesh. No postoperative complications occurred.

  6. Polycystic Kidney Disease with Renal Failure Presenting as Incarcerated Inguinal Hernia in the ED

    Directory of Open Access Journals (Sweden)

    Silman, Eric F

    2009-02-01

    Full Text Available Autosomal dominant polycystic kidney disease may present to the emergency department (ED with vomiting, abdominal pain or hernias, renal insufficiency or failure, or bleeding from cerebral aneurysms. A 37-year-old man presented to the ED with signs and symptoms of incarcerated inguinal hernia. Laboratory studies showed renal failure with anion gap acidosis, and bedside ultrasound showed multicystic kidneys. Computed tomography confirmed the diagnosis. Emergency physicians should be aware of this common connective tissue defect and its serious associated conditions. [WestJEM. 2009;10:55-57

  7. A large incarcerated Meckel's diverticulum in an inguinal hernia

    Directory of Open Access Journals (Sweden)

    Michael J. Horkoff

    2014-01-01

    CONCLUSION: Littre's hernia, although rare, should be a consideration at the time of repair for any abdominal hernia involving small bowel as resection of the Meckel's diverticulum is critical in avoiding recurrent complications.

  8. An Incarcerated Colon Inguinal Hernia That Perforated into the Scrotum and Exhibited an Air-Fluid Level

    Directory of Open Access Journals (Sweden)

    Seisuke Ota

    2015-01-01

    Full Text Available There are few reports of a transverse colon inguinal hernia; furthermore, an inguinal hernia perforating the scrotum is rare. Here we report the case of a 79-year-old man who died after developing an incarcerated colon inguinal hernia that perforated the scrotum and exhibited an air-fluid level. The patient was referred to our hospital in November 2011 with a complaint of inability to move. Physical examination revealed an abnormally enlarged left scrotum and cold extremities. He reported a history of gastric cancer that was surgically treated more than 30 years ago. His white blood cell count and C-reactive protein level were elevated. Abdominal and inguinal computed tomography revealed that his transverse colon was incarcerated in the left inguinal canal. Free air and air-fluid level were observed around the transverse colon, suggestive of a perforation. The patient and his family refused any surgical intervention; therefore, he was treated with sultamicillin tosilate hydrate and cefotiam hydrochloride. However, he succumbed to panperitonitis 19 days after admission. The findings from this case indicate that the transverse colon can perforate into an inguinal hernia sac.

  9. Inflamed vermiform appendix within the sac of incarcerated left inguinal hernia.

    Science.gov (United States)

    Turanlı, Sevim; Yüksel, Murat Ulvi; Pirhan, Yavuz; Çetin, Abdullah

    2011-09-01

    A 54-year-old male complained of a continuous pain together with an irreducible swelling of the left inguinal region 8 hours prior to admission to the surgical emergency department. His physical examination revealed a very painful, erythematous, irreducible swelling in the left inguinal region without abdominal peritoneal irritation. Routine blood tests disclosed mild leukocytosis. Abdominal plain X-ray film was not specific, and ultrasonography revealed a 10 cm in length inactive, edematous intestinal section within the inguinal hernia. With the diagnosis of strangulated inguinal hernia, he underwent surgical exploration through a transverse inguinal incision. By opening the hernia sac, 6-8 cc inflammatory fluid drained out, and an inflamed vermiform appendix adhered to the inner surface of the sac was seen. Appendicectomy and primary hernia repair were performed at the same time through the inguinal incision. The postoperative course was uneventful, and the histological examination of the specimen revealed an inflamed appendix.

  10. Acute incarcerated external abdominal hernia

    OpenAIRE

    Yang, Xue-Fei; Liu, Jia-Lin

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surg...

  11. Inguinal hernia (image)

    Science.gov (United States)

    Inguinal hernia is the result of an organ, usually bowel, protruding through a weak point or tear in the thin muscular abdominal wall. Inguinal hernias can restrict blood supply to the bowel herniated through the defect, creating a medical emergency.

  12. Leiomyoma mimicking an incarcerated inguinal hernia: A rare complication of laparoscopic hysterectomy

    Directory of Open Access Journals (Sweden)

    Carlos Apestegui

    2011-01-01

    Full Text Available A 52-year-old, obese, female patient was referred for a right inguinal mass, which appeared seven months after a laparoscopic hysterectomy, which was performed because of myomatosis. Despite several examinations, including ultrasound, computed tomography (CT-Scan, positron emission tomography (PET-CT, and ultrasound-guided biopsy, the diagnosis remained unclear until surgical exploration, which disclosed a well-encapsulated solid tumour corresponding to a fibrotic leiomyoma. Spilling of leiomyoma cells is a rare and unusual complication of laparoscopic surgery. Tumour development in the inguinal canal after laparoscopic gynaecological surgery should be kept in mind in the differential diagnosis of inguinal hernia and other uncommon pathologies.

  13. Factors Associated With Manual Reduction of Incarcerated Inguinal ...

    African Journals Online (AJOL)

    Background: In patients with incarcerated inguinal hernia, initial manual reduction, which is not always feasible, rather than immediate surgery, is associated with fewer complications. The aim of the study was to evaluate factors associated with successful manual reduction of incarcerated inguinal hernia in children.

  14. Endoscopic inguinal hernia repair

    NARCIS (Netherlands)

    M.T.T. Knook

    2002-01-01

    textabstractInguinal hernias are among the oldest surgical challenges, having been recognized by the Egyptians in 1500 BC and Hippocrates in 400 BC. Celsus in 40 AD described Roman surgical practice, including manual hernia reduction for strangulated hernia, truss for reducible hernia and surgery

  15. Inguinal hernia - discharge

    Science.gov (United States)

    ... your child had surgery to repair an inguinal hernia caused by a weakness in the abdominal wall in your groin area. Now that you or your child is going home, follow the surgeon's instructions on self-care at home. ... (numb from the waist down) anesthesia. If the hernia was small, it was likely repaired under local ...

  16. Direct diverticular inguinal hernia

    International Nuclear Information System (INIS)

    Ekberg, O.; Kullenberg, K.; Sollefteaa General Hospital

    1988-01-01

    Nineteen patients with direct diverticular inguinal hernia (DDIH) were examined with herniography and surgically explored. A lump medially in the groin and pain were the prominent clinical manifestations in 18 patients. Physical examination indicated the presence of a DDIH in 6 patients. In 16 patients herniography revealed hernial sacs protruding from the supravesical fossa in 5 and from the medial inguinal fossa in 11. At operation a circumscribed defect was found in the transverse fascia laterally and cranially to the pubic tubercle in all patients. In 16 patients peritoneal hernial sacs were demonstrated at surgery while in 3 only lipomas (fatty hernia) were contained within the defect. In our opinion DDIH is a specific variety of inguinal hernia with a fairly typical clinical presentation and radiographic appearance but probably often overlooked at surgery. (orig.)

  17. Hernia inguinal laparoscopic surgery

    International Nuclear Information System (INIS)

    Morelli Brum, R. . E mail: raulmorelli@hotmail.com

    2005-01-01

    The purpose of this paper is to enhance treatment of inguinal hernia through a bibliographic study of its main complications and the analysis of a retrospective series of laparoscopic restorations performed by the author in the same private medical care center. From December 1994 through July 2003, ninety-nine patients were operated in 108 procedures.The technique employed was trans-abdominal peritoneal (TAPP)Follow-up covered over 2 years in 80% of patients with a relapse of 2.8%. Main morbidity was neuralgia due to a nerve being trapped, which fact required re-intervention.There was no mortality.The conclusion arrived at is that it is and excellent technique which requires a long learning curve and its main indication would be relapse of conventional surgery, bilateralism, coexistence with another laparoscopic abdominal pathology and doubts concerning contra lateral hernia

  18. Amyad's hernia while reparing the bilateral inguinal hernia

    OpenAIRE

    Arif Aslaner; Tuğrul Çakır; Umut Rıza Gündüz; Burhan Mayir; Nurullah Bülbüller

    2015-01-01

    Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  19. Amyad's hernia while reparing the bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Arif Aslaner

    2015-01-01

    Full Text Available Amyand's hernia is the term used for inguinal hernia containing appendix. It is a rare condition and found in 1% of inguinal hernia repairs. Here we report a case of Amyand's hernia in a 61 years old male who was diagnosed with bilateral inguinal hernia. He underwent surgery and bilateral inguinal hernia repair with prosthetic meshes and without appendectomy. The patient was discharged uneventfully. 

  20. A comparative study on trans-umbilical single-port laparoscopic approach versus conventional repair for incarcerated inguinal hernia in children

    Directory of Open Access Journals (Sweden)

    Zhang Jun

    2016-01-01

    Full Text Available Purpose: The purpose of this study is to determine whether singleport laparoscopic repair (SLR for incarcerated inguinal hernia in children is superior toconventional repair (CR approaches. Method: Between March 2013 and September 2013, 126 infants and children treatedwere retrospectively reviewed. All the patients were divided into three groups. Group A (48 patients underwent trans-umbilical SLR, group B (36 patients was subjected to trans-umbilical conventional two-port laparoscopic repair (TLR while the conventional open surgery repair (COR was performed in group C (42 patients. Data regarding the operating time, bleeding volume, post-operative hydrocele formation, testicular atrophy, cosmetic results, recurrence rate, and duration of hospital stay of the patients were collected. Result: All the cases were completed successfully without conversion. The mean operative time for group A was 15 ± 3.9 min and 24 ± 7.2 min for unilateral hernia and bilateral hernia respectively, whereas for group B, it was 13 ± 6.7 min and 23 ± 9.2 min. The mean duration of surgery in group C was 35 ± 5.2 min for unilateral hernia. The recurrence rate was 0% in all the three groups. There were statistically significant differences in theoperating time, bleeding volume, post-operative hydrocele formation, cosmetic results and duration hospital stay between the three groups (P < 0.001. No statistically significant differences between SLR and TLR were observed except the more cosmetic result in SLR. Conclusion: SLR is safe and effective, minimally invasive, and is a new technology worth promoting.

  1. The Danish Inguinal Hernia database

    DEFF Research Database (Denmark)

    Friis-Andersen, Hans; Bisgaard, Thue

    2016-01-01

    AIM OF DATABASE: To monitor and improve nation-wide surgical outcome after groin hernia repair based on scientific evidence-based surgical strategies for the national and international surgical community. STUDY POPULATION: Patients ≥18 years operated for groin hernia. MAIN VARIABLES: Type and size...... of hernia, primary or recurrent, type of surgical repair procedure, mesh and mesh fixation methods. DESCRIPTIVE DATA: According to the Danish National Health Act, surgeons are obliged to register all hernia repairs immediately after surgery (3 minute registration time). All institutions have continuous...... the medical management of the database. RESULTS: The Danish Inguinal Hernia Database comprises intraoperative data from >130,000 repairs (May 2015). A total of 49 peer-reviewed national and international publications have been published from the database (June 2015). CONCLUSION: The Danish Inguinal Hernia...

  2. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era.

    Science.gov (United States)

    Esposito, Ciro; Escolino, Maria; Turrà, Francesco; Roberti, Agnese; Cerulo, Mariapina; Farina, Alessandra; Caiazzo, Simona; Cortese, Giuseppe; Servillo, Giuseppe; Settimi, Alessandro

    2016-08-01

    The surgical repair of inguinal hernia and hydrocele is one of the most common operations performed in pediatric surgery practice. This article reviews current concepts in the management of inguinal hernia and hydrocele based on the recent literature and the authors׳ experience. We describe the principles of clinical assessment and anesthetic management of children undergoing repair of inguinal hernia, underlining the differences between an inguinal approach and minimally invasive surgery (MIS). Other points discussed include the current management of particular aspects of these pathologies such as bilateral hernias; contralateral patency of the peritoneal processus vaginalis; hernias in premature infants; direct, femoral, and other rare hernias; and the management of incarcerated or recurrent hernias. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and hydrocele, emphasizing that the current use of MIS in pediatric patients has completely changed the management of pediatric inguinal hernias. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  4. Inguinal hernia repair

    Science.gov (United States)

    ... your abdomen. The surgeon then closes your weakened abdominal muscles with stitches. Often a piece of mesh is ... or your hernia bothers you during your everyday activities. If the hernia is not causing you problems, ...

  5. Sutureless repair of inguinal hernia.

    Science.gov (United States)

    Gilbert, A I

    1992-03-01

    Sutureless repair is successful for all but the largest of indirect inguinal hernias. After reduction of the peritoneal sac, the presenting indirect component of the hernia is immediately resolved by placement of a polypropylene mesh through the internal ring. The posterior wall is reinforced with a second swatch of Prolene mesh to prevent herniation, which often results from future degenerative changes. Both swatches of mesh are held in place in separate tissue planes by the body's internal hydrostatic forces. Being sutureless, no tension is placed on any layer; there is no damage to tissues from an errant suturing technique. This procedure has been used in 412 of the 1,091 inguinal hernia repairs over the past 36 months.

  6. Isolated Inguinal Bladder Hernia

    OpenAIRE

    BAYSAL, Tamer; SOYLU, Ahmet; ERDOĞAN, Özgül

    2010-01-01

    Isolated urinary bladder herniation into the inguinal canal is rare. It is often diagnosed intraoperatively during surgery or is identified after intraoperative injury. Early diagnosis with radiologic imaging is important to avoid complications during repair surgery. Computed tomography seems the best imaging choice to outline the details of herniation. We report an incidentally discovered case of inguinal bladder herniation with intravenous pyelography and computed tomography findings. ...

  7. An incarcerated Amyand’s hernia: Shall we apply appendectomy routinely?

    Directory of Open Access Journals (Sweden)

    Gökhan Demiral

    2018-03-01

    Full Text Available Amyand’s hernia is a very rare clinical condition characterized by the presence of a normal or inflammed appendix within the inguinal hernia sac. It may be present as an acute apendicitis inside the sac or incarcerated hernia. Sometimes it may be asymptomatic. We report a case of 70-year-old male patient that was presented to our emergency service with a huge right inguinal mass that was diagnosed as an incarcerated inguinal hernia and underwent operation. The intraoperative findings included small intestinal segment, large omental tissue and mobile cecum with healthy appendix inside the sac. There was no sign of strangulation. Lichtenstein herniorhaphy was done without appendectomy.

  8. Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series

    Directory of Open Access Journals (Sweden)

    Pavlidis Theodoros

    2011-09-01

    Full Text Available Abstract Introduction A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia. Case presentations We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%. A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis, presenting as an incarcerated right groin hernia, and underwent simultaneous appendectomy and Bassini suture hernia repair. Two patients, Caucasian men aged 36 and 43 years old, had normal appendices in their sacs, which clinically appeared as non-incarcerated right groin hernias. Both underwent a plug-mesh hernia repair without appendectomy. The fourth patient, a 25-year-old Caucasian man with a large but not inflamed appendix in his sac, had a plug-mesh hernia repair with appendectomy. Conclusion A hernia surgeon may encounter unexpected intraoperative findings, such as Amyand's hernia. It is important to be prepared and apply the appropriate treatment.

  9. Amyand's hernia-a vermiform appendix presenting in an inguinal hernia: a case series.

    Science.gov (United States)

    Psarras, Kyriakos; Lalountas, Miltiadis; Baltatzis, Minas; Pavlidis, Efstathios; Tsitlakidis, Anastasios; Symeonidis, Nikolaos; Ballas, Konstantinos; Pavlidis, Theodoros; Sakantamis, Athanassios

    2011-09-19

    A vermiform appendix in an inguinal hernia, inflamed or not, is known as Amyand's hernia. Here we present a case series of four men with Amyand's hernia. We retrospectively studied 963 Caucasian patients with inguinal hernia who were admitted to our surgical department over a 12-year period. Four patients presented with Amyand's hernia (0.4%). A 32-year-old Caucasian man had an inflamed vermiform appendix in his hernial sac (acute appendicitis), presenting as an incarcerated right groin hernia, and underwent simultaneous appendectomy and Bassini suture hernia repair. Two patients, Caucasian men aged 36 and 43 years old, had normal appendices in their sacs, which clinically appeared as non-incarcerated right groin hernias. Both underwent a plug-mesh hernia repair without appendectomy. The fourth patient, a 25-year-old Caucasian man with a large but not inflamed appendix in his sac, had a plug-mesh hernia repair with appendectomy. A hernia surgeon may encounter unexpected intraoperative findings, such as Amyand's hernia. It is important to be prepared and apply the appropriate treatment.

  10. [Logistic regression analysis of high-risk factors for neonatal incarcerated hernia with intestinal necrosis].

    Science.gov (United States)

    Zeng, Cheng; Yu, Lei; Chen, Yu; Bian, Hong-Qiang; Zheng, Kai; Ye, Guo-Gang

    2012-12-01

    To investigate the high-risk factors for neonatal incarcerated hernia with intestinal necrosis by logistic regression analysis. Retrospective analysis was performed on the clinical data of 131 neonates with incarcerated oblique inguinal hernia containing the intestine. Of the 131 cases, 14 suffered from intestinal necrosis. The high risk factors for neonatal incarcerated hernia with intestinal necrosis were determined by logistic regression analysis. Manual reduction after incarceration (>2 times) (χ2 = 69.289, P2 times) (χ2 = 84.731, Pneonatal incarcerated hernia with intestinal necrosis. Intestinal necrosis tends to occur in neonates with incarcerated hernia who have incarceration or received manual reduction more than twice and suffer from mesentery incarceration. Manual reduction is prohibited for these cases, which should be surgically treated immediately.

  11. Lichtenstein versus Onstep for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2013-01-01

    Inguinal hernia is a common condition that affects millions of people world-wide every year. In Denmark (population of 5.5 million), more than 10,000 repairs of inguinal hernias are performed annually. The optimal surgical procedure for mesh placement and fixation is still being debated because...

  12. ONSTEP versus laparoscopy for inguinal hernia repair

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-01

    INTRODUCTION: The optimal repair of inguinal hernias remains controversial. It is recommended that an inguinal hernia be repaired using a mesh, either with a laparoscopic or an open approach. In Denmark, the laparoscopic approach is used in an increasing number of cases. The laparoscopic repair h...

  13. Day surgery for inguinal hernia.

    Science.gov (United States)

    Gilbert, A I

    1995-01-01

    Historical developments of groin herniorrhaphy date from Bassini's contributions through many present-day simplified tension-free techniques. Availability of sterile-packaged prosthetic mesh has currently given every surgeon an inexhaustible "tissue bank" for hernia repair surgery. The value of using a local anesthetic is unequaled in verifying the completeness of a repair. Same-day surgery has many advantages including lowered rates of infection, quicker ambulation, and more rapid return to regular activities. The sutureless umbrella plug technique is discussed. It is the simplest technique to permanently repair indirect inguinal hernias. Taking advantage of Nature' window through the internal inguinal ring, the properitoneal space can be reached. By dissecting the peritoneal sac high on its neck and shoulders, the retromuscular properitoneal space can be actualized. It allows a permanent repair to be done by simply protecting the internal ring with a swatch of polypropylene mesh shaped as an umbrella. The body's natural forces that created the hernia work to repair it by transversalis fascia. The procedure is easy to perform, done with local anesthesia, inexpensive, safe, and has minimal recurrence and complication rates.

  14. Mullerian dysgenesis with bilateral inguinal hernia

    Directory of Open Access Journals (Sweden)

    Rohan Khairatkar

    2015-01-01

    Full Text Available The 45-year-female patient came with complaints of bilateral groin pain since 1-year. Clinical examination revealed bilateral groin swelling with cough impulse. Ultrasonography (USG revealed Mullerian dysgenesis with two separate noncommunicating uterine tissues and two ovaries. USG showed bilateral inguinal hernia with herniation of right ovary in right inguinal canal and left fallopian tube in left inguinal canal. Exploration of both inguinal canal revealed underdeveloped uterus, fallopian tube and ovary. Patient underwent bilateral hernioplasty.

  15. Male Fertility After Inguinal Hernia Mesh Repair

    DEFF Research Database (Denmark)

    Kohl, Andreas Pagh; Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    OBJECTIVE:: To determine whether patients who receive an inguinal hernia repair father the same number of children as the background population. BACKGROUND:: Although the effect of inguinal hernia repair on male fertility has previously been investigated through indirect measures, no previous...... studies have evaluated the final measure of male fertility, which is the number of children fathered by patients. METHODS:: Prospectively collected data on 32,621 male patients between the ages of 18 and 55 years who received 1 or more inguinal hernia repairs during the years 1998 to 2012 were found in 5...... hernia repair using Lichtenstein technique or laparoscopic approach did not father fewer children than expected. Thus, inguinal hernia repair using Lichtenstein or laparoscopic approach did not impair male fertility....

  16. Perforated Sigmoid Colon Cancer within an Irreducible Inguinal Hernia: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Kai Hsiung; Yu, Chih Yung; Kao, Chien Chang; Tsai, Shih Hung; Huang, Guo Shu; Chang, Wei Chou [Tri-Service General Hospital, Taipei (China)

    2010-04-15

    A perforated sigmoid colon cancer within an inguinal hernia is extremely rare. This unexpected finding is usually discovered during surgery and causes an unavoidable septic evolution. Here, we describe the case of an 84-year-old man who presented with fever, abdominal distension, and a painful, enlarged, left scrotum. A CT showed a left, incarcerated, inguinal hernia containing a perforated sigmoid adenocarcinoma (which was confirmed by histopathology). The possibility of an irreducible inguinal hernia in association with perforated sigmoid colon cancer should be considered in the array of diagnoses. A pre-operative CT scan would be helpful in facilitating an accurate diagnosis.

  17. Laparoscopic Hernia Repair in Infancy and Childhood; Evaluation of ...

    African Journals Online (AJOL)

    IIR) using two needle holders (TNH). Group B was subjected to laparoscopic hernia repair of inguinal hernia by. Reverdin Needle (RN). Inclusion criteria included; bilateral inguinal hernia, recurrent hernia, hernia in obese child, incarcerated ...

  18. STRANGULATED INGUINAL HERNIA IN ADULT MALES IN KUMASI

    African Journals Online (AJOL)

    2014-06-01

    Jun 1, 2014 ... Keywords: Strangulated inguinal hernia: incidence: inguinal hernia repair rates: adults: Kumasi. INTRODUCTION. In our practice in Kumasi, strangulated inguinal hernia is a common cause of acute surgical admission for ab- dominal emergency second only to abdominal pain.1. Strangulated inguinal ...

  19. Pain characteristics after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Strandfelt, Pernille; Rosenberg, Jacob

    2011-01-01

    Previous studies have shown different pain characteristics in different types of laparoscopic operations, but pain pattern has not been studied in detail after laparoscopic inguinal hernia repair. To optimise preoperative patient information and postoperative analgesic treatment the present study...

  20. Planned inguinal herniorrhaphy but no hernia sac?

    DEFF Research Database (Denmark)

    Jensen, P; Bay-Nielsen, M; Kehlet, H

    2004-01-01

    Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention.......Planned inguinal herniorrhaphy may present a clinical dilemma when no hernia is found. No large-scale data are available on the incidence of this problem, and, therefore, no recommendations exist for choice of surgical intervention....

  1. Nerve degeneration in inguinal hernia specimens.

    Science.gov (United States)

    Amato, G; Ober, E; Romano, G; Salamone, G; Agrusa, A; Gulotta, G; Bussani, R

    2011-02-01

    The histological study of the herniated inguinal area is rare in the literature. This report is focused on the detection of structural changes of the nerves within tissues bordering the inguinal hernia of cadavers. Their physiopathological consequences are hypothesized. Primary inguinal hernia was diagnosed in 30 fresh cadavers. Tissue specimens from the inguinal region close to and around the hernia opening were excised for histological examination. A control of the data was achieved through tissue samples excised from equivalent sites of the inguinal region in 15 cadavers without hernia. The detected nerves in the inguinal area demonstrated pathological changes such as fibrotic degeneration, atrophy, and fatty dystrophy of the axons. The thickening of the perineural sheath was constantly seen. These findings were consistently present, independent of the hernia type. The detected nerve alterations lead us to imagine a worsening, or even the cessation, of the nervous impulse to the muscles, leading to atrophy and weakening of the abdominal wall. This could represent one of the multifactorial causes of hernia genesis.

  2. Surgical approach for recurrent inguinal hernias

    DEFF Research Database (Denmark)

    Öberg, S; Andresen, K; Rosenberg, J

    2016-01-01

    Purpose: Guidelines recommend that the reoperation of a recurrent inguinal hernia should be by the opposite approach (anterior–posterior) than the primary repair. However, the level of evidence supporting the guidelines is partially low. The purpose of this study was to compare re-reoperation rates...... between repairs performed according to the guidelines with the ones performed against it. Methods: This cohort study was based on the Danish Hernia Database, including 4344 patients with two inguinal hernia repairs in the same groin. Four groups were compared as follows: Lichtenstein–Lichtenstein vs......-reoperation for Lichtenstein–Lichtenstein was only seen if the primary hernia was medial. Conclusions: A primary Lichtenstein repair of a primary medial hernia should be reoperated with a laparoscopic repair. A primary Lichtenstein repair of a primary lateral hernia can be reoperated with either a Lichtenstein...

  3. Direct and Recurrent Inguinal Hernias are Associated with Ventral Hernia Repair

    DEFF Research Database (Denmark)

    Henriksen, Nadia A; Sorensen, Lars T; Bay-Nielsen, Morten

    2013-01-01

    A systemically altered connective tissue metabolism has been demonstrated in patients with abdominal wall hernias. The most pronounced connective tissue changes are found in patients with direct or recurrent inguinal hernias as opposed to patients with indirect inguinal hernias. The aim...... of the present study was to assess whether direct or recurrent inguinal hernias are associated with an elevated rate of ventral hernia surgery....

  4. Incarcerated appendix in a Spigelian hernia

    Directory of Open Access Journals (Sweden)

    Caroline Reinke

    2010-12-01

    Full Text Available Spigelian hernias are rare, making up only 1-2% of all hernias. Like other hernias, they may contain abdominal contents but are more likely to be incarcerated due to the small size of the fascial defect.(1 We describe here the case of a 71-year-old female with a 10-year history of right lower quadrant pain that remained undiagnosed despite multiple imaging studies. Prior to presentation the patient developed a new bulge and increasing pain at this site; an ultrasound revealed the presence of a bowel-containing hernia. The patient was taken urgently to the operating room for a laparoscopic Spigelian hernia repair, and was found to have an incarcerated appendix in the hernia. After the hernia was reduced, an appendectomy was performed and the hernia was repaired with biological mesh. Postoperatively, the patient did well, and her pain resolved.

  5. Paraperitoneal Inguinal Hernia of Ureter

    OpenAIRE

    Lu, Albert; Burstein, Jerome

    2012-01-01

    Inguinal herniation of ureter is an uncommon finding that can potentially lead to obstructive uropathy. We report a case of inguinal herniation of ureter discovered incidentally during workup for acute renal failure and ultrasound finding of hydronephrosis.

  6. Complicated childhood inguinal hernias in UITH, Ilorin

    Directory of Open Access Journals (Sweden)

    Kayode T Bamigbola

    2012-01-01

    Full Text Available Background: Complicated inguinal hernias pose a threat to the life of the child as well as increase the morbidity associated with management of an otherwise straightforward condition. The aim of this study was to determine the presentation, treatment and management outcome of complicated inguinal hernias in children. Materials and Methods: A retrospective study of all children 15 years and less managed for complicated inguinal hernia between 2002 and 2010. Data obtained included demographic characteristics, presentation, operative findings and outcome. Results: Complicated hernia rate was 13.9%.There were 41 children, 38 boys (92.7% and 3 girls. Ages ranged between 4 days and 15 years (Median = 90days. Most were infants (48.8%, n = 20 and neonates accounted for 19.5% (n = 8. Median duration of symptoms prior to presentation was 18 h (range = 2-96 h. Seven patients had been scheduled for elective surgery. Hernia was right sided in 68.3% (n = 28. Symptoms included vomiting (68.3%, abdominal distension (34.1% and constipation (4.9%; one patient presented with seizures. In 19 (46.3% patients hernia was reducible while 22(53.7% had emergency surgery. Associated anomalies included undescended testis (12.2%, umbilical hernia (14.6%. Intestinal resection rate was 7.3% and testicular gangrene occurred in 14.6%. Mean duration of surgery was 60.3 ± 26.7 min. Wound infection occurred in six patients (14.6%. Overall complication rate was 24.4%, 30% in infants. The mortality rate was 2.4% (n = 1. Conclusions: Morbidity associated with complicated inguinal hernia is high in neonates and infants. Delayed presentation is common in our setting. Educating the parents as well as primary care physicians on the need for early presentation is necessary.

  7. Right Inguinal Hernia Encompassing the Uterus, Right Ovary and Fallopian Tube in an Elderly Female: Case Report.

    Science.gov (United States)

    Ueda, Junji; Yoshida, Hiroshi; Makino, Hiroshi; Maruyama, Hiroshi; Yokoyama, Tadashi; Hirakata, Atsushi; Akagi, Ichiro; Watanabe, Manabu; Uchida, Eiichi; Uchida, Eiji

    2016-01-01

    The uterus, ovary, and fallopian tube are rarely present in an inguinal hernia. We report on an operation to treat just such a rare condition for a right inguinal hernia. An 87-year-old Japanese woman was admitted with swelling in the right inguinal region and a purulent discharge from the vagina. Vital signs were stable, but the mobile mass was irreducible. Computed tomography of the abdomen indicated uterine tissue in a right inguinal hernia. We diagnosed an inguinal hernia with an incarcerated uterus and performed surgery on that basis. An incision approximately 6 cm long was made in the skin above the swollen area to open the inguinal sac, disclosing a tumor enveloped by a hernial sac. Opening the hernial sac revealed the prolapsed uterus, the fallopian tube, and the right ovary. Because no ischemic change was noted, the incarcerated uterus was returned to the abdominal cavity, and the hernial opening was closed with the onlay mesh technique. The posterior wall of the inguinal canal was found to have prolapsed laterally to the inferior epigastric artery, resulting in an external inguinal hernia. This case demonstrates that careful attention must be paid to inguinal hernias in female patients because the uterus, ovary, and fallopian tube may be involved.

  8. Round Ligament Varicosities Mimicking inguinal Herniae In

    African Journals Online (AJOL)

    SEGUN ADENIJI

    Immediate post partum thrombosis of the veins of the round ligament imitating an irreducible inguinal hernia. Acta Obstet. Gynecol Scand 1994; 73(6):514-5. 11. Tokue H , Aoki J,Tsushima Y, Endo K .Characteristic of. Computed Tomography and Magnetic Resonance. Imaging Finding of Thrombosed Varices of the Round.

  9. Left-sided incarcerated Amyand’s hernia with cecum and terminal ileum: a case report

    Directory of Open Access Journals (Sweden)

    Bekele K

    2017-10-01

    Full Text Available Kebebe Bekele,1 Desalegn Markos2 1Department of Surgery, School of Medicine, Madda Walabu University, Bale Robe, Ethiopia; 2Unit of Neonatology Nursing, St Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia Background: Amyand’s hernia, which is the presence of a normal or pathological appendix as a part of an inguinal hernia, is a rare clinical entity. We are reporting a very rare case of left-sided incarcerated Amyand’s hernia with cecum and terminal ileum involvement. Case presentation: A 4-year-old male child with left inguinal swelling of 2-year duration presented to Goba Referral Hospital. Two days before the patient visited our hospital, the swelling had become irreducible and caused severe groin pain. He had abdominal cramps, bilious vomiting, and mild abdominal distention, but passed feces. With the diagnosis of left-sided incarcerated inguinal hernia, the patient was investigated and prepared for surgical management. During the operative procedure, we identified the presence of appendix, cecum, and terminal ileum in the scrotum as the herniated component. After the sack was dissected, since there was also appendicitis, an appendectomy was performed. Then, high ligation of sack was done after cecum and ileum were reduced. After 3 uneventful postoperative days in the hospital, the patient was discharged. The patient was followed-up for 6 months, and he did not develop any complications. Conclusion: Left-sided incarcerated Amyand’s hernia with cecum and terminal ileum involvement is a rare clinical entity. Even though it is not common, appendicitis is one of the comorbidities that can be seen in patients with left-sided incarcerated Amyand’s hernia with cecum and terminal ileum. Surgeons should have a high index of clinical suspicion and be aware of the potential involvement of appendix, cecum, and ileum as part of an incarcerated hernia during surgery, even in the left inguinal region. In this case, left

  10. Left inguinal hernia mimicking metastasis on bone scan

    OpenAIRE

    Goel, Sumina; Gadiraju, Ramesh

    2015-01-01

    Inguinal hernia is a well-known entity that usually affects males. The most common herniated organs are parts of the bowel, omentum, or fat. Urinary bladder herniation into the inguinal region is very rare and is often diagnosed during inguinal hernia surgery. This case highlights the importance of additional views and anatomic imaging to accurately interpret the unusual scan findings.

  11. Ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Su Mi; Chai, Jee Won [Dept. of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of)

    2016-09-15

    To characterize the ultrasonographic and clinical findings of inguinal hernia containing the ovary or omentum in girls. We studied 46 girls (49 cases) who were diagnosed with inguinal hernia on ultrasonography between March 2009 and December 2015. The ultrasonographic findings were retrospectively analyzed with respect to location, age at detection, contents of hernia, diameter of the canal of Nuck, and incidence of reducibility, incarceration and strangulation. The clinical findings included the number of cases that underwent operation, contents of hernia discovered during operation, and duration between ultrasonographic diagnosis and operation. The two groups in which inguinal hernia contained the ovary and omentum were statistically compared. Of the 49 cases, the contents of hernia were the ovary or tube in 14 cases, omentum in 32 cases, and bowel in 3 cases. The ovarian herniation group was significantly younger (10.1 months vs. 4.9 years, p < 0.001), had a lower incidence of reducibility (n = 3 vs. n = 29, p < 0.001), higher incidence of incarceration (n = 4 vs. n = 0, p = 0.006), and a shorter duration between ultrasonographic diagnosis and operation (5.7 days vs. 55.8 days, p = 0.032) than the omental herniation group. The ovarian herniation group was younger, had a lower incidence of reducibility, higher incidence of incarceration, and a shorter duration between ultrasonographic diagnosis and operation.

  12. Sliding inguinal hernia is a risk factor for recurrence

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Bisgaard, Thue; Rosenberg, Jacob

    2015-01-01

    PURPOSE: A sliding inguinal hernia is defined as a hernia where part of the hernial sac wall is formed by an organ, e.g., the colon or bladder. Thus, repair of a sliding inguinal hernia may have higher risk of complications and recurrence compared with non-sliding inguinal hernia. The aim......: In total, 70,091 primary hernia repairs were included for analysis. The occurrence of sliding inguinal hernias of the total group of included hernia repairs was 9.4 % among males and 2.9 % among females (p ... compared with non-sliding inguinal hernias (6.0 versus 4.2 %, log-rank p = 0.001). A Cox regression model was fitted and showed that the type of repair affected the risk for reoperation for recurrence; hazard ratio (95 % confidence interval): open non-mesh: reference, Lichtenstein 0.43 (0.39-0.48), other...

  13. Laparoscopic repair of massive inguinal hernia containing the urinary bladder

    Directory of Open Access Journals (Sweden)

    Atif Khan

    2014-01-01

    Full Text Available Inguinal herniation of the urinary bladder is an extremely rare occurrence involving less than 5% of inguinal hernias reported in literature. These hernias require a high index of suspicion for their diagnosis and pose significant challenges to the operating surgeon. The majority of these hernias have been repaired by an open technique. We report two cases managed laparoscopically.

  14. Irreducible Inguinal Hernias in the Paediatric Age Group | Ezomike ...

    African Journals Online (AJOL)

    BACKGROUND: An inguinal hernia is said to be irreducible when the content fails to return into the peritoneal cavity without surgical intervention. Irreducibility is an ever present risk in untreated inguinal hernias and its management remains an important part of pediatric surgery practice. When a hernia is irreducible ...

  15. Inguinal hernia recurrence: Classification and approach

    Directory of Open Access Journals (Sweden)

    Campanelli Giampiero

    2006-01-01

    Full Text Available The authors reviewed the records of 2,468 operations of groin hernia in 2,350 patients, including 277 recurrent hernias updated to January 2005. The data obtained - evaluating technique, results and complications - were used to propose a simple anatomo-clinical classification into three types which could be used to plan the surgical strategy:Type R1: first recurrence ′high,′ oblique external, reducible hernia with small (< 2 cm defect in non-obese patients, after pure tissue or mesh repairType R2: first recurrence ′low,′ direct, reducible hernia with small (< 2 cm defect in non-obese patients, after pure tissue or mesh repairType R3: all the other recurrences - including femoral recurrences; recurrent groin hernia with big defect (inguinal eventration; multirecurrent hernias; nonreducible, linked with a controlateral primitive or recurrent hernia; and situations compromised from aggravating factors (for example obesity or anyway not easily included in R1 or R2, after pure tissue or mesh repair.

  16. Presence of Inguinal Hernia in Soccer Players with Osteitis Pubis

    Directory of Open Access Journals (Sweden)

    Ali Eraslan

    2017-11-01

    Conclusion: The study revealed that soccer players with osteitis pubis may have concomitant inguinal hernia, and that osteitis pubis may develop in soccer players who have undergone hernia repair. In addition, more severe osteitis pubis findings on the same side with hernia indicate that the two pathologies occur with common mechanisms. It should not be forgotten that inguinal hernia be considered in the differential diagnosis of osteitis pubis, which it may accompany. Conservative methods are mostly used in the treatment of osteitis pubis, whereas the treatment of inguinal hernia is surgery. If only one entity is diagnosed when both are present, the success of treatment will decrease.

  17. Inguinal Hernia in Athletes: Role of Dynamic Ultrasound.

    Science.gov (United States)

    Vasileff, William Kelton; Nekhline, Mikhail; Kolowich, Patricia A; Talpos, Gary B; Eyler, Willam R; van Holsbeeck, Marnix

    Inguinal hernia is a commonly encountered cause of pain in athletes. Because of the anatomic complexity, lack of standard imaging, and the dynamic condition, there is no unified opinion explaining its underlying pathology. Athletes with persistent groin pain would have a high prevalence of inguinal hernia with dynamic ultrasound, and herniorrhaphy would successfully return athletes to activity. Case-control study. Level 3. Forty-seven amateur and professional athletes with sports-related groin pain who underwent ultrasound were selected based on history and examination. Patients with prior groin surgery or hip pathology were excluded. Clinical and surgical documentation were correlated with imaging. The study group was compared with 41 age-matched asymptomatic athletes. Ultrasound was positive for hernia with movement of bowel, bladder, or omental tissue anterior to the inferior epigastric vessels during Valsalva maneuver. The 47-patient symptomatic study group included 41 patients with direct inguinal hernias, 1 with indirect inguinal hernia, and 5 with negative ultrasound. Of 42 patients with hernia, 39 significantly improved with herniorrhaphy, 2 failed to improve after surgery and were diagnosed with adductor longus tears, and 1 improved with physical therapy. Five patients with negative ultrasound underwent magnetic resonance imaging and were diagnosed with hip labral tear or osteitis pubis. The 41-patient asymptomatic control group included 3 patients with direct inguinal hernias, 2 with indirect inguinal hernias, and 3 with femoral hernias. Inguinal hernias are a major component of groin pain in athletes. Prevalence of direct inguinal hernia in symptomatic athletes was greater than that for controls ( P < 0.001). Surgery was successful in returning these athletes to sport: 39 of 42 (93%) athletes with groin pain and inguinal hernia became asymptomatic. Persistent groin pain in the athlete may relate to inguinal hernia, which can be diagnosed with dynamic

  18. Radiologic investigation after laparoscopic inguinal hernia repair

    Energy Technology Data Exchange (ETDEWEB)

    Larmark, Martin; Ekberg, Olle [Department of Diagnostic Radiology, Malmoe University Hospital, 205 02, Malmoe (Sweden); Montgomery, Agneta [Department of Surgery, Malmoe University Hospital, 205 02, Malmoe (Sweden)

    2003-12-01

    Laparoscopic instead of open surgical repair of inguinal hernias is becoming more frequent. Radiologists may expect different postoperative findings depending on the technique used. We studied how radiology had been used postoperatively and what findings were encountered after laparoscopic herniorraphy. Postoperative radiologic examinations related to hernia repair of all consecutive patients that had had laparoscopic herniorraphy in Malmoe University hospital between 1992 and 1998 were retrospectively evaluated. A total of 538 groins were included, 3.9% (n=21) of these were postoperatively examined with ultrasound (n=10), herniography (n=7), plain abdominal films (n=2), CT (n=1), or fistulography (n=1). Significant findings were found in five groins, namely, one sinus tract, two hematomas, one small bowel obstruction, and one recurrence of hernia. Four insignificant seromas were found. The characteristics of the findings and pitfalls are described. Symptoms resulting in radiologic examination are rare after laparoscopic herniorraphy. The radiologist must be familiar with the spectrum of such findings. (orig.)

  19. Giant recurrent retroperitoneal liposarcoma presenting as a recurrent inguinal hernia

    Directory of Open Access Journals (Sweden)

    Ajay H. Bhandarwar

    2011-11-01

    Full Text Available Retroperitoneal liposarcoma presenting as an inguinal hernia is a rare entity. We present the first case of Giant recurrent liposarcoma presenting as a recurrent inguinal hernia in a 40-year-old male. Physical examination showed an irreducible lump in the right inguinal region and a scar in the right lumbar and right inguinal region. Computed tomography (CT scan of abdomen revealed it to be a retro peritoneal mass extending into the right inguinal region along and involving the cord structures. Wide local excision of the tumour with right orchidectomy and inguinal hernioplasty was performed. Histo-pathology confirmed it to be a liposarcoma. Patient received postoperative radio therapy. Follow up of two years has shown him to be disease free. Retroperitoneal liposarcoma can grow along cord structures into the inguinal canal and mimic an irreducible indirect inguinal hernia.

  20. An inguinal hernia with cryptorchidism with a Leydig cell tumor in an elderly man: A case report.

    Science.gov (United States)

    Zuiki, Toru; Ohki, Jun; Komatsubara, Toshihide; Lefor, Alan Kawarai; Miyahara, Yuzo; Ochi, Masanori; Hirota, Norio

    2017-01-01

    Cryptorchidism is common in children but is rare in the elderly. It often presents with a constellation of signs and symptoms similar to routine inguinal hernias. We present the case of an elderly man with cryptorchidism containing a Leydig cell tumor and provide clinical insights. An-84-year old man was admitted with an incarcerated right lower quadrant hernia. Both testes were absent on palpation of the scrotum. After reduction of the hernia, computed tomography scan revealed a round lesion in the hernia sac, which was suspected to be the ectopic testis. Laparoscopic exploration was performed in combination with an open anterior approach. The hernia orifice was the right internal inguinal ring, and the inguinal canal was obliterated by adhesions because the spermatic cord did not pass through it. The ectopic testis was resected with the hernia sac, and the hernia repaired with a KUGEL™ patch (Bard, USA). Laparoscopic exploration was useful to delineate the anatomy of this unusual inguinal hernia. The open anterior approach was necessary to dissect the ectopic testis and the hernia sac. Pathological findings revealed tumor cells with clear cytoplasm in the resected testis, diagnosed as a Leydig cell tumor. The combination of laparoscopic and anterior approaches facilitated the surgical treatment of an unusual inguinal hernia with cryptorchidism. The resected ectopic testis should undergo thorough histopathologic examination. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  1. Laparoscopic Inguinal Hernia Repair in a Developing Nation: Short ...

    African Journals Online (AJOL)

    Journal of Surgical Technique and Case Report | Jan-Jun 2013 | Vol-5 | Issue-1. 13. Laparoscopic Inguinal Hernia Repair in ... this is the first report of a series of laparoscopic inguinal hernia repairs from the region. MATERIALS ... Trendelenburg position and monitors near the feet. A visual port was inserted at the umbilicus ...

  2. Strangulated Inguinal Hernia in Adult Males in Kumasi | Ohene ...

    African Journals Online (AJOL)

    Background: The complications of untreated inguinal hernias are common surgical emergencies in adult Ghanaian men. Objective: To describe the epidemiology of strangulated inguinal hernia in adult males in Kumasi. Method: From the hospital records the age and sex of all male adult patients treated for strangulated ...

  3. Pain after inguinal hernia repair

    International Nuclear Information System (INIS)

    Al-Mulhim, Abdulrahman S.

    2007-01-01

    Objective was to evaluate the possible effectiveness of bowel preparation on pain after hernia repair. This was prospective randomized study, performed at King Fahd Hospital, Hofuf, Kingdom of Saudi Arabia between January 2000 and December 2002. The group of patient was randomly divided in 2 groups. Sixty-two patients in (Group-I) had bowel preparation and 65 patients in (Group II) had no bowel preparation. All patients in the Group I received lactulose 2 days before surgery and rectal enema on the day of surgery. Patients were assessed at eight hours interval in the hospital. They were assessed for the severity of pain during the first micturation and bowel motion. The pain score in the first 24 hours was significantly lower in the Group 1 (p<0.01) as well as second 24 hours (p<0.001). The pain in the first micturation (p<0.001) and during the first bowel motion (p<0.001) was less in group I compared to Group II. Patients with bowel preparation before hernia repair had significantly less pain postoperatively even in the first micturation as well as the first bowel motion than those without bowel preparation. (author)

  4. Recurrent gastric outlet obstruction due to an inguinal hernia.

    OpenAIRE

    Naraynsingh, V.; Sieunarine, K.; Raju, G. C.

    1987-01-01

    Although gastric strangulation in an inguinal hernia has been reported on three previous occasions, recurrent gastric outlet obstruction due to this hernia has not been previously documented. Prolonged traction on the distal stomach by omentum and transverse colon can draw the antrum and pylorus into the hernia and produce gastric outlet obstruction.

  5. Analysis of 3,776 pediatric inguinal hernia and hydrocele cases in a tertiary center.

    Science.gov (United States)

    Erdoğan, Derya; Karaman, Ibrahim; Aslan, Mustafa Kemal; Karaman, Ayşe; Cavuşoğlu, Yusuf Hakan

    2013-08-01

    This study describes the pediatric inguinal hernia and hydrocele experience of a tertiary care training hospital. A total of 3776 patients who had been operated between January 2005 and June 2009 for inguinal hernia, cord hydrocele, and hydrocele were included. The surgeries and patient follow-up were performed by 6 pediatric surgery specialists and 8 pediatric surgery residents. The patient age varied from 6 days to 17 years. There were 2959 (78.4%) males and 817 (21.6%) females (ratio: 3.6:1). The hernia was on the right in 2306 (61.1%) patients, on the left in 1111 (29.4%) patients, and bilateral in 359 (9.5%) patients. Age at presentation was younger in males (p<.001). Contralateral hernia repair was required later on during follow-up in 2% of the patients. Postoperative complications developed in 1.2% of the patients. Reoperation was needed because of wound infection in 0.6%, recurrence in 0.4%, hematoma in 0.1%, testicular atrophy in 1 patient, and acquired undescended testis in 1 patient. The age of first hernia symptoms was younger in males compared to females and in premature babies compared to term babies (p<.05). The recurrent hernia rate was higher in infancy. The complication rate was higher in hernia surgery in the newborn period and in cases of incarcerated hernia compared to the overall rate (p<.05). There was no indication for contralateral routine exploration. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Diagnosis of an Inguinal Hernia after a Blunt Inguinal Trauma with an Intestinal Perforation

    Directory of Open Access Journals (Sweden)

    Farès Moustafa

    2014-01-01

    Full Text Available Introduction. Inguinal hernias are very common in men. A clinical exam can do the diagnosis easily. But bowel perforation inside an inguinal hernia caused by a directly blunt trauma is rare and can have important consequences. Up to now, there have been a few case reports that described blunt injury to the inguinal area causing traumatic perforation of the bowel in the inguinal hernia. Case Report. We present a case of a 45-year-old Eastern European man with a small perforation of ileal bowels and a peritonitis after direct blunt trauma to the inguinal hernia region, with no inguinal hernia known by the patient, and show how the diagnosis can be difficult. Conclusion. This case shows that external forces, that may seem too trivial to cause intraperitoneal injury, can cause significant injury when applied to a patient with a hernia and shows how a careful examination, with the help of an abdominal CT scan, is important even if the patient do not seem to have an inguinal hernia.

  7. Usefulness of {sup 18}F-FDG PET/CT to detect metastatic mucinous adencarcinoma within an inguinal hernia

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Hyo Jung; Min, Byung Wook; Eo, Jae Seon; Lee, Sun Il; Kang, Sang Hee; Jung, Sung Yup; Oh, Sang Chul; Choe, Jae Gol [Korea University College of Medicine, Guro Hospital, Seoul (Korea, Republic of)

    2016-03-15

    Metastatic mucinous adenocarcinoma in an inguinal hernia is a rare disease and the image findings of {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) are little known. Here, we introduce a 57-year-old man with metastatic mucinous adenocarcinoma in an inguinal hernia. On initial {sup 18}F-FDG PET/CT, hypermetabolism was observed in mucinous adenocarcinoma of the cecum, and adenocarcinomas of the transverse and ascending colon, respectively. Follow-up {sup 18}F-FDG PET/CT revealed newly developed multiple hypermetabolism in peritoneal seeding masses and nodules in the pelvic cavity and scrotum. Peritoneal carcinomatosis in the right pelvic side wall was extended to the incarcerated peritoneum and mesentery in the right inguinoscrotal hernia. {sup 18}F-FDG PET/CT was useful to reveal unexpected peritoneal seeding within the inguinal hernia. Also, this case demonstrated that metastatic mucinous adenocarcinomas had variably intense FDG uptake.

  8. Two Ports Laparoscopic Inguinal Hernia Repair in Children

    Directory of Open Access Journals (Sweden)

    Medhat M. Ibrahim

    2015-01-01

    Full Text Available Introduction. Several laparoscopic treatment techniques were designed for improving the outcome over the last decade. The various techniques differ in their approach to the inguinal internal ring, suturing and knotting techniques, number of ports used in the procedures, and mode of dissection of the hernia sac. Patients and Surgical Technique. 90 children were subjected to surgery and they undergone two-port laparoscopic repair of inguinal hernia in children. Technique feasibility in relation to other modalities of repair was the aim of this work. 90 children including 75 males and 15 females underwent surgery. Hernia in 55 cases was right-sided and in 15 left-sided. Two patients had recurrent hernia following open hernia repair. 70 (77.7% cases were suffering unilateral hernia and 20 (22.2% patients had bilateral hernia. Out of the 20 cases 5 cases were diagnosed by laparoscope (25%. The patients’ median age was 18 months. The mean operative time for unilateral repairs was 15 to 20 minutes and bilateral was 21 to 30 minutes. There was no conversion. The complications were as follows: one case was recurrent right inguinal hernia and the second was stitch sinus. Discussion. The results confirm the safety and efficacy of two ports laparoscopic hernia repair in congenital inguinal hernia in relation to other modalities of treatment.

  9. SEGMENTAL EPIDURAL ANAESTHESIA FOR INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Sachidanand

    2015-09-01

    Full Text Available BACKGROUND: Epidural anaesthesia is suitable as a sole agent for lower abdominal surgery and surgery on lower limbs. It has some definite advantages over spinal anaesthesia like avoidance of post spinal headache, minimal chances of meningitis, and minimal chances of nausea and vomiting in postoperative period. But administration of conventional dosage of local epidural anaesthetics (15ml and above for surgical anaesthesia frequently results in multiple hemodynamic changes, including decreases in chronotropism, inotro pism, dromotropism, systemic vascular resistance, cardiac output, and myocardial oxygen consumption. The segmental epidural block denotes the use of a small volume enough to block only the segments involved in the field of surgery. AIM: To study the effect iveness of segmental epidural anaesthesia for inguinal hernia repair. DESIGN: R andomized control study. METHODS: 100 pts belonging to ASA PS I & II posted for inguinal hernia repair given 5ml of 0.5% bupivacaine through epidural route at L1 - L2 level and a fter conforming the adequacy and level of analgesia, the surgery was commenced. If the patient complained of pain during needle prick, then injected local anaesthetic (0.5% Bupivacaine with an incremental dosage of 1ml at a time, till the complete onset o f analgesia Pulse Rate and Blood Pressure were recorded at an interval of 1 minute for first 5 minutes and then every 5 minutes till the end of the surgery. Oxygen saturation and ECG monitoring was done continuously. Onset of analgesia, level of analgesia ( P re & post operatively, duration of analgesia, total dosage of local anaesthetic used were recorded. Complications like bradycardia, hypotension, respiratory depression, shivering, nausea and vomiting, sweating and inadvertent dural puncture were recorde d. RESULTS: 53% of patients had excellent quality of analgesia and relaxation. 34% patients had good quality analgesia and relaxation, mild discomfort while handling sac

  10. Acceptable nationwide outcome after paediatric inguinal hernia repair

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Kehlet, H; Oehlenschlager, J

    2014-01-01

    PURPOSE: The primary objective was to describe 30-day outcomes after primary inguinal paediatric hernia repair. METHODS: Prospectively collected data from the National Patient Registry covering a 2-year study period 1 January 2005 to 31 December 2006 were collected. Unexpected outcomes were defined...... was not associated with the inguinal hernia repair. The usual technique was a simple sutured plasty (96.5 %). Emergency repair was performed in 54 patients (2.2 %) mainly in children between 0 and 2 years (79.6 %). During the 1 year follow-up, reoperation for recurrent inguinal hernia was performed in 8 children...... after elective repair (recurrence rate 0.3 %). Paediatric repairs were for most parts performed in surgical public hospitals, and most departments performed less than 10 inguinal hernia repairs within the 2 years study period. CONCLUSION: These nationwide results are acceptable with low numbers...

  11. Anastomosis Procedure through an Inguinal Hernia Incision in ...

    African Journals Online (AJOL)

    The bowel resection was performed extracorporeally, and an anvil was placed at the proximal end of the colon over a purse-string suture. After colorectal anastomosis was performed using a circular stapler inserted through the anus, the inguinal hernia was repaired with a mesh. The inguinal wound healed without surgical ...

  12. Pediatric inguinal hernia repair-a critical appraisal

    DEFF Research Database (Denmark)

    Rosenberg, J.

    2008-01-01

    Inguinal hernia repair in infants and babies is a routine operation, but many issues have not been addressed scientifically. Thus, it is not known, e.g., if all children with a hernia should be operated on, what is the best timing of surgery, or if the operation should be performed with an open...

  13. Incidence of inguinal hernia in children with congenital cerebral palsy

    DEFF Research Database (Denmark)

    Reimers, J I; Latocha, J E

    1990-01-01

    The incidence of inguinal hernia among 247 children with cerebral palsy was ascertained. During the first year of life, 20 of the 153 boys developed hernia, as did one of the 94 girls. Among boys with birthweights of 1000 to 2000g the incidence was 31 per cent, which is twice the rate for normal...

  14. An animal model to train Lichtenstein inguinal hernia repair

    DEFF Research Database (Denmark)

    Rosenberg, J; Presch, I; Pommergaard, H C

    2013-01-01

    pigs, and a total of 55 surgeons have been educated to perform Lichtenstein's hernia repair in these animals. CONCLUSIONS: This new experimental surgical model for training Lichtenstein's hernia repair mimics the human inguinal anatomy enough to make it suitable as a training model. The operation...

  15. Unsuspected femoral hernia in patients with a preoperative diagnosis of recurrent inguinal hernia

    DEFF Research Database (Denmark)

    Henriksen, N A; Thorup, J; Jorgensen, L N

    2012-01-01

    Small femoral hernias may be difficult to diagnose by physical examination and are sometimes identified unexpectedly by laparoscopy. The aim of this study was to examine the incidence of unsuspected femoral hernia discovered during laparoscopic inguinal hernia repair in two well-defined patient...

  16. Incidence of inguinal hernia in children with congenital cerebral palsy

    DEFF Research Database (Denmark)

    Reimers, J I; Latocha, J E

    1990-01-01

    The incidence of inguinal hernia among 247 children with cerebral palsy was ascertained. During the first year of life, 20 of the 153 boys developed hernia, as did one of the 94 girls. Among boys with birthweights of 1000 to 2000g the incidence was 31 per cent, which is twice the rate for normal ......, particularly for boys with birthweights less than 2000g and with spastic tetraplegia. Conversely, one should be alert to the possibility of concurrent spasticity in preterm males with inguinal hernia....

  17. Laparoscopic surgery for inguinal hernia: Current status and controversies

    Directory of Open Access Journals (Sweden)

    Bhandarkar Deepraj

    2006-01-01

    Full Text Available Repair of inguinal hernia is one of the commonest operations performed by surgeons around the world. The treatment of this common problem has seen an evolution from the pure tissue repairs to the prosthetic repairs and in the recent past to laparoscopic repair. The fact that so many hernia repairs are practiced is a testimony to the fact that probably none is distinctly superior to the other. This review assesses the current status of surgery for repair of inguinal hernia and examines the various controversial issues surrounding the subject.

  18. Outcome of laproscopic totally extraperitoneal hernioplasty for inguinal hernia

    International Nuclear Information System (INIS)

    Hanif, H.; Memon, S.H.

    2015-01-01

    Background: Hernioplasty for Inguinal hernia is one of the commonest operations performed in general surgical wards. More recently, interest has waxed and waned regarding the minimally invasive approach to hernioplasty. This study was carried out to assess the management outcome of minimally invasive hernioplasty (Totally extra-peritoneal approach) as the treatment of choice for uncomplicated (incomplete and reducible) inguinal hernia. Method: In this quasi experimental study patients aged between 14-83 years who were otherwise fit and willing for total extra-peritoneal laparoscopic repair were recruited prospectively over a 10 month period. Thirty-seven such patients were operated and followed up in the hernia clinics. Six cases were later excluded for lack of proper follow-up. Results: The typical patient was middle-aged male with right-sided inguinal hernia. Mean operating time was 53.3 minutes. No conversion was undertaken; however, there was one case of small bowel injury that went unrecognized on-table but necessitated subsequent laparotomy. Overall morbidity was 13.5 percentage. Mean length of hospitalization was 2.89 days. Mean duration to normal routine life was 9.25 days. Overall, 70.9 percentage of patients expressed satisfaction with the surgery. Conclusion: Totally extra-peritoneal mesh repair is a new and safe technique for hernioplasty with acceptable rates of morbidity and it is procedure of choice for recurrent and bilateral inguinal hernias and also used as alternate to open hernioplasty for uncomplicated (incomplete and reducible) inguinal hernia. (author)

  19. An inguinal hernia sac tumor of extrahepatic cholangiocarcinoma origin

    Directory of Open Access Journals (Sweden)

    Yamazaki Hidehiro

    2006-03-01

    Full Text Available Abstract Background Metastatic hernia sac tumor from biliary malignancy is extremely rare with only one such case previously reported. We herein report an additional case of extrahepatic cholangiocarcinoma presenting as a hernia sac tumor. Case presentation A 78-year-old man presented with an irreducible right inguinal hernia associated with a firm tumor, 2.0 cm in diameter. A computed tomography scan demonstrated a soft tissue density mass with heterogeneous enhancement within the right inguinal canal. The patient underwent a hernia repair and the hernia sac tumor was resected. Histological examination of the tumor revealed a metastatic adenocarcinoma suggesting the tumor was of pancreato-biliary origin. Further investigation using imaging studies disclosed a primary tumor in the upper bile duct. The patient died of the disease nine months after the resection. Conclusion Hernia sac tumors should be considered when an irreducible, growing mass appears within an inguinal hernia. Computed tomography may be useful for the early detection of hernia sac tumors from undiagnosed intra-abdominal malignancies.

  20. Acute Osteomyelitis of the Symphysis Pubis after Inguinal Hernia Surgery

    Directory of Open Access Journals (Sweden)

    Recep Tekin

    2015-01-01

    Full Text Available Osteomyelitis of pubic symphysis is infectious inflammatory condition of the symphysis pubis and rare complication of surgery around inguinal and groin region. It should be kept in mind in the differential diagnosis of lower pelvic pain and should be sought in cases of pelvic insufficiency fractures. Herein, we present a case of a 55-year-old man with osteomyelitis of the symphysis pubis following inguinal hernia surgery for diagnosis and management of this rare condition.

  1. Current status of laparoscopic inguinal hernia repair in Denmark

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Bay-Nielsen, M

    2008-01-01

    BACKGROUND: Laparoscopic inguinal hernia repair is becoming more common in many countries, but the quality of care, experience of the operating surgeon, and details of the surgical technique are not known in detail on a national level in Denmark. In a period of expanding surgical volume for lapar......BACKGROUND: Laparoscopic inguinal hernia repair is becoming more common in many countries, but the quality of care, experience of the operating surgeon, and details of the surgical technique are not known in detail on a national level in Denmark. In a period of expanding surgical volume...... for laparoscopic inguinal hernia repair, it is important to know the typical indications for surgery, re-operation rates, details of surgical technique, and status of surgical training on a national level in order to rationalize interventions to improve outcome. METHODS: Data from the National Hernia Database...... for the last 8 years regarding laparoscopic inguinal hernia repair were used in combination with questionnaire data obtained from all surgical units in Denmark. The questionnaire included issues such as the number of operating surgeons in the department, number of residents training in the laparoscopic...

  2. A Rare Case of Inguinal Hernia with Complete Bladder Herniation

    Directory of Open Access Journals (Sweden)

    Ayaaz Habib

    2017-01-01

    Full Text Available Involvement of the bladder in inguinal hernias is rare and occurs in less than 5% of the cases. The diagnosis and management of this condition may present a challenge to the surgeon. We present a case of an elderly gentleman who presented with a large left-sided inguinoscrotal hernia causing an obstructive uropathy which was surgically repaired. The patient made a quick postoperative recovery with complete resolution of renal function.

  3. A Rare Case of Inguinal Hernia with Complete Bladder Herniation

    OpenAIRE

    Habib, Ayaaz

    2017-01-01

    Involvement of the bladder in inguinal hernias is rare and occurs in less than 5% of the cases. The diagnosis and management of this condition may present a challenge to the surgeon. We present a case of an elderly gentleman who presented with a large left-sided inguinoscrotal hernia causing an obstructive uropathy which was surgically repaired. The patient made a quick postoperative recovery with complete resolution of renal function.

  4. Type V Collagen is Persistently Altered after Inguinal Hernia Repair

    DEFF Research Database (Denmark)

    Lorentzen, L; Henriksen, N A; Juhl, P

    2018-01-01

    elective cholecystectomy served as controls (n = 10). Whole venous blood was collected 35-55 months after operation. Biomarkers for type V collagen synthesis (Pro-C5) and degradation (C5M) and those for type IV collagen synthesis (P4NP) and degradation (C4M2) were measured by a solid-phase competitive...... assay. RESULTS: The turnover of type V collagen (Pro-C5/C5M) was slightly higher postoperatively when compared to preoperatively in the inguinal hernia group (P = 0.034). In addition, the results revealed a postoperatively lower type V collagen turnover level in the inguinal hernia group compared...... and incisional hernia. The aim of this study was to determine if the altered collagen metabolism was persistent after hernia repair. MATERIAL AND METHODS: Patients who had undergone repairs for inguinal hernia (n = 11) or for incisional hernia (n = 17) were included in this study. Patients who had undergone...

  5. Laparoscopic inguinal preperitoneal injection--novel technique for inguinal hernia repair: preliminary results of experimental study.

    Science.gov (United States)

    Kozlov, Yury; Novogilov, Vladimir; Rasputin, Andrey; Podkamenev, Alexey; Krasnov, Pavel; Weber, Irina; Solovjev, Alexey

    2012-04-01

    Inguinal hernia repair is the most common procedure in pediatric surgery. Suture techniques for laparoscopic inguinal hernia repair in children are easy to perform and popular with a low recurrence rate. The aim of this study was to evaluate the effect of laparoscopic preperitoneal injection of three-dimensional gel on closing of the inguinal hernia sac (IHS) in laboratory animals. With the animals under general anesthesia, we performed peritoneoscopy in 12 male Chinchilla rabbits weighing 1200-1400 g. The endoscope was introduced into the abdominal cavity, and bilateral deep inguinal rings were identified. A Tuohy needle with the injectable polymeric bulking agent DAM+™ (three-dimensional polyacrylamide gel with silver ions [Argiform(®) from Bioform(®)]) was introduced preperitoneally. The implant was then injected across the entire orifice of the deep inguinal rings and draped over the cord structures. After completion of bilateral repairs, the rabbits were extubated and observed in the animal laboratory. Then the second laparoscopy was performed 6 months later, and the deep inguinal rings were inspected. The postoperative course was uneventful in all the animals. At the second laparoscopy no reopening of the entire orifice of the deep inguinal rings was noted. Accurate placement of the polymeric agent and adequate coverage of the vas deferens were accomplished in all the animals. This study demonstrates that the biopolymeric implant gives good postoperative results and a stable trend of closing the IHS in long-term follow-up. In conclusion, we hope that injectable polymeric bulking agents can be used for treatment of inguinal hernias of pediatric patients after additional animal and human research.

  6. Mesh Plug Repair of Inguinal Hernia; Single Surgeon Experience

    Directory of Open Access Journals (Sweden)

    Ahmet Serdar Karaca

    2013-10-01

    Full Text Available Aim: Mesh repair of inguinal hernia repairs are shown to be an effective and reliable method. In this study, a single surgeon%u2019s experience with plug-mesh method performs inguinal hernia repair have been reported. Material and Method: 587 patients with plug-mesh repair of inguinal hernia, preoperative age, body / mass index, comorbid disease were recorded in terms of form. All of the patients during the preoperative and postoperative hernia classification of information, duration of operation, antibiotics, perioperative complications, and later, the early and late postoperative complications, infection, recurrence rates and return to normal daily activity, verbal pain scales in terms of time and postoperative pain were evaluated. Added to this form of long-term pain ones. The presence of wound infection was assessed by the presence of purulent discharge from the incision. Visual analog scale pain status of the patients was measured. Results: 587 patients underwent repair of primary inguinal hernia mesh plug. One of the patients, 439 (74% of them have adapted follow-ups. Patients%u2019 ages ranged from 18-86. Was calculated as the mean of 47±18:07. Follow-up period of the patients was found to be a minimum of 3 months, maximum 55 months. Found an average of 28.2±13.4 months. Mean duration of surgery was 35.07±4.00 min (min:22mn-max:52mn, respectively. When complication rates of patients with recurrence in 2 patients (0.5%, hematoma development (1.4% in 6 patients, the development of infection in 11 patients (2.5% and long-term groin pain in 4 patients (0.9% appeared. Discussion: In our experience, the plug-mesh repair of primary inguinal hernia repair safe, effective low recurrence and complication rates can be used.

  7. Post Operative Pain Control in Inguinal Hernia Repair: Comparison ...

    African Journals Online (AJOL)

    ADMIN

    approach. Rotterdam Erasmus University. 13. Farzaneh E, Navid N, Mohammed F, Meysan M. Analgesic effect of Naproxen suppository and local marcaine injection on inguinal hernia surgery. Arch crit care. Med 2015;1(1) e521. 14. Timothy J. Brennan. Pathophysiology of Postoperative pain. Pain 2011;152(3): 533-. 540.

  8. Recurrence and Pain after Mesh Repair of Inguinal Hernias ...

    African Journals Online (AJOL)

    Background: Surgery for inguinal hernias has evolved over a prolonged period of time with the main outcome of interest being recurrence and pain. Mesh hernioplasty has been practiced with increasing frequency at Kenyatta National hospital (KNH) since its formal introduction in 2006. There has not been any published ...

  9. Factors Influencing Choice of Inguinal Hernia Repair Technique

    African Journals Online (AJOL)

    at which practical training on inguinal hernia repair occurred ... repair method(s). Results: Fifteen surgeons and sixty surgical trainees were recruited. Awareness levels and practical training were highest in the modified Bassini and Lichtenstein repair techniques. ... account individual capability and rate of progress”. (16).

  10. Anastomosis Procedure through an Inguinal Hernia Incision in ...

    African Journals Online (AJOL)

    was laparoscopically transected by a stapler. A 4 cm skin incision was then made in the left inguinal region and carried down to the peritoneum through the hernia sac [Figure 1]. Bowel resection was performed extracorporeally, and an anvil was placed at the proximal end of the colon, over a purse-string suture. [Figure 2].

  11. Early Complications of Prosthetic Inguinal Hernia Repair | Fadlalla ...

    African Journals Online (AJOL)

    Results: tension-free mesh repair was done for 87 males and 4 females. Three patients developed seroma, two patients developed haematoma and one patient developed superficial wound infection. Early recurrence (6 months) was not seen in this study. Conclusions: mesh repair for inguinal hernia is a simple, safe and ...

  12. A female infant with an inguinal hernia containing the uterus and bilateral ovaries

    Directory of Open Access Journals (Sweden)

    Toshiko Takezoe

    2015-02-01

    Full Text Available Indirect inguinal hernia is one of the most common congenital abnormality in children. In approximately 15–20% of female patients, the hernia sac contains an ipsilateral ovary, but a few cases have been reported in which the uterus and both ovaries are within the hernia sac. Ultrasonography is a very effective tool to detect prolapsed organs in inguinal hernia; however, detection may be difficult in infants. The present study describes a rare case of inguinal hernia containing the uterus and both ovaries. The hernia was sliding hernia and Bevan's technique was adopted for radical herniorrhaphy. The clinical features of the disease are discussed.

  13. Secondary inguinal hydatidosis mimicking irreducible inguinal hernia: report of a rare case.

    Science.gov (United States)

    Singh, A; Soni, M L; Khandelwal, R G; Gora, N

    2016-06-01

    Peritoneal hydatidosis secondary to liver hydatid disease is not uncommon but peritoneal hydatidosis herniating to the inguinal canal is rare, with fewer than five cases reported in the literature. We describe a 54-year-old man who presented with a progressively enlarging soft, cystic swelling in the right inguinal region. Clinical examination suggestive of irreducible right inguinal hernia and ultrasonography revealed it to be a cystic swelling within the hernial sac. The swelling was excised en bloc and open mesh hernioplasty was performed. Cyst biopsy revealed hydatid disease; hence, the patient was put on adjunctive albendazole chemotherapy for 3 months.

  14. Patient-Related Risk Factors for Recurrence After Inguinal Hernia Repair

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Pommergaard, Hans-Christian; Bisgaard, Thue

    2015-01-01

    Background. Several factors influence the risk of recurrence after inguinal hernia surgery; however, a systematic review and meta-analysis of patient-related risk factors for recurrence after inguinal hernia surgery has not been performed earlier. Methods. MEDLINE, Embase, and Cochrane databases...... were searched in June 2013 for studies evaluating patient-related risk factors for recurrence after inguinal hernia operation. Observational studies evaluating nontechnical patient-related risk factors for recurrence after inguinal hernia surgery were included. Outcome variables were grouped under...... patient demographics, hernia characteristics, connective tissue composition and degradation, habits and social relations, and conditions related to inguinal hernia recurrence. Results. From a total of 5061 records screened, we included 40 observational studies enrolling 720 651 inguinal hernia procedures...

  15. Duplicate Vas Deferens Encountered during Inguinal Hernia Repair: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Maxwell C. Breitinger

    2016-01-01

    Full Text Available Duplication of the vas deferens is a rare anomaly, defined as the presence of two distinct vasa deferentia within one spermatic cord, with only 28 cases reported worldwide since 1959. We report the case of a 63-year-old man with a duplicate vas deferens, presenting with abdominal pain from bowel obstruction secondary to incarcerated inguinal hernia. Spermatic cord dissection during hernioplasty revealed duplication of the vas deferens within the right spermatic cord. Doppler ultrasonography confirmed absence of waveforms in both vasa deferentia with arterial signal in the accompanying vessel. The hernia was repaired without complication. This report emphasizes recognition of duplicate vas deferens in avoiding iatrogenic injury and optimizing surgical outcome.

  16. Inguinal/inguinoscrotal hernias are the com

    African Journals Online (AJOL)

    hi-tech

    Results: There were 110 patients with 111 obstructed hernias, accounting for 26.4% of all abdominal wall hernias. ... intestinal obstruction and gangrenous bowel segments, accounting for 2.7% of the patients. Twenty eight per cent of ... into Computer and analyzed using statistical package Epi-Info version 6 software.

  17. Mesh Inguinal Hernia Repair and Appendectomy in the Treatment of Amyand's Hernia with Non-Inflamed Appendices

    Science.gov (United States)

    Kose, Emin; Sisik, Abdullah

    2017-01-01

    Amyand's hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand's hernia with noninflamed appendices. There were five male patients with a mean age of 42.4 ± 16.1 years in this retrospective study in which Amyand's hernia was treated with mesh inguinal hernia repair plus appendectomy for noninflamed appendices. Patients with acute appendicitis and perforated vermiform appendix were excluded. There were four right sided and one bilateral inguinal hernia. Postoperative courses were uneventful. During the follow-up period (14.0 ± 7.7 months), there was no inguinal hernia recurrence. Mesh inguinal hernia repair with appendectomy can be performed for Amyand's hernia in the absence of acute appendicitis. However, presence of fibrous connections between the vermiform appendix and the surrounding hernia sac may be regarded as a parameter to perform appendectomy. PMID:28194430

  18. Mesh Inguinal Hernia Repair and Appendectomy in the Treatment of Amyand’s Hernia with Non-Inflamed Appendices

    Directory of Open Access Journals (Sweden)

    Emin Kose

    2017-01-01

    Full Text Available Amyand’s hernia is defined as protrusion of the vermiform appendix in an inguinal hernia sac. It is a rare entity with variable clinical presentation from normal vermiform appendix to abscess formation due to perforation of acute appendicitis. Although surgical treatment includes appendectomy and hernia repair, appendectomy in the absence of an inflamed appendix and use of a mesh in cases of appendectomy remain to be controversial. The aim of this study was to review the experience of mesh inguinal hernia repair plus appendectomy performed for Amyand’s hernia with noninflamed appendices. There were five male patients with a mean age of 42.4 ± 16.1 years in this retrospective study in which Amyand’s hernia was treated with mesh inguinal hernia repair plus appendectomy for noninflamed appendices. Patients with acute appendicitis and perforated vermiform appendix were excluded. There were four right sided and one bilateral inguinal hernia. Postoperative courses were uneventful. During the follow-up period (14.0 ± 7.7 months, there was no inguinal hernia recurrence. Mesh inguinal hernia repair with appendectomy can be performed for Amyand’s hernia in the absence of acute appendicitis. However, presence of fibrous connections between the vermiform appendix and the surrounding hernia sac may be regarded as a parameter to perform appendectomy.

  19. The epidemiology and risk factors for recurrence after inguinal hernia surgery.

    Science.gov (United States)

    Burcharth, Jakob

    2014-05-01

    Recurrence after inguinal hernia surgery is a considerable clinical problem, and several risk factors of recurrence such as surgical technique, re-recurrence, and family history have been identified. Non-technical patient related factors that influence the risk of recurrence after inguinal hernia surgery are sparsely studied. The purpose of the studies included in this PhD thesis, was to describe the epidemiologic characteristics of inguinal hernia occurrence and recurrence, as well as investigating the patient related risk factors leading to recurrence after inguinal hernia surgery. Four studies were included in this thesis. Study 1: The study was a nationwide register-based study combining the Civil Registration System and the Danish National Hospital Register during a five-year period. We included a total of 46,717 persons operated for a groin hernia from the population of 5,639,885 people (2,799,105 males, 2,008,780 females). We found that 97% of all groin hernia repairs were inguinal hernias and 3% femoral hernias. Data showed that inguinal hernia surgery peaked during childhood and old age, whereas femoral hernia surgery increased throughout life. Study 2: Using data from the Danish Hernia Database (DHDB), we included all male patients operated for elective primary inguinal hernia during a 15-year period (n = 85,314). The overall inguinal hernia reoperation rate was 3.8%, and subdivided into indirect inguinal hernias and direct inguinal hernias, the reoperation rates were 2.7% and 5.2%, respectively (p thesis have studies the natural history of groin hernias on a nationwide basis; have identified the epidemiologic distribution of groin hernias and the non-technical risk factors associated with recurrence. Data showed that non-technical patient-related risk factors have great impact on the risk of recurrence after inguinal hernia surgery. The reason to why inguinal hernias recur is most likely multifactorial and lies in the span of technical and non

  20. Surgical management of chronic pain after inguinal hernia repair

    DEFF Research Database (Denmark)

    Aasvang, E; Kehlet, H

    2005-01-01

    BACKGROUND: Chronic pain after inguinal hernia repair is an adverse outcome that affects about 12 per cent of patients. Principles of treatment have not been defined. This review examines neurectomy and mesh or staple removal as possible treatments. METHOD: A literature search was carried out using...... the Medline and Ovid databases. Keywords were 'pain; chronic', 'herniorrhaphy; inguinal', 'neurectomy' and similar words. Article references were cross-checked for additional references. Articles were reviewed for data on surgical treatment of chronic pain after hernia repair. RESULTS: Neurectomy...... of the ilioinguinal, iliohypogastric, genitofemoral or lateral femoral cutaneous nerve was described in 14 papers. Overall, a favourable outcome was reported. However, the methodological quality was poor in all studies in respect of preoperative diagnostic criteria and treatment, intraoperative success in identifying...

  1. [Amyand's hernia: a report of two cases and review of the bibliography].

    Science.gov (United States)

    Manzanares-Campillo, Maria del Carmen; Muñoz-Atienza, Virginia; Sánchez-García, Susana; García-Santos, Esther; Ruescas-García, Francisco; Martín-Fernández, Jesús

    2014-01-01

    Presence of the vermiform appendix in an inguinal hernia sac is an uncommon finding (1%), exceptionally rare if it's inflamed (0.13%). Clinically simulating incarcerated inguinal hernia and proper preoperative diagnosis is exceptional. We present two unusual cases of Amyand's hernia, and review of the bibliography. 1. Male patient 78 year old with an incarcerated right inguinal hernia which was performed preoperatively the diagnosis of Amyand's hernia by abdominal Computed Tomography. Clinical case 2. Female patient 82 year old with symptoms of an incarcerated right femoral hernia that finally showed an Amyand's hernia through a right inguinal hernia. Amyand's hernia is a rare entity whose preoperative diagnosis is uncommon, that it should always be considered in the differential diagnosis in cases with clinical signs of incarcerated right inguinal hernia.

  2. Liposarcoma of the Spermatic Cord Masquerading as an Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    William Londeree

    2014-01-01

    Full Text Available This is a case of a 70-year-old male who presented with a mass in his right testicle. He was treated with antibiotics for epididymitis while undergoing serial ultrasounds for one year due to testicular swelling and pain. His fourth ultrasound revealed a mild hydrocele with a large paratesticular mass of undescribed size, superior to the right testicle, thought to be an inguinal hernia. Preoperative CT scan demonstrated a large fat-containing inguinal hernia extending into the scrotal sac. An inguinal hernia repair was complicated by fatty tissue surrounding the testicle requiring a right orchiectomy. Pathology review of the tissue demonstrated well-differentiated liposarcoma with a small focus of dedifferentiation grade 2 tumor. Tumor was identified at the inked margins indicating an incomplete resection. It was decided that no further surgical intervention was needed and the patient would undergo surveillance for local tumor recurrence. Six-month follow-up MRI scan was negative for any recurrence of disease. A liposarcoma presenting as a paratesticular mass with spermatic cord involvement is rare, and imaging studies may fail to distinguish a liposarcoma from normal adipose tissue.

  3. Amyand’s Hernia – Vermiform Appendix in an Inguinal Hernia: A Rare Finding

    Directory of Open Access Journals (Sweden)

    Prakash Kumar Sahoo

    2017-10-01

    Full Text Available A variety of surprises may spring up when the sac is opened in an inguinal hernia. Omentum, bowel diverticulum, ovary, fallopian tube, urinary bladder, large bowel, Meckel’s diverticulum or foreign bodies being the varied contents of a hernia sac. The presence of vermiform appendix in the hernia sac in an inguinal hernia is a rare finding. This condition has been named as “Amyand’s Hernia” in the honour of an English surgeon, Claudius Amyand. A diagnosis preoperatively is difficult and is most often made intraoperatively. We report here a 52-year-old patient who presented with acute intestinal obstruction due to an obstructed right sided inguinal hernia. A diagnosis of Amyand’s hernia was confirmed when on exploration appendix along with a part of ascending colon was found to be content of the sac along with a few loops of small bowel. The contents were reduced after checking the viability and Bassini’s repair was done. The patient had an uneventful postoperative period.

  4. Pubic inguinal pain syndrome: the so-called sports hernia.

    Science.gov (United States)

    Cavalli, Marta; Bombini, Grazia; Campanelli, Giampiero

    2014-03-01

    The "sportsman's hernia" commonly presents as a painful groin in those sports that involve kicking and twisting movements while running, particularly in rugby, football, soccer, and ice hockey players. Moreover, sportsman's hernia can be encountered even in normally physically active people. The pain experienced is recognized at the common point of origin of the rectus abdominis muscle and the adductor longus tendon on the pubic bone and the insertion of the inguinal ligament on the pubic bone. It is accepted that this chronic pain caused by abdominal wall weakness or injury occurs without a palpable hernia. We proposed the new name "pubic inguinal pain syndrome." In the period between January 2006 and November 2013 all patients afferent in our ambulatory clinic for chronic groin pain without a clinically evident hernia were assessed with medical history, physical examination, dynamic ultrasound, and pelvic and lumbar MRI. All patients were proposed for a conservative treatment and then, if it was not effective, for a surgical treatment. Our etiopathogenetic theory is based on three factors: (1) the compression of the three nerves of the inguinal region, (2) the imbalance in strength of adductor and abdominal wall muscles caused by the hypertrophy and stiffness of the insertion of rectus muscle and adductor longus muscle, and (3) the partial weakness of the posterior wall. Our surgical procedure includes the release of all three nerves of the region, the correction of the imbalance in strength with the partial tenotomy of the rectus and adductor longus muscles, and the repair of the partial weakness of the posterior wall with a lightweight mesh. This treatment reported excellent results with complete relief of symptoms after resumption of physical activity in all cases.

  5. A STUDY OF POSTOPERATIVE COMPLICATIONS FOLLOWING OPEN MESH INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Abdul Kalam

    2016-09-01

    Full Text Available BACKGROUND Inguinal hernia is the most common type of hernia. Inguinal region consists of deep inguinal ring, inguinal canal and superficial inguinal ring, which make the region weak and susceptible to hernia. 65% of inguinal hernias are indirect hernias and 35% direct hernias. Hernioplasty is the strengthening of posterior wall of inguinal canal. It can be done either with the help of mesh repair or darning. Hernioplasty is indicated in recurrent hernia cases, inguinal hernia with weak abdominal muscle tone where mesh plasty is preferred and inguinal hernia with good muscle tone where darning can be done. In mesh repair, posterior wall (Lichtenstein repair of inguinal canal is strengthened by a Prolene or Marlex mesh. Over time, fibroblasts and capillaries grow over the mesh converting it into a thick sheath strengthening the posterior wall. Complications which can be encountered postsurgery are pain, bleeding, urinary retention, scrotal swelling, abdominal distension, seroma and wound infections, chronic pain, keloid and testicular atrophy. MATERIALS AND METHODS  The study was conducted in the Department of General Surgery, Travancore Medical College, Kollam.  The study was done from January 2015 to January 2016.  One hundred cases were identified and were chosen for the study. INCLUSION CRITERIA 1. Inguinal hernia cases treated by open mesh repair. EXCLUSION CRITERIA 1. Other types of inguinal hernia repair. RESULTS All the cases studied belonged to male sex. In our study, age group twenty to forty years amounted to sixty one cases followed by age group forty to sixty years, which amounted to twenty eight cases. Age group zero to twenty years amounted to six cases and age group more than sixty years amounted to five cases. In the study group, seventy two cases were indirect inguinal hernias and twenty eight cases were direct inguinal hernias. Based on the complications encountered, pain at the site was the commonest complaint, which

  6. An estimation of inguinal hernia epidemiology adjusted for population age structure in Tanzania.

    Science.gov (United States)

    Beard, J H; Oresanya, L B; Akoko, L; Mwanga, A; Dicker, R A; Harris, H W

    2014-04-01

    Surgical conditions represent a significant source of global disease burden. Little is known about the epidemiology of inguinal hernia in resource-poor settings. We present a method to estimate inguinal hernia disease burden in Tanzania. Using data from the United States National Health and Nutrition Examination Survey (NHANES) prospective cohort study and Tanzanian demographic figures, we calculated inguinal hernia incidence and prevalence in Tanzanian adults under three surgical rate scenarios. Gender-specific incidence figures from NHANES data were adjusted according to Tanzanian population age structure. Hernia duration was adjusted for Tanzanian life expectancy within each age group. The prevalence of inguinal hernia in Tanzanian adults is 5.36% while an estimated 12.09% of men had hernias. Today, 683,904 adults suffer from symptomatic inguinal hernia in Tanzania. The annual incidence of symptomatic hernias in Tanzanian adults is 163 per 100,000 population. At Tanzania's current hernia repair rate, a backlog of 995,874 hernias in need of repair will develop over 10 years. 4.4 million disability-adjusted life-years would be averted with repair of prevalent symptomatic hernias in Tanzania. Our data indicate the extent of inguinal hernia disease burden in Tanzania. By adjusting our figures for the age structure of Tanzania, we have demonstrated that while the incidence of symptomatic cases may be lower than previously thought, prevalence of inguinal hernia in Tanzania remains high. This approach provides an update to our previously described methodology for calculation of inguinal hernia epidemiology in resource-poor settings that may be used in multiple country contexts.

  7. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia.

    LENUS (Irish Health Repository)

    O'Reilly, Elma A

    2012-05-01

    Laparoscopic inguinal hernia repair (LIHR), using a transabdominal preperitoneal (TAPP) or totally extraperitoneal (TEP) technique, is an alternative to conventional open inguinal hernia repair (OIHR). A consensus on outcomes of LIHR when compared with OIHR for primary, unilateral, inguinal hernia has not been reached.

  8. Persistent Mullerian Duct Syndrome presenting as irreducible inguinal hernia – A surprise surgical finding!

    OpenAIRE

    Sekhon, V.; Luthra, M.; Jevalikar, G.

    2017-01-01

    Persistent Mullerian Duct Syndrome (PMDS) is diagnosed as a discrepancy between masculine external genitalia and female internal genitalia during surgery for cryptorchidism or inguinal hernia. Approximately 200 cases have been reported in the literature so far, most of whom are adults. We discuss the management in an infant presenting with irreducible inguinal hernia with contralateral undescended testis.

  9. Inguinal hernia repair: anaesthesia, pain and convalescence

    DEFF Research Database (Denmark)

    Callesen, Torben

    2003-01-01

    of less serious complications is lower by local anaesthesia, compared to other anaesthetic techniques. Of special interest is, that the rate of urinary retention can be eliminated by the use of local anaesthesia. Local anaesthesia results, in comparative studies, in a higher degree of patient satisfaction...... than other anaesthetic techniques. Local anaesthesia also facilitates faster mobilisation and earlier discharge/fulfilment of discharge criteria from post anaesthetic care units than other anaesthetic techniques. Pain after hernia repair is more pronounced at mobilisation or coughing than during rest....... Pain after laparoscopic surgery is less pronounced than after open surgery, while different open repair techniques do not exhibit significant differences. Postoperative pain is best treated with a combination of local analgesia and peripherally acting agents (paracetamol, NSAID or their combination...

  10. Imaging findings of angiomyxolipoma of the spermatic cord mimicking inguinal hernia

    NARCIS (Netherlands)

    Cho, H.S.; Woo, J.Y.; Hong, H.S.; Yang, I.; Lee, Y.; Jung, A.Y.; Yang, D.H.; Kim, J.W.

    2013-01-01

    We report the case in a 72-year-old man who presented with a right inguinal mass and with a one month history that was initially interpreted as an inguinal hernia. Ultrasonography (US) and computed tomography (CT) demonstrated a right inguinal mass, including myxoid and fat component, extending from

  11. Ovarian Hernia; A rarity

    Directory of Open Access Journals (Sweden)

    Kamran A Malik

    2012-05-01

    Full Text Available Ovarian hernias are extremely rare. The prevalence of ovaries and fallopian tubes in operable inguinal hernias is only about 2.9%. We report here an unusual case of an ovary in a hernia sac in an adult female. She presented with symptoms and signs of an incarcerated left inguinal hernia. The left ovary contained a haemorrhagic cyst and, along with the left fallopian tube and broad ligament, these were found in the sac. She underwent a left ovarian cystectomy and the inguinal hernia was repaired with mesh.

  12. Amyand's hernia masquerading inguinal abscess complicated with appendico-cutaeneous fistula in an infant with Hirschsprung's disease

    Directory of Open Access Journals (Sweden)

    Ruzaimie Noor

    2017-06-01

    Full Text Available A normal or diseased vermiform appendix located inside the inguinal hernia is called Amyand's hernia (AH. The incidence of appendicitis in Amyand's hernia is rare. The appendicitis per se is uncommon disease in infancy. We reported an extremely rare case of undiagnosed right Amyand's hernia mimicking inguinal abscess complicated with appendico-cutaneous fistula in total colonic Hirschsprung's Disease.

  13. Trauma to an inguinal hernia resulting in bowel rupture: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Daquan Liu

    2017-01-01

    Conclusion: Trauma directly to a known inguinal hernia is an uncommon, but a dangerous event, and the abnormal alterations of intestine in the hernial sac may be one of the major reasons for such event, so it is mandatory for the physician to explain the complication of the hernia to the patient, for the hernia being repaired as early as possible.

  14. Amyand\\'s Hernia - A Case Report | Nimako | African Journal of ...

    African Journals Online (AJOL)

    The finding of a vermiform appendix as the content of an inguinal hernia sac is rare. Even rarer is the finding of an inflamed appendix in the hernia sac, referred to asAmyand\\'s hernia.We report a case of a 5-year-old boy who presented with an inflamed appendix as the content of an incarcerated right inguinal hernia.

  15. Amyand′s hernia masquerading as a strangulated inguinal hernia: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Shahbaz Habib Faridi

    2014-01-01

    Full Text Available We report a rare case of a 62-year-old male who presented to surgical emergency department with the complaints of sudden onset pain and swelled in the right inguinal region with nausea, vomiting and abdominal distension. There was a history of a reducible swelling in the right inguino-scrotal region for the last 1 year. Based on history, clinical examination and investigations a provisional diagnosis of right-sided strangulated inguinal hernia was made and patient was planned for an emergency surgery. On the exploration, the hernial sac revealed a gangrenous vermiform appendix and the diagnosis of Amyand′s hernia was made. Appendectomy was performed through the same incision, and hernial repair was done using a polypropylene mesh.

  16. Application of Lichtenstein Method in Primary Inguinal Hernia by Under Experienced Surgeons

    Directory of Open Access Journals (Sweden)

    Serkan Yilmaz

    2016-01-01

    Full Text Available Aim: Lichtenstein technique is a mostly used inguinal hernia repair that provides important advantages to patient. Complication and recurrence rates are low for surgeons and it is an easy way to learn and apply. We have explained our results of Lichtenstein method which was applied by our assistant surgeons in order to emphasize that it can be used as a start method in repair of primer inguinal hernia. Material and Method: 154 patients that were operated with Lichtenstein method by our assistant surgeons after being diagnosed with primer inguinal hernia in Ižzmir Training Research Hospital between February 2008 and February 2011 were included in the study. For all patients, spinal anaesthesia was used as anaesthesia technic. Preoperatif sefazolin Na 1 gr. iv. was injected. The patients were followed 21 months (8-43 months in average. Patients started oral feeding in the operation evening and were allowed mobilisation. Results: 149 of the patients were male and 5 were female and age average was 53,5 (18-83. In 85 patients right inguinal hernia, in 65 patients left inguinal hernia and in 4 patients bilateral inguinal hernia were diagnosed. In exploration, it was detected that there were direct hernia in 62 patients, indirect hernia in 85 patients, pantaloon hernia in 3 patients, bilateral direct hernia in 4 patients. Average stay in hospital was 1,8 days postoperative. Early complications were seen 4,5 % as infection (n=4 , seroma (n=1 , urinary retention (n=1 and scrotal edema (n=1. Late term complications were seen 6,4 % as neuralgia (n=10. Mesh reaction and recurrence weren%u2019t detected in any of the patients. Discussion: In our study, Lichtenstein method were applied especially by our underexperienced surgeons. The fact that complication rate was low and no recurrence occured support its easy learning and application. We suggest its usage as a starting method in surgery education and primary inguinal hernia repair.

  17. Cystogram with dumbbell shaped urinary bladder in a sliding inguinal hernia

    Directory of Open Access Journals (Sweden)

    Joseph Thomas

    2009-01-01

    Full Text Available Sliding inguinal hernias present with various symptoms and these are usually direct inguinal hernias containing various abdominal viscera.  Case reports and series have been published with various organs and rare organs being part of the hernia.  Urinary bladder is a known content of sliding hernias.  This case report emphasizes this aspect in a picturesque manner and the importance of radiological investigations for pre-surgical evaluation.

  18. Inguinal hernia repair among men in relation to occupational mechanical exposures and lifestyle factors

    DEFF Research Database (Denmark)

    Vad, Marie Vestergaard; Frost, Poul; Rosenberg, Jacob

    2017-01-01

    OBJECTIVES: To evaluate exposure-response relationships between occupational mechanical exposures and first-time lateral and medial inguinal hernia repair and effects of lifestyle factors. To estimate if occupational mechanical exposures advance the repairs. METHODS: This longitudinal study...

  19. A nationwide survey of incidence rates and risk factors of inguinal hernia in preterm children.

    Science.gov (United States)

    Fu, Yu-Wei; Pan, Mei-Lien; Hsu, Yao-Jen; Chin, Tai-Wai

    2018-01-01

    Clinical observations showed a higher incidence rate of inguinal hernia (IH) in preterm infants. In this study, we calculated the incidence rate of preterm IH from the National Health Insurance Research Database (NHIRD) of Taiwan. From NHIRD, 92,308 subjects born in the year of 1997-2005 were randomly selected as the study cohort. The medical claims of these subjects from birth to 6th year of age were analyzed. Preterm births were defined using ICD code 765.1*. Risk factors such as birth weight, lung disorders, and ventilator supports before IH repairs were investigated. The risk of incarceration and bowel resection were also evaluated. From 92,308 subjects, 2560 preterm births were identified. IH was repaired in 231 preterm (9.02%) and 3650 term subjects (4.07%). Male (preterm 13.3% and non-preterm 6.3%) had more hernia repairs than female (preterm 3.8% and non-preterm 1.6%). The incidence rate of IH is 13.7% for those under 1500 g, 8.2% for those 1500-1999 g, 7.7% for those 2000-2499 g, and 6.3% for those above 2500 g. The incidence rate of IH in preterms with past history of lung disorders and ventilation supports is 8.7 and 13.6%, respectively. There was no significant difference in the incidences of incarceration and bowel resection between preterms and non-preterms. Birth weight under 2500 g is a significant risk factor for IH repairs. Other risk factors are male gender, past history of lung diseases, and ventilator supports.

  20. Concomitant inguinal endometriosis and groin hernia – Case report

    Directory of Open Access Journals (Sweden)

    Daniel Ion

    2017-12-01

    Full Text Available Endometriosis is a condition which affects women during their reproductive age. We present the case of a 42 years old Caucasian nulliparous woman accusing in the last three months a painful bulging mass in the right groin. The patient reported that the mass increases in size during prolonged standing and lifting of heavyweights. In addition, the inguinal pain was exacerbated during ovulation. The patient underwent surgery, during which wide excision of the nodule was performed. Furthermore, both direct and indirect hernia sacs were found and dissected, the content was reduced and the sacs were excised. Four months after the surgery, the patient was free of symptoms and had no signs of recurrence.

  1. Chronic pain after TEP inguinal hernia repair, does MRI reveal a cause?

    NARCIS (Netherlands)

    Burgmans, J. P J; Voorbrood, C. E H; Van Dalen, T.; Boxhoorn, R. N.; Clevers, G. J.; Sanders, F. B M; Naafs, D. B J; Simmermacher, R. K J

    2016-01-01

    Purpose: Persistent pain is a known side effect after TEP inguinal repair disabling 2–5 % of patients. A standardized diagnostic work-up so far is not available. MRI is a diagnostic tool in the work-up of inguinal hernias. In the present study the yield of MRI in evaluating chronic pain after TEP

  2. Hypogonadism and man’s infertility at patients with indirect inguinal hernia after hernioplasty

    Directory of Open Access Journals (Sweden)

    I. S. Sobennikov

    2014-11-01

    Full Text Available The article estimates hydrologic status and fertility prognosis of 35 year-old reproductive age men with unilateral inguinal hernioplasty in past history from the system syndrome-based approach perspective to the etiology and pathogenesis of indirect inguinal hernia and hypogonadism.

  3. Hypogonadism and man’s infertility at patients with indirect inguinal hernia after hernioplasty

    Directory of Open Access Journals (Sweden)

    I. S. Sobennikov

    2012-01-01

    Full Text Available The article estimates hydrologic status and fertility prognosis of 35 year-old reproductive age men with unilateral inguinal hernioplasty in past history from the system syndrome-based approach perspective to the etiology and pathogenesis of indirect inguinal hernia and hypogonadism.

  4. An inguinal hernia with cryptorchidism with a Leydig cell tumor in an elderly man: A case report

    Directory of Open Access Journals (Sweden)

    Toru Zuiki

    2017-01-01

    Conclusion: The combination of laparoscopic and anterior approaches facilitated the surgical treatment of an unusual inguinal hernia with cryptorchidism. The resected ectopic testis should undergo thorough histopathologic examination.

  5. Persistent Mullerian duct syndrome presenting as an inguinal hernia : A case report

    Directory of Open Access Journals (Sweden)

    Amit Dangi

    2016-10-01

    Full Text Available A brief report of persistent mullerian duct syndrome (PMDS with 46XY karyotype which is one of the rarest variety of disorders of sexual differentiation (DSD accounting only 5% cases of all is being presented. A 21 years old male with left inguinal hernia and absent right testis presented in surgical outdoor and was operated. On exploration female genital organs like uterus and fallopian tubes along with contralateral testis were present in left inguinal canal as a content of sliding left inguinal hernia.

  6. PROSPECTIVE STUDY ON DARNING AND LICHTENSTEIN MESH HERNIOPLASTY (LMH IN INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    Affin

    2016-01-01

    Full Text Available INTRODUCTION Prospective study on Darning and Lichtenstein Mesh Hernioplasty in Inguinal Hernia Repair is a study of 61 cases of inguinal hernias which were treated by either open Inguinal hernia mesh repair (Lichtenstein or darning repair. The study was conducted with an objective to compare the effectiveness of these procedures and complications if any. 61 cases of inguinal hernia admitted in Yenepoya Medical College Hospital, Mangalore were selected on the basis of the non-probability (prospective sampling method. All patients with uncomplicated direct and indirect hernias treated by darning or mesh repair were included. After preoperative preparation they were randomly chosen for darning or mesh repair. The age/sex incidence, mode of presentation, precipitating factors, surgical treatment and postoperative complications were all evaluated and compared with standard published literature. The total number of postoperative complications was reported in 13.9% patients, complications was high after Mesh repair when compared to Darning. Seroma was the most common complication followed by funiculitis and wound infection. There was one recurrence each noted till date in the two groups under study. Darn repair is equally effective and much less costly treatment for inguinal hernia than mesh repair which had more risk of infection.

  7. Strangulation and Necrosis of an Epiploic Appendage of the Sigmoid Colon in a Right Inguinal Hernia

    Directory of Open Access Journals (Sweden)

    Yuri N. Shiryajev

    2013-01-01

    Full Text Available An epiploic appendage of the sigmoid colon is considered to be an unusual type of inguinal hernia content. The strangulation of a sigmoid colon appendage into a right inguinal hernia is exclusively rare. We present a case of an 81-year-old female patient with severe cardiovascular comorbidities who was urgently admitted after an episode of strangulation and subsequent spontaneous reduction of a right inguinal hernia. The condition of the patient was stable, and an urgent operation was not indicated for three days after admission. However, we had to operate because the hernia strangulation recurred. In the hernia sac, a free fatty body (a separated and saponified epiploic appendage of the colon and a strangulated epiploic appendage of dolichosigmoid, with signs of necrosis, were found. Removal of the free fatty body and necrotic epiploic appendage and subsequent anterior-wall inguinal hernioplasty were successfully performed. In the world literature, this case may be the first report of a sigmoid epiploic appendage strangulation in a right inguinal hernia that is well documented by photography.

  8. Pain during sexual activity before and after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, Mette A; Rosenberg, Jacob

    2015-01-01

    included. Overall, 23% of patients complained preoperatively of pain during sexual activity. Sexual life was affected in moderate-to-severe degree in 17%. Ten percent had pain during sexual activity 6 months after hernia repair. The prevalence of men with pain during sexual activity was not increased after......BACKGROUND: Sexual life may be impaired by pain during sexual activity in patients with inguinal hernia. On the other hand, inguinal hernia repair has also been reported to cause sexual dysfunction in terms of pain during sexual activity and ejaculation. The primary aim of this study...... was to estimate the prevalence of pain during sexual activity before and after laparoscopic inguinal hernia repair, and the secondary, to describe pain location, frequency of pain during sexual activity, and to which degree sexual life was affected by the pain. Furthermore, to examine whether preoperative pain...

  9. Evidence-based management of postoperative pain in adults undergoing open inguinal hernia surgery

    DEFF Research Database (Denmark)

    Joshi, G P; Rawal, N; Kehlet, H

    2012-01-01

    BACKGROUND: Open inguinal hernia repair is associated with moderate postoperative pain, but optimal analgesia remains controversial. The aim of this systematic review was to evaluate the available literature on the management of pain after open hernia surgery. METHODS: Randomized studies, in Engl...... are recommended for moderate pain, and strong opioids for severe pain, on request. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.......BACKGROUND: Open inguinal hernia repair is associated with moderate postoperative pain, but optimal analgesia remains controversial. The aim of this systematic review was to evaluate the available literature on the management of pain after open hernia surgery. METHODS: Randomized studies......, in English, published between January 1966 and March 2009, assessing analgesic and anaesthetic interventions in adult open hernia surgery, and reporting pain scores, were retrieved from the Embase and MEDLINE databases. In addition to published evidence, clinical practice was taken into account to ensure...

  10. Lack of association between inguinal hernia and abdominal aortic aneurysm in a population-based male cohort

    DEFF Research Database (Denmark)

    Henriksen, N A; Sorensen, L T; Jørgensen, Lars Nannestad

    2013-01-01

    Previous studies have reported a higher prevalence of inguinal hernia in patients with abdominal aortic aneurysm (AAA). The aim of this study was to explore the association between inguinal hernia and AAA in a large population-based cohort of men who had screening for AAA....

  11. Long-term results of giant prosthetic reinforcement of the visceral sac for complex recurrent inguinal hernia.

    NARCIS (Netherlands)

    Beets, G.L.; van Geldere, D.; Baeten, C.G.M.I.; Go, P.M.

    1996-01-01

    Long-term results of giant prosthetic reinforcement of the visceral sac for complex recurrent inguinal hernia. Beets GL, van Geldere D, Baeten CG, Go PM. Department of Surgery, University Hospital Maastricht, The Netherlands. The results of recurrent inguinal hernia repair in a prospective cohort

  12. Congenital inguinal hernias associated with a rent in the common vaginal tunic in five foals.

    Science.gov (United States)

    Spurlock, G H; Robertson, J T

    1988-11-01

    Five foals were admitted because of colic that developed within 24 hours after birth. Physical examination revealed swelling from the inguinal region to the cranial aspect of the prepuce. Through the skin overlying the swelling, distended loops of bowel could be palpated. The hernias could be reduced with the foals restrained in dorsal recumbency. Surgical exploration showed the swelling to be an inguinal hernia with small bowel herniation through a rent in the common vaginal tunic. Concurrent rupture of the vaginal tunic should be suspected when a congenital inguinal hernia is associated with colic, swelling that extends to the prepuce, or intestine that is easily palpated within the hernial swelling. Repeated manual reduction in these cases would be of little benefit and surgical intervention would be recommended.

  13. STOPPA’S REPAIR FOR INGUINAL HERNIA: STILL AN IDEAL PROCEDURE

    Directory of Open Access Journals (Sweden)

    Durganna

    2015-08-01

    Full Text Available BACKGROUND : Inguinal hernia repairs are commonly performed operations. GPRVS is one of the methods . Also known as Stoppa s repair uses large prosthetic mesh placed in preperitoneal plane covering both the hernial orifices i . e ., it covers the whole Myopectineal Orifice Bilaterally. Stoppas repair is use full in cases of bilateral hernias, recurrent and multi recurrent hernias, unilateral hernias where risk of recurrence is more i . e. , When associated with COPD, BPH, Poor abdominal tone and previous surgery. Purpose of present study is to know the role of Stoppa s repair in management of inguinal hernias especialy Bilateral , recurrent and unilateral hernias which are at the risk of recu rrence. METHODS: Study done in victoria hospital attached toBangalore medical college and research centre . 250 cases were included for stoppa s repair. Bilateral hernias , recurrent hernias, unilateral hernias with one or more risk factors for recurrence and femoral hernias . Demographic data such as age, gender, occupation, smoking, symptoms as well as comorbid conditions such as chronic obstructive pulmonary disease, prostatism, and recurrence were collected. Duration of surgery was also noted. Complications such as seroma, hematoma, orchitis, and wound infection were recorded. Duration of hospital stay was recorded. Chronic groin pain and recurrences in each group were also recorded. RESULTS: Out of 250 patients 225 had bilateral inguinal hernia and 25 unila teral inguinal hernia , 48 were recurrent and 7 were re recurrent hernia. All the patients were males with age group between 21 to 80 years. All the patients had swelling in the groin region 43.3 % of patients had associated pain. Direct hernia was common v ariety in this study as mean age in the study was more than 40 yrs. Most of the patients had one or the other risk factor for recurrence smoking was most common 76.6% . O ther risk factors are COPD , BPH , Poor abdominal tone, previous surgery

  14. A case report of unexpected pathology within an incarcerated ventral hernia

    Directory of Open Access Journals (Sweden)

    Erica D. Kane

    2017-01-01

    Conclusion: This is the first report of incisional hernia appendicitis with nonhealing colocutaneous fistulas secondary to Crohn’s. It is a lesson in developing a differential diagnosis of an inflammatory process within an incarcerated hernia and management of the complications related to laparoscopic hernial appendectomy in a patient with undiagnosed Crohn’s disease.

  15. Histological findings in direct inguinal hernia : investigating the histological changes of the herniated groin looking forward to ascertain the pathogenesis of hernia disease.

    Science.gov (United States)

    Amato, G; Agrusa, A; Romano, G; Salamone, G; Cocorullo, G; Mularo, S A; Marasa, S; Gulotta, G

    2013-12-01

    The study is focused on recognizing the histological changes of the structures close to and around the hernia opening in patients having direct inguinal hernia. In 15 patients with primary bilateral direct inguinal hernia who underwent a Stoppa open posterior inguinal hernia repair, tissue specimens from the abdominal wall surrounding a direct hernia border were excised for histological examination. These findings in patients with direct inguinal hernia were compared with tissue specimens excised from the fossa inguinalis media of cadavers without hernia. Significant degenerative modifications such as fibrohyaline degeneration and fatty substitution of the muscle fibers were seen in the biopsy samples. Inflammatory infiltration with lympho-histiocitary elements, artery sub-occlusion and vascular congestion were also constantly identified. Noteworthy injuries of the nervous structures such as edema, degenerative fibrosis and atrophy were also detected. No comparable tissue damage was witnessed in the control samples. Presence of inflammatory infiltration, vascular damage and regressive nerve lesions, as well as fibrohyaline degeneration and fatty dystrophy of the muscle fibers are the features seen within the examined structures surrounding the direct hernia opening. These findings could represent a reason for a structural and functional weakening of the inguinal region. Consequently, the described results lead the authors to depict these changes as a plausible cause of direct inguinal hernia protrusion.

  16. Dedifferentiated retroperitoneal liposarcoma presenting as right inguinal hernia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Myung; Lee, Su Lim; Ku, Young Mi [Dept. of Radiology, Uijeongbu St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu (Korea, Republic of); Choi, Moon Hyung [Dept. of Radiology, Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2016-01-15

    Retroperitoneal liposarcomas usually present as painless, slow-growing abdominal masses. When masses grow large enough to compress surrounding structures, symptoms may occur. Retroperitoneal liposarcoma clinically manifesting as inguinal hernia is a very rare entity; only 11 cases have been reported. Herein, we present radiographic features of a 37-year-old male with a painless palpable mass in the right groin that was identified as dedifferentiated retroperitoneal liposarcoma herniated through the right inguinal canal.

  17. Ascending testis after repair of pediatric inguinal hernia and hydrocele: A misunderstood operative complication.

    Science.gov (United States)

    Wang, Furan; Zhong, Hongji; Zhao, Junfeng

    2017-02-01

    Ascending testis (AT) is a rare complication after repair of an inguinal hernia/hydrocele. However, there has been some controversy concerning the AT following laparoscopic and open procedures. To review the experience of, and discuss the associated mechanisms with, testicular ascent after pediatric inguinal hernia/hydrocele surgery. A retrospective review of the medical records of male children who underwent inguinal hernia/hydrocele repair at the present hospital between January 2000 and December 2014. Those who underwent subsequent orchiopexies due to ipsilateral cryptorchidism were identified. The ATs that were misdiagnosed, caused by improper operation, and retractile testes were excluded. The Poisson distribution evaluated the incidences of subgroups. A total of 17,295 inguinal hernias and hydroceles were repaired on 12,849 males; of whom, 10 testes (0.058%) developed ATs on nine individuals postoperatively (Summary Table). The difference of AT incidences between subgroups was insignificant (P > 0.05), except for that grouped by the age at initial operation (cutoff = 1 year, P = 0.008; cutoff = 2 years, P = 0.012). During orchiopexy, extensive adhesions were found in the inguinal canal only in the two cases following open repair. The hernia sac/processus vaginalis remained intact in the canal of AT after laparoscopic repair, and partial after open herniotomy. It was generally assumed that testicular ascent after repair of an inguinal hernia/hydrocele was caused by adhesion of the spermatic cord. However, the cord was not dissected during laparoscopic procedure, so adhesion was not the major reason for AT following laparoscopic surgery. The sac/processus were partially excised during open repair, but kept intact in laparoscopic procedure. Therefore, remnants of the sac/processus might play a greater role in postoperative testicular ascent than adhesions. Furthermore, it was found that AT incidence after the repair was not higher than that in 'normal

  18. Academic Performance in Adolescence after Inguinal Hernia Repair in Infancy: A Nationwide Cohort Study

    DEFF Research Database (Denmark)

    Hansen, Tom G; Pedersen, Jacob K; Henneberg, Steen W

    2011-01-01

    for inguinal hernia repair in infancy and subsequent academic performance. METHODS:: Using Danish birth cohorts from 1986-1990, we compared the academic performance of all children who had undergone inguinal hernia repair in infancy to a randomly selected, age-matched 5% population sample. Primary analysis...... found no evidence that a single, relatively brief anesthetic exposure in connection with hernia repair in infancy reduced academic performance at age 15 or 16 yr after adjusting for known confounding factors. However, the higher test score nonattainment rate among the hernia group could suggest...... repair in infancy. A randomly selected, age-matched 5% population sample consists of 14,575 individuals. Although the exposure group performed worse than the control group (average score 0.26 lower; 95% CI, 0.21-0.31), after adjusting for known confounders, no statistically significant difference (-0...

  19. [Supravesical hernia as a rare cause of inguinal herniation and its laparoscopic treatment with TAPP approach].

    Science.gov (United States)

    Lindovský, M; Kameníček, V

    Supravesical hernia is a rare cause of hernias in the groin; the authors describe its surgical treatment using a laparoscopic technique - TAPP. From 2003 to 2015, laparoscopic hernioplasty of inguinal hernia using TAPP was performed at our clinic in 1227 patients; this patient group included 12 patients with the diagnosis of supravesical hernia. Clipped polypropylene mesh was used to cover the defect in all patients. All patients were operated on with this technique. Mean duration of hospitalization was 2.7 days and mean age of the patients was 52 years. One patient experienced a relapse due to failure of fixation of the mesh. Surgical treatment of supravesical hernias using laparoscopic (TAPP) technique appears safe and reliable. supravesical hernia - TAPP.

  20. Quality-of-life scores in laparoscopic preperitoneal inguinal hernia repair.

    Science.gov (United States)

    Wennergren, John E; Plymale, Margaret; Davenport, Daniel; Levy, Salomon; Hazey, Jeffrey; Perry, Kyle A; Stigall, Kyle; Roth, J Scott

    2016-08-01

    Published support exists for using lightweight polypropylene mesh (PPM) to repair inguinal hernias with increased biocompatibility and decreased foreign body reaction and pain. However, quality of life (QOL) has not been assessed. We assess QOL in patients undergoing laparoscopic totally extraperitoneal hernia repair (TEP) with lightweight PPM. We performed an IRB-approved study of patients undergoing TEP hernia repair. Demographic information and hernia characteristics were collected perioperatively. Baseline Short Form-36 (SF-36), Carolinas Comfort Scale (CCS), and visual analog scale (VAS) for pain were performed preoperatively, and then after 1, 26, and 52 weeks. Forty-eight patients undergoing TEP with mesh were selected. Average age was 43.2 years (SD = 13.2), and average BMI was 26.1 kg/m(2) (SD = 4.3). Procedures include bilateral hernia, right inguinal hernia, and left inguinal hernia repairs. Mean scores on the CCS(®) and VAS were low during the immediate post-op period and 1 year. SF-36 mean scores for body pain, physical function, and role physical showed decreases at the postoperative survey and then subsequent increases. Pain-associated scores increased during the immediate post-op period. CCS and SF-36 scores demonstrated improvement after 1 year. There was no significant difference in VAS. Bilateral repair patients reported more pain and reduced physical function versus unilateral repairs. Patients with larger mesh reported greater pain scores and reduced physical function scores. Laparoscopic inguinal hernia repair is associated with initial declines in QOL in the postoperative period. Improvements appear in the long term. General health does not appear to be impacted by laparoscopic TEP. Smaller mesh and unilateral repairs are associated with improved QOL following laparoscopic TEP with PPM. Multiple metrics for QOL are required to reflect patient recovery.

  1. Small-intestinal volvulus as a complication of acquired inguinal hernia in two horses.

    Science.gov (United States)

    Moll, H D; Juzwiak, J S; Santschi, E M; Slone, D E

    1991-04-15

    Volvulus of the small intestine was diagnosed as a complication of acquired inguinal herniation in 2 horses. One of the horses continued to have signs of pain after reduction of the hernia. The volvulus was diagnosed at a second surgery, but the intestine was devitalized, and the horse was euthanatized. Ventral midline exploratory surgery was performed on the second horse, in conjunction with an inguinal approach. The small-intestinal volvulus was diagnosed and corrected at this time. It is suggested that ventral midline abdominal exploration be performed when acquired inguinal herniation causes acute small-intestinal obstruction in horses.

  2. Abdominal musculature abnormalities as a cause of groin pain in athletes. Inguinal hernias and pubalgia.

    Science.gov (United States)

    Taylor, D C; Meyers, W C; Moylan, J A; Lohnes, J; Bassett, F H; Garrett, W E

    1991-01-01

    There has been increasing interest within the European sports medicine community regarding the etiology and treatment of groin pain in the athlete. Groin pain is most commonly caused by musculotendinous strains of the adductors and other muscles crossing the hip joint, but may also be related to abdominal wall abnormalities. Cases may be termed "pubalgia" if physical examination does not reveal inguinal hernia and there is an absence of other etiology for groin pain. We present nine cases of patients who underwent herniorrhaphies for groin pain. Two patients had groin pain without evidence of a hernia preoperatively (pubalgia). In the remaining seven patients we determined the presence of a hernia by physical examination. At operation, eight patients were found to have inguinal hernias. One patient had no hernia but had partial avulsion of the internal oblique fibers from their insertion at the public tubercle. The average interval from operation to return to full activity was 11 weeks. All patients returned to full activity within 3 months of surgery. One patient had persistent symptoms of mild incisional tenderness, but otherwise there were no recurrences, complications, or persistence of symptoms. Abnormalities of the abdominal wall, including inguinal hernias and microscopic tears or avulsions of the internal oblique muscle, can be an overlooked source of groin pain in the athlete. Operative treatment of this condition with herniorrhaphy can return the athlete to his sport within 3 months.

  3. Factor influencing morbidity and mortality in elderly population undergoing inguinal hernia surgery

    International Nuclear Information System (INIS)

    Malik, A.M.; Khan, A.; Laghari, A.A.

    2010-01-01

    To study various factors influencing outcome of open hernia repair in elderly population. This is a retrospective descriptive study from January 2004 to December 2008 including all patients (n=212) of 60 years and above operated for inguinal hernias either electively or in emergency during this period. One of the co-authors was assigned the duty to collect the record files of all patients over 60 years age operated for inguinal hernia in the department of surgery LUMHS as well as in private hospitals in Hyderabad. The records of all patients were reviewed and data retrieved on a proforma mentioning variables to investigate the common co-morbidities and their influence on the overall results of surgical intervention in geriatric patients. SPSS version 12 was used for statistical analysis of the data. The mean age of the patients in this series was 69.82 +- 7.8 years of whom 208(98%) were males and 4 (2%) females. In 190 (89.61%) patients the hernias were unilateral while 12 (5.7%) cases had bilateral inguinal hernias and 10 (4.7%) patients presented with recurrent hernias. In 159 (75%) patients the hernia was simple while 53 (25%) patients presented with one or the other complication such as obstruction or strangulation. Elective surgery was performed in 161(75.9%) patients while 51 (24.1 %) patients were operated in emergency. Co-morbidities were present in 79 (37.26%) patients. Out of the total study population, 7(3.30%) patients died of which 6 were operated in emergency and had co-morbidities. All of them had gangrene of bowel for which resection and anastomosis was done. One patient died of acute MI on 5th post-operative day. Emergency hernia surgery carries a high mortality in elderly patients. Co-existing medical problems make surgery still challenging in the geriatric population. An early elective hernia repair is highly recommended (JPMA 60:45; 2010). (author)

  4. First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient

    Science.gov (United States)

    Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-01-01

    Abstract Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt

  5. First Case Report of Acute Renal Failure After Mesh-Plug Inguinal Hernia Repair in a Kidney Transplant Recipient.

    Science.gov (United States)

    Veroux, Massimiliano; Ardita, Vincenzo; Zerbo, Domenico; Caglià, Pietro; Palmucci, Stefano; Sinagra, Nunziata; Giaquinta, Alessia; Veroux, Pierfrancesco

    2016-03-01

    Acute renal failure due to ureter compression after a mesh-plug inguinal repair in a kidney transplant recipient has not been previously reported to our knowledge. A 62-year-old man, who successfully underwent kidney transplantation from a deceased donor 6 years earlier, was admitted for elective repair of a direct inguinal hernia. The patient underwent an open mesh-plug repair of the inguinal hernia with placement of a plug in the preperitoneal space. We did not observe the transplanted ureter and bladder during dissection of the inguinal canal. Immediately after surgery, the patient became anuric, and a graft sonography demonstrated massive hydronephrosis. The serum creatinine level increased rapidly, and the patient underwent an emergency reoperation 8 hours later. During surgery, we did not identify the ureter but, immediately after plug removal, urine output increased progressively. We completed the hernia repair using the standard technique, without plug interposition, and the postoperative course was uneventful with complete resolution of graft dysfunction 3 days later. Furthermore, we reviewed the clinical features of complications related to inguinal hernia surgery. An increased risk of urological complications was reported recently in patients with a previous prosthetic hernia repair undergoing kidney transplantation, mainly due to the mesh adhesion to surrounding structures, making the extraperitoneal dissection during the transplant surgery very challenging. Moreover, older male kidney transplant recipients undergoing an inguinal hernia repair may be at higher risk of graft dysfunction due to inguinal herniation of a transplanted ureter. Mesh-plug inguinal hernia repair is a safe surgical technique, but this unique case suggests that kidney transplant recipients with inguinal hernia may be at higher risk of serious urological complications. Surgeons must be aware of the graft and ureter position before proceeding with hernia repair. A prompt diagnosis

  6. Academic Performance in Adolescence after Inguinal Hernia Repair in Infancy: A Nationwide Cohort Study

    DEFF Research Database (Denmark)

    Hansen, Tom G; Pedersen, Jacob K; Henneberg, Steen W

    2011-01-01

    compared average test scores at ninth grade adjusting for sex, birth weight, and paternal and maternal age and education. Secondary analysis compared the proportions of children not attaining test scores between the two groups. RESULTS:: From 1986-1990 in Denmark, 2,689 children underwent inguinal hernia...

  7. [A baby boy with cryptorchism, inguinal hernia and internal female genitalia: the persistent Mullerian duct syndrome

    NARCIS (Netherlands)

    Halbertsma, F.J.; Otten, B.J.; Wijnen, R.M.H.; Feitz, W.F.J.

    2004-01-01

    During operation for a right inguinal hernia, a baby boy aged 3 months was discovered to have internal female genitalia. Biopsies were taken from the gonads and blood was sent for karyotyping. The biopsies showed normal testicular tissue and the karyotyping result was 46XY, so the diagnosis of

  8. Sexual dysfunction after inguinal hernia repair with the Onstep versus Lichtenstein technique

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Burcharth, Jakob; Fonnes, Siv

    2017-01-01

    BACKGROUND: Sequelae after inguinal hernia repair include pain-related impairment of sexual function. Pain during intercourse can originate from the scar, scrotum, penis, or during ejaculation. The aim of this study was to investigate if the Onstep technique resulted in better results than...

  9. Polypropylene mesh repair of a unilateral, congenital hernia in the inguinal region in a Thoroughbred filly

    Science.gov (United States)

    Moorman, Valerie J.; Jann, Henry W.

    2009-01-01

    A 2-day-old Thoroughbred intact female was presented for a large subcutaneous swelling in the right inguinal region. Surgical repair was performed using a double layer polypropylene mesh. To the authors’ knowledge, there have been no previous reports of surgical repair of congenital body wall hernias with polypropylene mesh in foals. PMID:19721780

  10. Chronic pain after open mesh and sutured repair of indirect inguinal hernia in young males

    DEFF Research Database (Denmark)

    Bay-Nielsen, M; Nilsson, E; Nordin, P

    2004-01-01

    it as worse after than before surgery, and 56.6 per cent stated that it interfered with social activities. CONCLUSION: Chronic pain is common after primary inguinal hernia repair in young males, but there is no difference in the pain associated with open mesh and non-mesh repair....

  11. The Usefulness of International Cooperation in the Repair of Inguinal Hernias in Sub-Saharan Africa.

    Science.gov (United States)

    Gil, José; Rodriguez, J M; Gil, E; Hernández Agúera, Q; González, F M; García, J A; Balsalobre, M D; Tortosa, J A; Hernández Palazón, D; Diallo, A B; Parrilla, P

    2015-11-01

    The burden of disease and mortality associated with inguinal hernia in Africa, especially in sub-Saharan Africa, is very high. The purpose of this study is to show that International Cooperation work in the field of hernia repair is effective; it minimizes the delay in hernia repairs in the targeted population, and can prevent a large number of disability-adjusted life years (DALYs). As a part of an International Cooperation program, a total of 990 black patients with inguinal hernias were studied, in whom hernioplasty was performed using polypropylene mesh. The type of hernia and surgical technique were studied. Indicators of scientific and technical quality, indicators of efficiency and of effectiveness were analyzed. The results on the usefulness of interventions were calculated as avoided DALYs. Surgery was performed on 926 patients with a total of 1033 hernia repairs. 87.2 % of the repairs were made with mesh. There was no mortality in the series, complications were minor, and 85.7 % of patients remained less than 24 h in the center. There was a 2.8 % of recurrence, with a follow-up 58.7 % of the patients in the first year. 5014 DALYs were avoided, and the average of the avoided DALYs per patient was of 5.41. Hernia repair with mesh in low development countries is a procedure with low morbidity and high effectiveness that can prevent a large number of DALYs.

  12. [Incarcerated Spigelian hernia: a rare cause of ileus

    NARCIS (Netherlands)

    Ozdemir-van Brunschot, D.; Buyne, O.R.

    2012-01-01

    BACKGROUND: First described in 1764, the hernia of the semilunar line is called a Spigelian hernia. Spigelian hernias are rare: comprising only 1-2% of all abdominal hernias. CASE DESCRIPTION: A 73-year-old man presented at the emergency department complaining of not having defaecated and swelling

  13. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Kehlet, H

    2001-01-01

    To evaluate the feasibility and safety of unmonitored local anesthesia (ULA) for elective open inguinal hernia repair, we made a prospective, consecutive data collection from 1000 operations on primary and recurrent hernias. Follow-up consisted of a questionnaire 1 mo after surgery and retrieval...... from the electronic patient data management system. In 921 ASA Group I and II and 79 ASA Group III and IV patients, the median age was 60 yr (range, 18-95 yr). ULA was converted to general anesthesia in 5 of 1000 cases, and 961 patients were discharged on the day of surgery after 95 min (median...... anesthesia, day-case setup, or both, primarily because of intraoperative pain (n = 74; 7.8%). We conclude that open inguinal hernia repair can be conducted under ULA, regardless of comorbidity, with a small rate of deviation from day-case setup and minimal morbidity. It provides a safe alternative to other...

  14. Inguinal hernias in patients of 50 years and above. Pattern and outcome

    Directory of Open Access Journals (Sweden)

    Devajit Chowlek Shyam

    Full Text Available OBJECTIVE: to evaluate a one year experience with inguinal hernia repair, in patients of > 50years, with respect to the type of inguinal hernia, type of surgery, postoperative complications and recurrence. METHODS: a prospective descriptive study of patients (n=57 > 50 years operated for inguinal hernia during a one year period. Tension-free meshplasty and herniorrhaphy, using 3"x6" polypropylene mesh and 2-0 polypropylene suture, were performed in elective and emergency surgery respectively. Follow-up visits were scheduled at six weeks, three and six months postoperatively. RESULTS: the most representative age group was 61-70 years, and all patients were male. 52 (91.22% patients had unilateral inguinal hernias, while five (8.77% had bilateral hernias. In 50 (87.71% patients, the hernia was uncomplicated, while seven (12.28% patients presented with some complication such as obstruction or strangulation. Elective surgery was performed in 50 (87.71% patients while seven (12.28% patients were operated in emergency. Postoperatively, 50 (87.7% patients had uneventful recovery, while seven (12.28% patients developed some complications which were treated conservatively. Mean hospital stay was six days. One recurrence was observed and there was no peri/postoperative death. CONCLUSION: tension-free meshplasty and herniorrhaphy are safe, simple and applicable even in elderly patients after adequate pre-operative assessment and optimization. Although associated with longer hospital stay, the mortality rate is nil and complication as well as recurrence rate is low. Hence, timely repair is necessary in elderly patients even in those with comorbid conditions.

  15. Inguinal hernia repair at the Aga Khan Hospital, Nairobi: Practice ...

    African Journals Online (AJOL)

    Objectives: To review the current hernia repair methods at the Aga Khan University Hospital (AKUH) and relate to the preferred method of choice for groin hernia repair among the practicing general surgeons. Design: An audit from retrospective practices. Setting: A tertiary referral hospital, Aga Khan University Hospital, ...

  16. The Tilburg double blind randomised controlled trial comparing inguinal hernia repair according to Lichtenstein and the transinguinal preperitoneal technique

    Directory of Open Access Journals (Sweden)

    Gerritsen Pieter G

    2009-09-01

    Full Text Available Abstract Background Anterior open treatment of the inguinal hernia with a tension free mesh has reduced the incidence of recurrence and direct postoperative pain. The Lichtenstein procedure rules nowadays as reference technique for hernia treatment. Not recurrences but chronic pain is the main postoperative complication in inguinal hernia repair after Lichtenstein's technique. Preliminary experiences with a soft mesh placed in the preperitoneal space showed good results and less chronic pain. Methods The TULIP is a double-blind randomised controlled trial in which 300 patients will be randomly allocated to anterior inguinal hernia repair according to Lichtenstein or the transinguinal preperitoneal technique with soft mesh. All unilateral primary inguinal hernia patients eligible for operation who meet inclusion criteria will be invited to participate in this trial. The primary endpoint will be direct postoperative- and chronic pain. Secondary endpoints are operation time, postoperative complications, hospital stay, costs, return to daily activities (e.g. work and recurrence. Both groups will be evaluated. Success rate of hernia repair and complications will be measured as safeguard for quality. To demonstrate that inguinal hernia repair according to the transinguinal preperitoneal (TIPP technique reduces postoperative pain to Discussion The TULIP trial is aimed to show a reduction in postoperative chronic pain after anterior hernia repair according to the transinguinal preperitoneal (TIPP technique, compared to Lichtenstein. In our hypothesis the TIPP technique reduces chronic pain compared to Lichtenstein. Trial registration ISRCTN 93798494

  17. Abdominal wall endometrioma mimicking an incarcerated hernia: a case report

    Directory of Open Access Journals (Sweden)

    Simoglou C

    2012-06-01

    Full Text Available Christos Simoglou,1 Paul Zarogoulidis,2 Nikolaos Machairiotis,3 Konstantinos Porpodis,2 Lambros Simoglou,4 Alexandros Mitrakas,5 Agisilaos Esebidis,5 Eirini Sarika,6 George Kouklakis,7 Alkis Iordanidis,8 Nikolaos Katsikogiannis31Cardiothoracic Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 2Pulmonary Department, "G Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Greece; 3Surgery Department (NHS, University General Hospital of Alexandroupolis, Greece; 4Surgical Clinic (NHS, Komotini General Hospital, Thrace, Greece; 51st University Surgery Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 6Biopathology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Greece; 7Gastrointestinal Endoscopy Unit, University General Hospital of Alexandroupolis, Democritus University of Thrace, 8Radiology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, GreeceAbstract: The case of a tender, isolated abdominal wall tumor within a Pfannenstiel incision due to a seeding deposit of endometrial tissue secondary to a previous obstetric operation (caesarean section in a 39-year-old female without previously reported pelvic endometriosis is presented. The lesion clinically mimicked the appearance of an incarcerated incisional hernia at the outer corner of the healed Pfannenstiel incision. The preoperative differential diagnosis also included that of a locally forming post-operative tender granuloma and the remote possibility of an incisional endometrioma (although no link to menstruation could be made. Local malignancy was not taken as a serious possibility. Definitive diagnosis of the excised lesion was made at histology. The pre-operative diagnostic dilemma is presented, along with a short review of the literature.Keywords: endometrioma, seeding

  18. [Study of collagen and elastic fibers of connective tissue in patients with and without primary inguinal hernia].

    Science.gov (United States)

    Bórquez, Pablo; Garrido, Luis; Manterola, Carlos; Peña, Patricio; Schlageter, Carol; Orellana, Juan José; Ulloa, Hugo; Peña, Juan Luis

    2003-11-01

    There are few studies looking for collagen matrix defects in patients with inguinal bernia. To study the skin connective tissue in patients with and without inguinal bernia. Skin from the surgical wound was obtained from 23 patients with and 23 patients without inguinal bernia. The samples were processed for conventional light microscopy. Collagen fibers were stained with Van Giesson and elastic fibers with Weigert stain. Patients without hernia had compact collagen tracts homogeneously distributed towards the deep dermis. In contrast, patients with hernia had zones in the dermis with thinner and disaggregated collagen tracts. Connective tissue had a lax aspect in these patients. Collagen fiber density was 52% lower in patients with hernia, compared to subjects without hernia. No differences in elastic fiber density or distribution was observed between groups. Patients with inguinal bernia have alterations in skin collagen fiber quality and density.

  19. A minimally invasive treatment of an asymptomatic case of mesh erosion into the caecum after total extraperitoneal inguinal hernia repair.

    Science.gov (United States)

    Mulleners, Gert; Olivier, Frederick; Abasbassi, Mohamed

    2017-12-28

    Mesh migration and erosion into adjacent viscera is a rare complication after laparoscopic inguinal hernia repair. We present a minimally invasive treatment of an asymptomatic case of mesh erosion into the caecum after total extraperitoneal inguinal hernia repair, including an overview of the relevant recent literature. A male patient underwent a laparoscopic inguinal hernia repair at the age of 42. Two years after this procedure, a screening colonoscopy revealed erosion of the mesh into the caecum. A laparoscopy was performed with partial resection of the mesh and minimal resection of the involved colon. Results of a systematic review of English PubMed articles on mesh migration and erosion after inguinal hernia repair is presented. We report a first-time minimally invasive treatment of mesh erosion into the colon. A laparoscopic approach is feasible and provides an excellent exposure. Partial removal of the mesh is suggested in uncomplicated cases to avoid complications associated with complete mesh removal.

  20. Biologic mesh versus synthetic mesh in open inguinal hernia repair: system review and meta-analysis.

    Science.gov (United States)

    Fang, Zhixue; Ren, Feng; Zhou, Jianping; Tian, Jiao

    2015-12-01

    Biologic meshes are mostly used for abdominal wall reinforcement in infected fields, but no consensus has been reached on its use for inguinal hernia repairing. The purpose of this study was to compare biologic mesh with synthetic mesh in open inguinal herniorrhaphy. A systematic literature review and meta-analysis was undertaken to identify studies comparing the outcomes of biologic mesh and synthetic mesh in open inguinal hernia repair. Published studies were identified by the databases PubMed, EMBASE and the Cochrane Library. A total of 382 patients in five randomized controlled trials were reviewed (179 patients in biologic mesh group; 203 patients in synthetic mesh group). The two groups did not significantly differ in chronic groin pain (P = 0.06) or recurrence (P = 0.38). The incidence of seroma trended higher in biologic mesh group (P = 0.03). Operating time was significantly longer with biologic mesh (P = 0.03). There was no significant difference in hematomas (P = 0.23) between the two groups. From the data of this study, biologic mesh had no superiority to synthetic mesh in open inguinal hernia repair with similar recurrence rates and incidence of chronic groin pain, but higher rate of seroma and longer operating time. However, this mesh still needs to be assessed in a large, multicentre, well-designed randomized controlled trial. © 2015 Royal Australasian College of Surgeons.

  1. External Genital Abnormalities and Inguinal Hernia among Males of Children Nurseries, North West of Iran

    Directory of Open Access Journals (Sweden)

    Hossein Haratipour

    2016-02-01

    Full Text Available Background Abnormalities of external genitalia in male children nurseries and inguinal hernia are the most common congenital disorders in children. We aimed to determine prevalence rate of inguinal hernia and other genital among children nurseries, in Shahrood-Iran. Materials and Methods In this descriptive cross-sectional study, we examined 920 children nurseries boys. Physical examination of children was performed in presence of a parent in a warm room in supine and upright position with and without Valsalva maneuver. A written consent was obtained from parents before examination. Past medical history and history of surgery on inguinal and genital area was taken. Examination was performed 2 interns who were trained about genital system examination.   Results A total of 920 children nurseries boys aged 3 to 6 years were examined which were detected in 88 children and prevalence rate of these abnormalities were 9.6%. The prevalence of abnormalities in the children under study were as follows: Inguinal hernia (5.1%, cryptorchidism (2.1%, Hydrocele (1.5%, hypospadias (0.4%, Varicocele (0.1%, micropenis (0.4%. Conclusion Regarding to relatively high prevalence rate of these abnormalities and low level of people knowledge, seem screening systems for diagnosis and appropriate treatment of these abnormalities to be necessary.

  2. La hernia inguinal en la era laparoscópica.

    OpenAIRE

    WEBER SÁNCHEZ, Alejandro; VAZQUEZ, José A.; MANSILLA DORIA, Percy; CUETO GARCÍA, Jorge

    2013-01-01

    Objetivo: Describir los resultados de 327 reparaciones via laparoscópica de hernias inguinales. Materiales y métodos: Estudio descriptivo de 327 reparaciones vía laparoscópica de hernias inguinales practicadas en 257 pacientes, realizadas entre 1992 y 1996 en el Servicio de Cirugia del American British Cowdray Medical Center, en México Distrito Federal. Resultados: El sexo fue predominantemente masculino (77.4 %); las edades oscilaron entre 9 y 89 años. En 85 pacientes se trató de hernia ingu...

  3. Posterolateral diaphragmatic hernia with small-bowel incarceration ...

    African Journals Online (AJOL)

    Bochdalek hernia (BH), a closing defect of the peripheral posterior aspect of the diaphragm, is the most common of the congenital diaphragmatic hernias and is usually diagnosed in neonates. Symptomatic presentation of a right-sided diaphragmatic hernia in an adult is unusual. Owing to their rarity and varied presentation, ...

  4. A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair.

    Science.gov (United States)

    Tai, Huai-Ching; Lin, Chia-Da; Chung, Shiu-Dong; Chueh, Shih-Chieh Jeff; Tsai, Yao-Chou; Yang, Stephen Shei-Dei

    2011-09-01

    Laparoscopic inguinal hernia repair has been around since the 1990s. A novel surgical approach known as laparoendoscopic single-site surgery (LESS) has been developed to reduce the port-related morbidities and improve the cosmetic outcomes of laparoscopic surgery, including totally extraperitoneal (TEP) inguinal hernia repair. The aim of the present study was to evaluate the safety and feasibility of the LESS TEP technique for inguinal hernia repair and compare the outcomes with the standard TEP approach. Between January and May 2009, 54 consecutive healthy patients (48 men and 6 women) underwent LESS TEP inguinal hernia repair at our institute. All procedures were performed using our homemade single port for simultaneous passage of the laparoscope and instruments. The perioperative data, including patient age, sex, body mass index (BMI), hernia characteristics, operative time, complications, length of hospital stay, return to normal activity, pain score, and cosmetic result, were prospectively collected. All LESS TEP procedures were completed successfully without conversion to standard laparoscopic or open surgery. A total of 98 LESS TEP hernia repairs were performed in 54 patients and compared with 152 standard TEP operations. The mean operative time was significantly shorter in the standard TEP series (61.8 ± 26.0 vs. 70.9 ± 23.8 min, p = 0.04). Other perioperative parameters, including the length of hospital stay, time until return to full activity, complication rate, pain score, and cosmetic result, were all comparable between the two techniques. Our short-term experience with LESS TEP inguinal hernia repair has shown that in experienced hands, inguinal hernia repair via the LESS TEP technique is as safe as the standard TEP technique. However, based on our evidence, we currently believe that the LESS TEP technique is not an efficacious surgical alternative to the standard TEP technique for inguinal hernias.

  5. Evaluation of outcome of totally extra peritoneal laparoscopic inguinal hernia repair with lichtenstein open repair

    International Nuclear Information System (INIS)

    Ahmed, I.; Dian, A.; Azam, U.F.; Khan, M.

    2015-01-01

    The objective of this study was to evaluate outcome of total extraperitoneal laparoscopic inguinal hernia repair with Lichtenstein open repair in terms of postoperative pain. Study Design: Quasi experimental study. Place and Duration of Study: Surgical unit l Rawalpindi and Allied hospitals from January to June 2012. Patients and Methods: Sixty patients, with unilateral, primary, inguinal hernia were alternately allocated to undergo either total extraperitoneal (TEP) laparoscopic repair of inguinal hernia or Lichtenstein tension free, mesh repair of inguinal hernia. Pain scores at 12, 24, and 48 hours and at 7 days of follow up were noted using a visual analogue scale. Total number of intravenous injections of Diclofenac Sodium requested by the patient for pain relief was also noted. Results: At 12 hours after surgery, the mean pain scores in the TEP group were 3.1 ± 1.8 and in the Lichtenstein group they were 4.2 ± 2.1 (p 0.031). At 24 hours after surgery, the scores were 2.3 ± 1.5 and 3.1 ± 1.9 for the TEP and Lichtenstein groups, respectively (p = 0.026). At 48 hours after surgery, the mean pain scores in the TEP group were 1.5 ± 1.1 while in the Lichtenstein group they were 2.0 ± 1.6 (p = 0.041). At 7 days after surgery, the scores were 0.3 ± 0.5 in the TEP group and 0.4 ± 0.8 in the Lichtenstein group (0.137). The mean number of injection of Diclofenac Sodium required by the TEP and Lichtenstein groups was 3.1 ± 1.6 and 5.8 ± 2.2, respectively (p = 0.011). Conclusion: Less postoperative pain and requirement for analgesics were reported by patients who underwent total extraperitoneal laparoscopic repair of inguinal hernia as compared to those who underwent inguinal hernia repair by Lichtenstein tension free mesh hernioplasty. (author)

  6. The collagen turnover profile is altered in patients with inguinal and incisional hernia

    DEFF Research Database (Denmark)

    Henriksen, Nadia A; Mortensen, Joachim H; Sorensen, Lars T

    2015-01-01

    BACKGROUND: Disturbed metabolism in the extracellular matrix (ECM) contributes to formation of abdominal wall hernias. The aim of this study was to gain deeper insight into the ECM turnover in hernia patients by analyzing serum biomarkers specifically reflecting collagen synthesis and breakdown......). Patients without hernias scheduled to undergo elective operation for gallstones (n = 18) served as controls. Whole venous blood was collected preoperatively. Biomarkers for synthesis of interstitial matrix (PINP, Pro-C3, P5CP) and basement membrane (P4NP) as well as corresponding degradation (C1M, C3M, C5M......, and C4M) were measured in serum by validated, solid-phase competitive assays. RESULTS: In inguinal hernia patients, the turnover of the interstitial matrix collagens type III (P turnover of the basement membrane collagen type IV...

  7. Surgical treatment of acquired inguinal hernia in the horse: a review of 51 cases.

    Science.gov (United States)

    van der Velden, M A

    1988-05-01

    During a seven year period, 51 cases of acquired inguinal herniation in 50 stallions were treated surgically. In 25 cases the herniated loop was ileal, in the other 26 it was jejunal. In cases of strangulation, the vaginal ring was enlarged by incising the peritoneum and transverse fascia. Closure of the superficial inguinal ring was advisable to prevent the hernia recurring. In all cases unilateral castration was performed. Laparotomy was carried out in 33 cases; 22 required intestinal resection and in four cases a bypass was made. Follow-up at least six months postoperatively indicated that surgery had been successful in 76 per cent of the cases treated.

  8. Outcome of laparoscopic inguinal hernia repair in a South African ...

    African Journals Online (AJOL)

    up notes were studied. Patients were interviewed telephonically regarding hernia recurrence, chronic pain and technique preference if they had previously undergone an open repair. All data collected were recorded on an electronic ...

  9. Acute appendicitis in inguinal hernia: report of two cases | Kidmas ...

    African Journals Online (AJOL)

    Amyand's hernia). One patient had gangrenous appendicitis that affected the adjoining caecum. A limited right hemicolectomy was done by extending the groin incision laterally and proximally. The second patient had simple appendicectomy.

  10. Neurophysiological characterization of persistent pain after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Linderoth, G; Kehlet, H; Aasvang, E K

    2011-01-01

    About 2-5% of patients undergoing laparoscopic inguinal repair experience persistent pain influencing everyday activities. However, compared with persistent pain after open repair, the combined clinical and neurophysiological characteristics have not been described in detail. Thus, the aim of the...... of the study was to describe and classify patients with severe persistent pain after laparoscopic herniorrhaphy.......About 2-5% of patients undergoing laparoscopic inguinal repair experience persistent pain influencing everyday activities. However, compared with persistent pain after open repair, the combined clinical and neurophysiological characteristics have not been described in detail. Thus, the aim...

  11. Neurophysiological characterization of persistent pain after laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Linderoth, G; Kehlet, H; Aasvang, E K

    2011-01-01

    About 2-5% of patients undergoing laparoscopic inguinal repair experience persistent pain influencing everyday activities. However, compared with persistent pain after open repair, the combined clinical and neurophysiological characteristics have not been described in detail. Thus, the aim of the...

  12. Amyand's hernia in the children: a single center experience.

    Science.gov (United States)

    Cankorkmaz, Levent; Ozer, Hatice; Guney, Cengiz; Atalar, Mehmet H; Arslan, Mehmet S; Koyluoglu, Gokhan

    2010-01-01

    The presence of a vermiform appendix in an inguinal hernial sac is termed Amyand's hernia. It may present as a tender inguinal or inguinoscrotal swelling, and it is often misdiagnosed as an incarcerated or strangulated hernia. Between 1998 and 2006, we have managed 564 patients with acute appendicitis, 1,090 patients with inguinal hernia, 33 patients with incarcerated inguinal hernia, and 12 patients with Amyand's hernia on our pediatric surgery service. A retrospective analysis of clinical data of these patients with Amyand's hernia was performed. All patients with Amyand's hernia were boys with a median age of 40 days (range, 15 days-14 months). One patient's condition was diagnosed pre-operatively. All of them, therefore, underwent emergency operation with a presumptive diagnosis of either incarcerated or strangulated inguinal hernia. Operative findings included 2 normal appendices, 6 inflamed appendices, and 4 appendices with external signs of serosal inflamation of uncertain significaince in the inguinal hernial sac. Two patients with a normal appendix had hernia repair without an appendectomy. The other 10 patients with an abnormal appendix underwent an emergency open appendectomy with repair of the inguinal hernia. None of the patients developed recurrent hernia. The median postoperative follow-up period was 2.5 years. In pediatric patients with Amyand's hernia, the inflammatory status of the appendix can be used to determine the type of hernia repair and the operative approach. Incidental appendectomy in the case of a normal appendix is not favored by us. Treatment includes appendectomy (via the hernia sac) and hernia repair in children with an inflamed appendix. Copyright (c) 2010 Mosby, Inc. All rights reserved.

  13. Repair of inguinal hernia: a comparison between extraperitoneal laparoscopy and Lichtenstein open surgery

    Directory of Open Access Journals (Sweden)

    Tavassoli A

    2010-06-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The inguinal hernia is a common disorder in general surgery. Different methods have been described for repair of these hernias. In modern methods, synthetic mesh is used to cover the wall defect and the most known method is Lichtenstein surgical repair. The laparoscopic totally extra peritoneal procedure (TEP is a newer technique of repairing hernia. The aim of this study is to compare the outcomes of totally extraperitoneal laparoscopic inguinal hernia repair versus Lichtenstein open repair in patients with inguinal hernia."n"nMethods: Among 50 patients, 25 cases underwent Lichtenstein procedure and 25 patients underwent TEP technique for repairing primary unilateral inguinal hernia. Findings during the operation have been recorded and the 12-months follow-up of patients in different views was performed through a questionnaire and then the results were compared."n"nResults: The operation duration, the rate of complications and frequency of recurrence were similar in two groups; but the hospital stay, postoperative pain, chronic groin pain and the required time to return to normal activity were significantly lower in patients who underwent the TEP method compared to the patients who underwent the

  14. Hernioplastia inguinal con técnica Prolene hernia system: Evaluación de los resultados a largo plazo

    OpenAIRE

    BUTTE B,JEAN MICHEL; LEÓN G,FRANCISCA; VAN SINT JAN D,NICOLETTE; HEVIA S,CAMILA; ZÚÑIGA A,ALVARO; IBÁÑEZ A,LUIS; MARTINEZ C,JORGE; LLANOS L,OSVALDO

    2007-01-01

    Introducción: En múltiples trabajos se han evaluado los resultados a corto y mediano plazo de la reparación de la hernia inguinal con la técnica prolene hernia system PHS). Sin embargo, en pocos estudios se han reportado resultados a largo plazo. Objetivos: Evaluar los resultados a largo plazo de la reparación de la hernia inguinal con la técnica PHS. Material y método: Se realizó un estudio prospectivo de 62 enfermos operados con la técnica PHS entre 2001 y 2002. Las complicaciones inmediata...

  15. Inguinal hernia repair: can one identify the three main nerves of the region?

    Directory of Open Access Journals (Sweden)

    João Vicente Machado Grossi

    Full Text Available OBJECTIVE: To identify the nerves in the groin during inguinal hernia repair by inguinotomy.METHODS: We conducted a prospective, sequenced, non-randomized study comprising 38 patients undergoing inguinal hernia repair with placement of polypropylene mesh.RESULTS: The male patients were 36 (94.7%, with a mean age and standard deviation of 43.1 ± 14.5, body mass index of 24.4 ± 2.8. Comorbidities were hypertension in two (5.2%, smoking in 12 (31.5% and obesity in two (5.2%. The hernia was located only on the right in 21 (55.2% patients, only on the left in 11 (28.9%, and was bilateral in six (15.7% patients. Prior hernia repair was present in seven (18.4% patients. The identification of the three nerves during operation was made in 20 (52.6% patients, the ilioinguinal nerve and the iliohypogastric nerve were identified in 33 (86.8%, and the genital nerve branch of the genitofemoral nerve, in 20 (52.6%. Resection of at least one of the nerves was performed in seven (18.4% cases, two iliohypogastric nerves and five ilioinguinal nerves. The average operating time was 70.8 ± 18.2 minutes. The hospital stay was 1.42 ± 1.18 days. Ten patients (26.3% returned to physical activity around the first postoperative visit, and 37 (97.3% in the last. The follow-up time was 95.6 ± 23.5 days. The inability to identify the ilioinguinal nerve was associated with previous repair (p = 0.035.CONCLUSION: The identification of the three nerves during inguinal hernia surgery has been described in more than half of the cases and prior repair interfered with the identification of ilioinguinal nerve.

  16. Recurrence and Pain after Mesh Repair of Inguinal Hernias

    African Journals Online (AJOL)

    from patients' files or by telephone survey where these were missing or were incomplete. Results: A total of ... system (PHS) or ultrapro hernia system (UHS). This bilayer mesh has shown promising results. Overall, ... via telephone for assessment of pain and recurrence. The follow up period ranged from 14 to 91 months.

  17. Post operative pain control in inguinal hernia repair: comparison of ...

    African Journals Online (AJOL)

    Background: Post-operative pain control is a key factor in surgery. It greatly increases patient satisfaction, and influences the hospital stay period. Local wound infiltration has often been used to control postoperative pain following hernia surgery, with the use of the conventional local anesthetics like Lidocaine or ...

  18. Male form of persistent Mullerian duct syndrome type I (hernia uteri inguinalis presenting as an obstructed inguinal hernia: a case report

    Directory of Open Access Journals (Sweden)

    Gujar Nishikant N

    2011-12-01

    Full Text Available Abstract Introduction Persistent Mullerian duct syndrome is a rare form of male pseudo-hermaphroditism characterized by the presence of Mullerian duct structures in an otherwise phenotypically, as well as genotypically, normal man; only a few cases have been reported in the worldwide literature. We report the case of a 30-year-old man with unilateral cryptorchidism on the right side and a left-sided obstructed inguinal hernia containing a uterus and fallopian tube (that is, hernia uteri inguinalis; type I male form of persistent Mullerian duct syndrome coincidentally detected during an operation for an obstructed left inguinal hernia. Case presentation A 30-year-old South Indian man was admitted to our facility with a left-sided obstructed inguinal hernia of one day's duration. He had a 12-year history of inguinal swelling and an absence of the right testis since birth. Our patient had well developed masculine features. Local physical examination revealed a left-sided obstructed inguinal hernia with an absence of the right testis in the scrotum. Exploration of the inguinal canal revealed an indirect inguinal hernia containing omentum, the left corner of the uterus and a left fallopian tube. Extension of the incision revealed a well formed uterus, cervix and upper part of the vagina attached to the prostate by a thick fibrosed band. Total excision of the uterus, bilateral fallopian tubes and right testis was performed. A biopsy was taken from the left testis. The operation was completed by left inguinal herniorraphy. Histopathological examination of the hernial contents was consistent with that of a uterus and fallopian tubes without ovaries. Both testes were atrophied, with complete arrest of spermatogenesis. Post-operative karyotype analyses were negative for 46,XY and Barr bodies on buccal smear. A semen examination revealed azoospermia with a low serum testosterone level. Conclusions In cases of unilateral or bilateral cryptorchidism

  19. The Comparison of Lichtenstein Procedure with and without Mesh-Fixation for Inguinal Hernia Repair

    Directory of Open Access Journals (Sweden)

    Feyzullah Ersoz

    2016-01-01

    Full Text Available Aim. Although inguinal hernia repair is the most frequently performed surgical procedure in the world, the best repair method has not gained acceptance yet. The ideal repair must be safe, simple, and easy to perform and require minimal dissection which provides enough exploration, maintain patient’s comfort in the early stage, and also be cost-effective, reducing operation costs, labor loss, hospital stay, and recurrence. Materials and Methods. There were eighty-five patients between the ages of 18 and 75, diagnosed with inguinal hernia in our clinic. Lichtenstein procedure for hernia repair was performed under spinal anesthesia in all patients. Forty-two patients had the standard procedure and, in 43 patients, the polypropylene mesh was used without fixation. All patients were examined and questioned on the 7th day of the operation in terms of pain, scrotal edema, and the presence of seroma and later on in the 6th postoperative month in terms of paresthesia, neuropraxia, and recurrence by a single physician. Results. Operative time and pain scores in the nonfixation group were significantly lower, without any increase in rates of recurrence. Conclusion. Based on these findings, in Lichtenstein hernia repair method, nonfixation technique can be used safely with better results.

  20. Risk factors for perioperative complications in inguinal hernia repair – a systematic review

    Directory of Open Access Journals (Sweden)

    Weyhe Dirk

    2017-02-01

    Full Text Available The current literature suggests that perioperative complications occur in 8%–10% of all inguinal hernia repairs. However, the clinical relevance of these complications is currently unknown. In our review, based on 571,445 hernia repairs reported in 39 publications, we identified the following potential risk factors: patient age, ASA score, diabetes, smoking, mode of admission (emergency vs. elective surgery, surgery in low resource settings, type of anesthesia, and (in men bilateral and sliding hernias. The most commonly reported complications are bleeding (0.9%, wound infection (0.5%, and pulmonary and cardiovascular complications (0.2%. In 3.9% of the included publications, a reliable grading of the reported complications according to Clavien-Dindo classification was possible. Using this classification retrospectively, we could show that, in patients with complications, these are clinically relevant for about 22% of these patients (Clavien-Dindo grade ≥IIIa. About 78% of all patients suffered from complications needing only minor (meaning mostly medical intervention (Clavien-Dindo grade inguinal hernia repair, future studies should use the Clavien-Dindo classification to achieve better comparability between studies, thus enabling better correlation with potential risk factors.

  1. Synthetic bioabsorbable hernia plug for plug and patch inguinal herniorrhaphy implantation technique.

    Science.gov (United States)

    Doerhoff, Carl

    2012-12-01

    New products have led the way in advancements of inguinal hernia repair. None is more impressive than the evolution of the plug patch. In 1968 Irving Lichtenstein introduced the first Marlex mesh plug repair when he rolled a piece of flat polypropylene into the shape of a cigarette to fill a femoral defect. He later expanded his use of the "cigarette plug" to repair recurrent hernias. Today, a wide array of mesh plugs, ranging from nonabsorbable to partially and fully absorbable biomaterials, are available from manufacturers. While some surgeons have used the plug alone for repair, most believe the overlay patch is of greater importance for the durability of the repair. With larger overlays, it is questionable whether a plug should be a permanent, nonabsorbable material. Heavyweight plugs have been reported to erode, migrate, or cause vocational-limiting inguinodynia. Using a fully absorbable plug in inguinal hernia repair minimizes the risk of these complications. This article focuses on the technical refinements associated with using the completely absorbable GORE BIO-A Hernia Plug (W.L. Gore & Associates, Inc, Elkton, MD) in combination with macroporous polypropylene or polyester. Additionally, this paper describes the use of GORE BIO-A Tissue Reinforcement as an alternative for repair following removal of prior polypropylene plug-patch herniorrhaphy that cause inguinodynia.

  2. Inguinal hernia repair with tension-free hernioplasty under local anesthesia

    International Nuclear Information System (INIS)

    Gao, Jia-Sen; Wang, Zhen-Jun; Zhao, Bo; Ma Song Zhang; Pang, Guo-Yi; Na, Dong-Ming; Zhang Yu-Dong

    2009-01-01

    To evaluate the use of local anesthesia in tension-free hernioplasty in a local hospital. The study took place at Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China during the period from January 2007 to May 2008. All 110 patients who had undergone inguinal hernia repair with mesh under local anesthesia were included in the study. To increase the homogeneity of the sample, we excluded umbilical hernia repairs, parastomal hernia repairs, non-elective procedures, procedures not involving mesh, and repairs performed concurrently with another surgical procedure. We performed a retrospective review of all 110 patients' data. The average operating time was 45 minutes (30-70 minutes), and the average hospital stay was 3-4 days. There was no postoperative mortality in this study. No surgical site infection occurred. Two patients (18%) that suffered from a moderate scrotal hematoma had recovered after extract injection therapy was applied. The duration of incisional pain was 2-3 days, and no patient required post-operative analgesia. During the follow-up, no recurrence occurred. The use of local anesthesia in inguinal hernia repair with tension-free hernioplasty is a safe and effective alternative for inpatient treatment. (aothor)

  3. Inguinal hernia repair: is there a benefit to using the robot?

    Science.gov (United States)

    Charles, Eric J; Mehaffey, J Hunter; Tache-Leon, Carlos A; Hallowell, Peter T; Sawyer, Robert G; Yang, Zequan

    2018-04-01

    The number of robotic surgical procedures performed yearly is constantly rising, due to improved dexterity and visualization capabilities compared with conventional methods. We hypothesized that outcomes after robotic-assisted inguinal hernia repair would not be significantly different from outcomes after laparoscopic or open repair. All patients undergoing inguinal hernia repair between 2012 and 2016 were identified using institutional American College of Surgeons National Surgical Quality Improvement Program data. Demographics; preoperative, intraoperative, and postoperative characteristics; and outcomes were evaluated based on method of repair (Robot, Lap, or Open). Categorical variables were analyzed by Chi-square test and continuous variables using Mann-Whitney U. A total of 510 patients were identified who underwent unilateral inguinal hernia repair (Robot: 13.8% [n = 69], Lap: 48.1% [n = 241], Open: 38.1% [n = 191]). There were no demographic differences between groups other than age (Robot: 52 [39-62], Lap: 57 [45-67], and Open: 56 [48-67] years, p = 0.03). Operative duration was also different (Robot: 105 [76-146] vs. Lap: 81 [61-103] vs. Open: 71 [56-88] min, p Robot: 2.9% [2], Lap: 3.3% [8], Open: 5.2% [10], p = 0.53). Although rare, there was a significant difference in rate of postoperative skin and soft tissue infection (Robot: 2.9% [2] vs. Lap: 0% [0] vs. Open: 0.5% [1], p = 0.02). Cost was significantly different between groups (Robot: $7162 [$5942-8375] vs. Lap: $4527 [$2310-6003] vs. Open: $4264 [$3277-5143], p robotic-assisted inguinal hernia repair were similar to outcomes after laparoscopic or open repair. Longer operative duration during robotic repair may contribute to higher rates of skin and soft tissue infection. Higher cost should be considered, along with surgeon comfort level and patient preference when deciding whether inguinal hernia repair is approached robotically.

  4. Reparación laparoscópica de las hernias inguinales Laparoscopic repair of inguinal hernias

    Directory of Open Access Journals (Sweden)

    Juan Ramón Cruz Alonso

    2012-06-01

    Full Text Available Introducción: se presenta una serie de 53 hernioplastias laparoscópicas realizadas en el Hospital General Docente "Enrique Cabrera". Objetivo: determinar los eventos perioperatorios, las complicaciones quirúrgicas y la evaluación del dolor referido por los pacientes operados. Métodos: entre junio de 2009 y junio de 2011, se realizaron 53 hernioplastias laparoscópicas en 35 pacientes; 17 padecían de hernias inguinales bilaterales. Se recogieron las variables: edad, sexo, tipo de hernia, eventos perioperatorios y complicaciones, y se aplicó una escala de dolor. Se llenó una base de datos y se procesó estadísticamente. Resultados: el sexo masculino predominó en relación 5:1, el tiempo quirúrgico promedio fue de 53,5 minutos para las hernias unilaterales y de 71,3 minutos para las bilaterales. La complicación más frecuente en el transoperatorio fue el sangrado menor en 28,3 %, y en el posoperatorio fue el hematoma en el 15,1 %, recidivó una hernia (1,9 %. A los 15 días de la intervención quirúrgica el 91,4 % de los operados no se quejaban de dolor, pero la reincorporación sociolaboral fue de solo 34 % de los pacientes. Conclusiones: la hernioplastia inguinal laparoscópica es una opción terapéutica más, fundamentalmente en pacientes con hernias bilaterales y reproducidas.Introduction: a series of 53 laparoscopic hernioplasties was presented in this study, which were performed at "Enrique Cabrera" general teaching hospital. Objective: to determine the perioperative events, the surgical complications and the pain assessment of surgical patients. Methods: fifty three laparoscopic hernioplasties were performed in 35 patients from June 2009 to June 2011, of whom 17 suffered bilateral inguinal hernias. The following variables were considered: age, sex, type of hernia, perioperative events and complications; additionally, a pain evaluation scale was applied. A database was developed and the data was processed by using statistical

  5. Long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair.

    Science.gov (United States)

    Iraniha, Andrew; Peloquin, Joshua

    2017-07-13

    Laparoscopic TAPP inguinal hernia repair is an established alternative to open hernia repair, which offers equivalent outcomes with less postoperative pain and faster recovery. Unfortunately, it remains technically challenging, requiring advanced laparoscopic skills which have limited its popularity among surgeons. The robotic platform has the potential to overcome these challenges. The objective of this study was to examine the long-term quality of life and outcomes following robotic assisted TAPP inguinal hernia repair, since these data have not been reported up to now. From October 2012 to October 2015, 159 inguinal hernias in 82 consecutive patients were repaired with 3D mesh (BARD) using da Vinci Si Surgical System (Intuitive Surgical, Sunnyvale, CA, USA). The patients' demographics and intraoperative data were documented. Patients were seen 2 and 6 weeks after the surgery and the complications were recorded. Patients were assessed 6 weeks after the surgery by a survey using a universal pain assessment tool to document their post-operative pain, narcotic use and time of return to work and exercise. A modified short form 12 (SF 12) was also sent out to the patients 12-36 months after the surgery to measure their health-related quality of life prior to surgery and at the 12- to 36-month follow-up, and to document any evidence of recurrence. Postoperative health-related quality of life scores were compared to the pre-operative baseline quality of life scores using the unpaired t test. Over the course of 3 years, 159 robotic assisted TAPP inguinal hernia repair were performed in 82 patients, 73 men and 9 women by one surgeon as an outpatient basis. The mean age was 53 and mean body mass index was 26. There were no intraoperative complications or conversions. The average operative time was 99 min. Four patients developed urinary retention post-operatively and one patient developed postoperative bowel obstruction requiring laparoscopic lysis of adhesion with no

  6. Acutely incarcerated abdominal wall hernia: what if it is a consequence?

    Science.gov (United States)

    Gonenc, M; Bozkurt, M A; Kapan, S; Aras, A; Surek, A; Alis, H

    2014-01-01

    The aim of this study was to emphasize the importance of differential diagnosis in patients with acutely incarcerated abdominal wall hernia (AWH). The medical records of patients who underwent emergency surgery with preoperative diagnosis of acutely incarcerated AWH and in whom acutely incarcerated AWH was the consequence of increased intraabdominal pressure due to other abdominal emergencies were reviewed. The following data were collected: demographics, the duration between the onset of symptoms and admission, clinical findings, biochemical test results that were abnormal, radiological findings, preoperative and intraoperative diagnosis, operative findings, surgical procedure, different diagnosis made in the postoperative period, reoperation, morbidity, mortality, and the length of hospital stay. Ten patients were included to the study. The primary pathology was found to be perforated peptic ulcer disease in three, bowel obstruction due to neoplastic mass in three, complicated appendicitis in two, acute mesenteric ischemia in one, and acute diverticulitis in one. The correct diagnosis was made during emergency surgery for hernia repair, whereas the primary pathology was identified postoperatively in two patients. Patients who are diagnosed to have acutely incarcerated AWH preoperatively should undergo further diagnostic workup, if any level of clinical suspicion for differential diagnosis is present. Moreover, the surgeon should consider general abdominal exploration if contradictory findings are encountered during the exploration of the hernia sac, even if preoperative diagnostic studies reveal no gross pathology or non-specific findings.

  7. Intestinal obstruction induced by a giant incarcerated Spigelian hernia: case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Edson Augusto Ribeiro

    Full Text Available CONTEXT: Spigelian hernia is an uncommon spontaneous lateral ventral hernia with an incarceration ratio of around 20%. However, complications such as intestinal obstruction are extremely rare. We report on a case of giant incarcerated Spigelian hernia with a clinical condition of complete intestinal obstruction that was treated using prosthetic polypropylene mesh. CASE REPORT: A 72-year-old woman was admitted to the emergency department complaining of diffuse abdominal pain. Abdominal examination revealed a firm 10 x 10 cm tender mass in the lower left quadrant, without surrounding cellulite or tenderness. Plain abdominal radiographs displayed the formation of levels, thus indicating the existence of intestinal obstruction. An abdominal computed tomography scan clearly showed a fluid and air-filled mass in the soft tissue area of the lower left-side abdominal wall. Spigelian incarcerated hernia was diagnosed and the patient underwent emergency surgical repair by means of local incision. The large defect in the abdominal wall was closed up as successive anatomical layers, and a prosthetic polypropylene mesh was set into the lateral aspect of the rectus sheath. The postoperative course was uneventful and the patient was discharged on the seventh postoperative day.

  8. Is unilateral laparoscopic TEP inguinal hernia repair a job half done? The case for bilateral repair.

    Science.gov (United States)

    Pawanindra Lal; Philips, Prejesh; Chander, Jagdish; Ramteke, Vinod K

    2010-07-01

    Bilateral laparoscopic totally extraperitoneal (TEP) repair of unilateral hernia is conspicuous in published literature by its absence. There are no studies or data on the feasibility, advantages or disadvantages of bilateral repair in all cases or in any subset of patients with unilateral primary inguinal hernia. The objective of this study is to investigate the feasibility of bilateral laparoscopic exploration for all unilateral cases followed by laparoscopic TEP in all cases and to compare complications, recurrence rates, postoperative pain, patient satisfaction, and return to work retrospectively with a similar number of age-matched retrospective controls. One hundred fifty TEP operations were performed in 75 patients (group A) prospectively and were compared with 75 unilateral TEP operations (group B) in age-matched controls done previously by the same surgeon. All cases were performed under general anesthesia, and TEP repair was performed using three midline ports. All uncomplicated patients were discharged at 24 h, in keeping with departmental policy. Of 75 patients (group A), 25 (33.3%) were clinically diagnosed with bilateral hernia and the rest (50, 66.66%) with unilateral hernia. The distribution of the 25 bilateral cases was 11 bilateral direct and 14 bilateral indirect inguinal hernias. The distribution of the 75 age-matched controls (group B) was all unilateral hernia, of which 47 were right-sided and 28 were left-sided. There were 23 direct hernias and 52 indirect hernias among the control group. The mean operative time for all 150 cases was 76.66 +/- 15.92 min. The operative time in the control group (unilateral hernias) was 66.16 +/- 12.44 min, whereas the operative time in the test group (bilateral repair) was 87.2 +/- 11.32 min. The operative time in the bilateral group was significantly higher, by 21.04 min or 31.88% (p = 0.000). The operative time in the true unilateral group was 82.45 +/- 9.38 min, whereas the operative time in the former

  9. The Role of Cremaster Muscle as a Cause of Ascending Testis after Inguinal Hernia/Hydrocele Repair

    Directory of Open Access Journals (Sweden)

    Amrollah Salimi

    2017-05-01

    Full Text Available Background Ascending testis (AT is one of the rare but serious complication that may occurs following inguinal hernia/hydrocele repair. We aimed to review our more than 7 years’ experience and discuss the possible mechanism through which the AT possibly occurs following inguinal hernia/hydrocele repair. Materials and Methods A retrospective analysis of 7,212 boys who had undergone inguinal hernia/hydrocele repair between March 2009 and April 2016 was conducted. Exclusion criteria were: undescended testis, misdiagnosed AT, and retractile testis. Two types of surgical procedures were performed based on the medical records: (1 transection of the hernia sac and processus vaginalisalone and (2 isolation of the vas deferens and testicular vessels and a global transection of the remaining structures. Subsequently, post-operative incidence of AT was compared across variables extracted from the medical records. Results Sixteen (0.22% patients were diagnosed with AT post operatively. AT incidence after inguinal hernia/hydrocele repair was reported in approximately 0.19% of the entire patient sample (in the 8491 hernia/hydrocele repairs. Comparison of AT incidence with the age at initial operation showed significant increase at the age of one year or less (P =0.017. In addition, AT incidence was significantly higher in the patients for whom only the sac/processus vaginalis was transected rather than the patients who underwent hernia/hydrocele repair with isolation of the vas deferens and testicular vessels (0.06% vs. 0.27%, respectively, P =0.023. Other subgroup analyses remained non-significant. Conclusion We conclude that transection of the cremaster muscle might decrease the incidence of ascending testis following inguinal hernia/ hydrocele repair.

  10. A Rare Presentation of Maydl’s Hernia

    Directory of Open Access Journals (Sweden)

    Elroy Patrick Weledji

    2014-01-01

    Full Text Available We present a case of an unsual type of obstructed indirect inguinal hernia with impending strangulation. The operative findings revealed a sliding Maydl’s hernia with an ischemic inner ileal loop and an adherent inflamed appendix. This case highlights the importance of intraoperative examination of the intra-abdominal bowel loops proximal to the hernia sac of an incarcerated, obstructed, or strangulated hernia.

  11. Immunohistochemical evaluation of fibrillar components of the extracellular matrix of transversalis fascia and anterior abdominal rectus sheath in men with inguinal hernia

    Directory of Open Access Journals (Sweden)

    Rogério De Oliveira Gonçalves

    Full Text Available OBJECTIVE: to evaluate the role of fibrillar extracellular matrix components in the pathogenesis of inguinal hernias. METHODS: samples of the transverse fascia and of the anterior sheath of the rectus abdominis muscle were collected from 40 men aged between 20 and 60 years with type II and IIIA Nyhus inguinal hernia and from 10 fresh male cadavers (controls without hernia in the same age range. The staining technique was immunohistochemistry for collagen I, collagen III and elastic fibers; quantification of fibrillar components was performed with an image analysis processing software. RESULTS: no statistically significant differences were found in the amount of elastic fibers, collagen I and collagen III, and the ratio of collagen I / III among patients with inguinal hernia when compared with subjects without hernia. CONCLUSION: the amount of fibrillar extracellular matrix components did not change in patients with and without inguinal hernia.

  12. Implante con el sistema de reparación herniaria inguinal de prolene (Prolene hernia system

    Directory of Open Access Journals (Sweden)

    José Goderich Lalán

    2002-04-01

    Full Text Available Se realizó un estudio clinicodescriptivo y prospectivo del seguimiento de 21 pacientes a los que se les realizó implante sistema de reparación herniaria inguinal de prolene en hernias inguinales, reproducidas entre el 15 de octubre de 1998 y el 31 de marzo de 1999, con el objetivo de evaluar sus resultados. En todos los casos se utilizó el método de cirugía de corta estadía, anestesia local y sedación o espinal y antibioticoterapia profiláctica. En el seguimiento a muy corto plazo no se reportan recidivas y ninguna complicación posoperatoria. Más de la mitad de los pacientes había recibido más de 2 operaciones. La media de edad fue 49 años y el sexo predominante el masculino. La técnica que se utilizó para implante fue la recomendada por los fabricantesA clinical descriptive and prospective study of the follow-up of 21 patients who received implant of the Prolene inguinal hernia repair system in inguinal hernias reproduced between October l5th, 1998, and March 31st, 1999, was conducted aimed at evaluating the results. The short-stay surgery method, local anesthesia and sedation, or spinal anesthesia and prophylactic antibiotic therapy were used in all cases. No relapses or postoperative complications were reported in a very short-term follow-up. More than half of the patients had undergone more than 2 operations. Average age was 49 and there was a predominance of males. The technique used for the implant was the one recommended by the manufacturers

  13. Feasibility study of natural orifice transluminal endoscopic surgery inguinal hernia repair.

    Science.gov (United States)

    Sherwinter, Danny A; Eckstein, Jeremy G

    2009-07-01

    A potentially less-invasive technique, transluminal surgery, may reduce or eliminate pain and decrease time to full return of activities after abdominal operations. Inguinal hernia repair is perfectly suited to the transgastric endoscopic approach and has not been previously reported. Our purpose was to evaluate the feasibility of transgastric bilateral inguinal herniorrhaphy (BIH). Feasibility study with a nonsurvival canine model. Under general anesthesia, male mongrel dogs weighing 20 to 30 kg had a dual-channel endoscope introduced into the peritoneal cavity over a percutaneously placed guidewire. An overtube with an insufflation channel was used. Peritoneoscopy was performed, and bilateral deep and superficial inguinal rings were identified. The endoscope was removed, premounted with a 4 x 6 cm acellular human dermal implant and then readvanced intraperitoneally through the overtube. The implant was then deployed across the entire myopectineal orifice and draped over the cord structures. Bioglue was then applied endoscopically, and the implant was attached to the peritoneum. After completion of bilateral repairs, the animals were killed and necropsy performed. Five dogs underwent pure natural orifice transluminal endoscopic surgery (NOTES) intraperitoneal onlay mesh (IPOM) BIH. Accurate placement and adequate myopectineal coverage was accomplished in all subjects. At necropsy no injuries to the major structures were noted but Bioglue misapplication with contamination of unintended sites did occur. Our study involved only a small number of subjects in nonsurvival experiments, and no gastric closure was used. Many of the characteristics of inguinal hernia repair are especially well suited to the transgastric approach. The repair is in line with the transgastric endoscope vector, bilateral defects are adjacent, and the IPOM technique does not require significant manipulation or novel instrumentation.

  14. Dynamical Analysis of Lower Abdominal Wall in the Human Inguinal Hernia

    OpenAIRE

    Fortuny Anguera, Gerard

    2009-01-01

    En aquesta tesi es construeix un simulador numèric de la paret abdominal inferior, per tal de determinar la gènesis i les causes de les hernies inguinal humanes. Així, un model amb dades reals d'aquesta regió del cos humà (correctament discretitzades) ens permetrà reproduir les propietats dinàmiques de diferents elements de la regió permetent la simulació de la hernia en el moment que te lloc.La simulació muscular en general, ha tingut un paper secundari en la simulació numèrica, ja que en o...

  15. [Pre-surgical period and non-work-related sickness absence due to inguinal hernia].

    Science.gov (United States)

    Ruiz-Moraga, Montserrat; Catalina-Romero, Carlos; Martínez-Muñoz, Paloma; Cobo-Santiago, María Dolores; González-López, Maite; Cabrera-Sierra, Martha; Porrero-Carro, José Luis; Calvo-Bonacho, Eva

    2014-04-01

    To analyze non-work-related sickness absence (NWR-SA) due to inguinal hernia and the factors related to its duration, paying particular attention to the pre-surgical period of NWR-SA. Prospective cohort study was conducted on 1,003 workers with an episode of NWR-SA due to an inguinal hernia, belonging to the insured population of a mutual insurance company. We assessed the duration of the NWR-SA episodes and the main demographic, occupational and clinical variables potentially related to it. Cox regression analyses were conducted to establish the predictors of NWR-SA duration. The mean duration of NWR-SA due to inguinal hernia was 68.6 days. After multivariate analysis (Cox regression), having a pre-surgical period of NWR-SA (HR = 0.35; 95%CI: 0.28-0.43), manual occupations (HR=0.68; 95%CI: 0.49-0.95), construction sector (HR=0.71; 95%CI: 0.58-0.88), direct payment methods by a Mutual Insurance Company during sick leave in self-employed workers (HR=0.58; 95%CI, 0.41-0.82), or employees (HR=0.51; 95%CI: 0.36-0.72), comorbidity (HR=0.45; 95%CI:0.34-0.59), and surgery performed under an entity other than the Public Health System or a mutual insurance company (HR=0,76; 95%CI: 0.59-0.97) were associated with longer NWR-SA. The Mutual Insurance Company always performed the surgery when a pre-surgery period of NWR-SA existed (mean duration=47 ±39.6 days); that was associated with shorter periods of post-surgical NWR-SA (P=.001). The NWR-SA due to inguinal hernia is a multifactorial phenomenon in which the pre-surgery period plays an important role. The collaboration between organizations involved in the management of NWR-SA seems to be an effective strategy for reducing its duration. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  16. One-thousand consecutive inguinal hernia repairs under unmonitored local anesthesia

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Kehlet, H

    2001-01-01

    from the electronic patient data management system. In 921 ASA Group I and II and 79 ASA Group III and IV patients, the median age was 60 yr (range, 18-95 yr). ULA was converted to general anesthesia in 5 of 1000 cases, and 961 patients were discharged on the day of surgery after 95 min (median...... anesthetic techniques with an acceptable rate of satisfaction, but intraoperative pain relief needs improvement. IMPLICATIONS: Inguinal hernia repair can be safely performed under unmonitored local anesthesia with infrequent postoperative morbidity and acceptable satisfaction, but intraoperative pain may...

  17. The Ultrasound Diagnosis of Round Ligament Varices That Mimicked Inguinal Hernias During Pregnancy:A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyung Jo; Shin, Hyun Woong; Kim, Seong Hun [Daegu Fatima Hospital, Daegu (Korea, Republic of); Cho, Sang Hee; Byun, Kyung Hwan [CHA Gumi Medical Center, CHA University, Gumi (Korea, Republic of)

    2010-03-15

    Round ligament varices during pregnancy are an important part of the differential diagnosis of inguinal hernia as they may cause symptoms and clinical features that are similar to those of inguinal hernia. When this condition is correctly diagnosed, an unnecessary operation may be prevented. The diagnosis of round ligament varices should be considered for pregnant women who present with a palpable mass in the groin. We describe here a case of round ligament varices that presented during pregnancy and this was readily diagnosed with Doppler sonography

  18. Causes of recurrence in laparoscopic inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Kukleta Jan

    2006-01-01

    Full Text Available Aim: The analysis of possible mechanisms of repair failure is a necessary instrument and the best way to decrease the recurrence rate and improve the overall results. Avoiding historical errors and learning from the reported pitfalls and mistakes helps to standardize the relatively new laparoscopic techniques of trans-abdominal preperitoneal and total extraperitoneal. Materials and Methods: The video tapes of all primary laparoscopic repairs done by the author that led to recurrence were retrospectively analyzed and compared with findings at the second laparoscopic repair. A review of the available cases of recurrences occurring between 1994 and 2003 is the basis of this report. Summary: Adequate mesh size, porosity of mesh material, slitting of the mesh, correct and generous dissection of preperitoneal space and wrinkle-free placement of the mesh seem to be the more important factors in avoiding recurrence rather than strength of the material or strong penetrating fixation. Special attention should be paid to preperitoneal lipoma as a possible overlooked herniation or potential future pseudorecurrence despite nondislocated correctly positioned mesh. Conclusion: Laparoscopic hernia repair is a complex but very efficient method in experienced hands. To achieve the best possible results, it requires an acceptance of a longer learning curve, structured well-mentored training and high level of standardization of the operative procedure.

  19. Reconstrucción en linfedema peneano y escrotal secundario a hernia inguinal bilateral gigante Reconstruction in penile and scrotal lymphedema secondary to billateral giant inguinal hernia

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2009-12-01

    Full Text Available El linfedema peneano y escrotal tiene consecuencias funcionales, estéticas, sociales y psicológicas significativas para el paciente que lo padece. Es una enfermedad infrecuente en los países desarrollados, aunque relativamente prevalente en los países tropicales. Su causa más común es la filariasis, aunque en nuestra práctica diaria se asocia más frecuentemente a cirugía, radioterapia, procesos inflamatorios y neoplásicos. Presentamos un caso singular de linfedema penoescrotal secundario a cirugía por hernia inguinal gigante bilateral que persistía un año después de la intervención. El tratamiento quirúrgico consistió en la exéresis de toda la piel linfedematosa del escroto involucrada y el uso de colgajos de piel escrotal posterior para la cobertura testicular. En un segundo tiempo quirúrgico se llevó a cabo una extirpación total de la piel del pene y del tejido subcutáneo superficial a la fascia de Buck. Empleamos injertos de piel de grosor parcial para cubrir el pene denudado. El resultado estético postoperatorio fue aceptable y los resultados funcionales y psicológicos son satisfactorios para el paciente 3 años después de la cirugía.Lymphedema of the penis and scrotum has important functional, cosmetic, social, psychological consequences for the affected patient. It is a rare disease in the developed countries, although it is relatively frequent in tropical countries. Globally, the most common cause is filariasis, although in our practice it is most frecuently associated to surgery, radiotherapy, inflammatory and neoplasic diseases. We report one rare case of penoscrotal lymphedema due to billateral giant inguinal hernia reconstrction. The lymphedema was persistent one year after the repair of the billateral hernia. The technique of reconstruction consisted of excision of all involved lymphedematous skin of the scrotum, and use of posterior scrotal flaps for testicular coverage. In a second surgical time, a total

  20. Learning Curves for Laparoscopic Repair of Inguinal Hernia and Communicating Hydrocele in Children

    Directory of Open Access Journals (Sweden)

    Catarina Barroso

    2017-09-01

    Full Text Available IntroductionWe analyzed the department and surgeon learning curves during implementation of the percutaneous internal ring suturing (PIRS technique in our department.MethodsChildren proposed for inguinal hernia or communicating hydrocele repair were included (n = 607. After mentorship, all surgeons were free to propose open or PIRS repair. From gathered data, we assessed department and surgeon learning curves through cumulative experience focusing in perioperative complications, conversion, ipsilateral recurrence, postoperative complications, and metachronous hernia, with benchmarks defined by open repair.ResultsDepartment-centered analysis revealed that perioperative complications, conversion, and ipsilateral recurrence rates were higher in the beginning, reaching the benchmarks when each surgeon performed, at least, 35 laparoscopic repairs. Postoperative complications and metachronous hernia rates were independent from learning curves, with the metachronous hernia rate being significantly lower in PIRS patients. During the program, the percentage of males in those operated by PIRS progressively increased reaching the percentage of males, in our sample, when department operated over 230 cases.ConclusionThirty-five laparoscopic cases per surgeon are required for perioperative complications, conversion, and ipsilateral recurrence reach the benchmark. The gap between the percentage of males, in those operated by PIRS and in those proposed for surgery, monitors the confidence of the team in the program.

  1. Laparoscopic and open inguinal hernia repair: Patient reported outcomes in the elderly from a single centre - A prospective cohort study

    Directory of Open Access Journals (Sweden)

    K. Bowling

    2017-10-01

    Conclusion: Time off work is not an absolute appropriate measure of return to premorbid status with respect to the elderly as a substantial number of >65 year olds have retired. We therefore present this interesting insight into patient perceptions following hernia repair by age group. Overall patients over 65 can expect the same high levels of satisfaction and low levels of pain following either technique for inguinal hernia repair as younger patients.

  2. Epithelioid malignant mesothelioma of tunica vaginalis with deciduoid features: An unusual malignancy clinically masquerading an inguinal hernia

    Directory of Open Access Journals (Sweden)

    Sharique Ahmed

    2012-01-01

    Full Text Available Paratesticular/scrotal and inguinal canal mass lesions in elderly patients may pose a diagnostic challenge to both the surgeon as well as the pathologist. In most cases, these represent hernial sacs with their contents, and true neoplasms like lipomas, rhabdomyosarcomas, and fibrous pseudotumors are infrequent. Malignant mesotheliomas arising from the tunica layers are rare cause of inguinal and paratesticular tumors. Herein, we report a case of an elderly patient who presented with an inguinal hernia which pathologically had features of deciduoid malignant mesothelioma.

  3. Single port laparoscopic repair of paediatric inguinal hernias: Our experience at a secondary care centre

    Directory of Open Access Journals (Sweden)

    Ameet Kumar

    2013-01-01

    Full Text Available Background: Congenital inguinal hernias are a common paediatric surgical problem and herniotomy through a groin incision is the gold standard. Over the last 2 decades minimally invasive surgery (MIS has challenged this conventional surgery. Over a period, MIS techniques have evolved to making it more minimally invasive - from 3 to 2 and now single port technique. All studies using single port technique are from tertiary care centres. We used a modification of the technique described by Ozgediz et al. and reviewed the clinical outcome of this novel procedure and put forth our experience at a secondary level hospital. Materials and Methods: Prospective review of 37 hernias in 31 children (29 male and 2 female (8 months - 13 years performed laparoscopically by a single surgeon at a single centre between September 2007 and June 2010. Under laparoscopic guidance, the internal ring was encircled extraperitoneally using a 2-0 non-absorbable suture and knotted extraperitoneally. Data analyzed included operating time, ease of procedure, occult patent processus vaginalis (PPV, complications, and cosmesis. Results: Sixteen right (52%, 14 left (45% and 1 bilateral hernia (3% were repaired. Five unilateral hernias (16.66%, all left, had a contralateral PPV that was repaired (P = 0.033. Mean operative time for a unilateral and bilateral repair were 13.20 (8-25 and 20.66 min (17 -27 min respectively. Only one of the repairs (2.7% recurred and another had a post operative hydrocoele (2.7%. One case (2.7% needed an additional port placement due to inability to reduce the contents of hernia completely. There were no stitch abscess/granulomas, obvious spermatic cord injuries, testicular atrophy, or nerve injuries. Conclusion: Single port laparoscopic inguinal hernia repair can be safely done in the paediatric population. It permits extension of benefits of minimal access surgery to patients being managed at secondary level hospitals with limited resources. The

  4. A Rare Case of Strangulated Meckel%u2019s Diverticulum in an Incarcerated Ventral Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Murat Kilic

    2014-02-01

    Full Text Available Incisional or postoperative hernia, one of the most common surgical procedure in general surgery practice, mostly occurs in the first years following abdominal operations. Incarceration or strangulation is a serious complication of these hernias, and mostly requires emergent surgery. Meckel%u2019s diverticulum, the most frequent congenital anomaly of the gastrointestinal tract, is rarely found within a hernial sac and this unusual condition is called as Littre%u2019s hernia. In addition, preoperative diagnosis of this unusual condition is rather difficult and it is almost always first discovered during operation. A small number of cases of strangulated Meckel%u2019s Diverticulum in an incarcerated ventral incisional hernia have been reported in the literature. Herein, we report a strangulated Meckel%u2019s Diverticulum through a ventral incisional hernia in a 65 year-old woman who presented with clinical signs of intestinal obstruction.

  5. Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults

    DEFF Research Database (Denmark)

    Rosenberg, Jacob; Bisgaard, Thue; Kehlet, Henrik

    2011-01-01

    and guidelines have been approved by the Danish Surgical Society. Diagnosis of groin hernia is based on clinical examination. Ultrasonography, CT or MRI are rarely needed, while herniography is not recommended. In patients with indicative symptoms of hernia, but no detectable hernia, diagnostic laparoscopy may...... or laparoscopic technique, depends on local expertise, economical considerations and patient preference. Compared to the Lichtenstein operation laparoscopic repair is associated with less acute pain and faster recovery. Furthermore, available data suggest less chronic long-term pain after laparoscopic repair......, using cost-effective local anaesthesia in open mesh repair and general anaesthesia for laparoscopic repair. Spinal anaesthesia is not recommended. Routine prophylactic antibiotics are not indicated. In the early convalescence period there are no physical restrictions. These guidelines will also...

  6. [Spinal anesthesia versus general anesthesia in the surgical treatment of inguinal hernia. Cost-effectiveness analysis].

    Science.gov (United States)

    Fernández-Ordóñez, M; Tenías, J M; Picazo-Yeste, J

    2014-05-01

    To compare the costs related to the clinical effectiveness of general anesthesia versus spinal anesthesia in inguinal hernioplasty ambulatory surgery. An observational, retrospective cohort study measurement and analysis of cost-effectiveness, in the ambulatory surgery unit of a general hospital. All patients over 18 years of age diagnosed with primary inguinal hernia and scheduled for unilateral hernioplasty between January 2010 and December 2011 were included. Duration of anesthetic induction, length of stay in both the operating room, and in the post-anesthesia care unit, the anesthetic effectiveness (the incidence of adverse effects and the patient's comfort level), and variable economic costs associated with the use of drugs, as well as the use of human resources, were compared. The final analysis included 218 patients, 87.2% male, with a mean age of 53 years (range: 18-85 years). Of these, 139 (63.76%) received subarachnoid anesthesia and 79,(36.2%) general anesthesia. The length of time a patient remained in the post-anesthesia care unit was 337.6±160.2min in the subarachnoid anesthesia group, and 210.0±97.5min for the general anesthesia group (P<.001). Costs of drugs for general anesthesia were higher than that for subarachnoid anesthesia (86.2±8.3 vs. 18.7±7.2). The total cost difference between the 2 techniques was €115.8 more for subarachnoid anesthesia (P<.001). Both techniques showed similar effectiveness. The overall costs for subarachnoid anesthesia were greater than for the general. The cost-effectiveness of general anesthesia is better for outpatient inguinal hernia repair surgery. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  7. Amyand's hernia with appendicitis in the children: A delayed diagnosis

    Directory of Open Access Journals (Sweden)

    Asma Jabloun

    2016-10-01

    Full Text Available The presence of a vermiform appendix in an inguinal hernia sac is known as Amyand's hernia. It is an uncommon and rare condition estimated to be found in approximately 1 % of hernia. However, in just 0.08 %, the condition is complicated by an acute appendicitis. The clinical presentation varies, depending on the extent of inflammation of the appendix, and is most often misdiagnosed as an incarcerated inguinal hernia. As such, it is rarely recognized prior to surgical exploration. We report a case of Amyand’s hernia in a 2-month-old male, who presented as a right-sided congenital hernia with pain in the right groin. He underwent herniotomy, which revealed that the hernia sac containing elongated inflamed appendix appeared with some adhesions to sac, lying in the inguinal canal.

  8. Inguinal hernia vs. arthritis of the hip in sporting adolescents--case report and review of the literature.

    Science.gov (United States)

    Holzheimer, R G; Gresser, U

    2007-07-26

    Chronic pain in the hip, groin or thigh can be caused by a wide spectrum of diseases posing extended diagnostic problems. We describe the case of a 10-years old child with chronic pain in the groin with gait restriction for more than six months without successful classification and treatment. The girl suffered from heavy pain in the groin after a sporting contest which forced her to walk with walking sticks and to avoid climbing stairs. Within six months she was examined by pediatric, orthopedic, pediatric surgery, pediatric orthopedic, radiology, pediatric rheumatology specialists. Working diagnoses were transient synovitis (coxitis fugax), arthritis, streptococcal arthritis, Morbus Perthes, rheumatic fever, rheumatoid arthritis. She was treated with antibiotics and ibuprofen in high dosage. Repeated laboratory tests and imaging studies (ultrasound, x-rays, magnetic resonance imaging) of the hip and pelvis did not support any of these diagnoses. Six months after beginning of the complaints the girl was presented by her mother to our institution. The physical examination showed a sharp localized pain in the groin, just in the region of the inguinal ligament with otherwise free hip movement. There was no visible inguinal hernia. The family history for hernia was positive. After infiltration of the ilioinguinal nerve the girl had a complete long-lasting disappearance of pain and gait disturbance. This led to the diagnosis of inguinal hernia with nerve entrapment. After hernia repair and neurolysis/neurectomy there was a continuous state of disappearance of pain and gait disturbances. To avoid such a diagnostic dilemma one should always discuss all possible causes. Non-visible inguinal hernia may be more common in females than previously thought. Nerve entrapment as a cause of groin pain has been well described. The relationship of the start of complaints with sporting activity, a positive family history for inguinal hernia, a lack of signs of inflammation and bone

  9. Pregnancy, parturition, parity and position in the family. Any influence on the development of paediatric inguinal hernia/hydrocele?

    Science.gov (United States)

    Irabor, D O; Ogundoyin O O; Ogunlana, D I

    2014-01-01

    To see if pre-partum factors have a relationship to the development of inguinal hernia in children. A prospective study on children with hernia. On first contact, the affected child was examined and data like the age, sex, weight, blood group, the diagnosis, side of the lesion and other co-morbid conditions was recorded. The mother filled a questionnaire about her age, parity, illness during pregnancy, her mode of delivery and the patient's position in the family. There were 104 patients from 103 mothers, their ages ranged from 13 days to 14 years with the highest incidence in the 1-4 age group. The sex ratio was overwhelmingly male (M:F ratio was 38:1). Right sided hernias were predominant. Only 7% had a family history. The peak age group of the mothers was 26-32 years and about 33% of the mothers had some illness during pregnancy. The birth positions of the patients showed that majority of them were either 1st or 2nd born children. Women of ages 26-32 likelyto have children with inguinal hernia. Malaria during pregnancy is unlikely to have a role to play. 1st and 2nd born male children have a higher chance of having inguinal hernia.

  10. Effects of non-woven mesh in preperitoneal tension-free inguinal hernia repair: a retrospective cohort study.

    Science.gov (United States)

    Liu, Yiting; Shen, Yingmo; Chen, Jie

    2017-08-01

    Tension-free hernia repair has been recognized as the gold standard for the treatment of inguinal hernia. Different mesh has different characteristics that influence the efficiency of surgery. We conducted this study to evaluate the effectiveness of non-woven mesh in preperitoneal tension-free inguinal hernia repair under local anesthesia. The medical records of patients who received preperitoneal tension-free inguinal hernia repair under local anesthesia in our hospital from 2012 to 2015 were reviewed. Patients were included if their surgery was conducted using non-woven or woven mesh. Outcome measures were operation time, length of stay in hospital, hospital fees, complications and degree of chronic pain, foreign body sensation and recurrence. A total of 389 cases were included. 186 cases were repaired with non-woven mesh (observation group), and 203 cases were repaired with woven mesh (control group). There were no significant differences in operation time and length of stay in the hospital, but hospital fees were significantly higher in the observation group. Seroma of the inguinal region occurred in 6 cases of the observation group and 8 cases of the control group with no significant difference and no other complications and recurrence in both groups. No cases of chronic pain were recorded in the observation group; 8 cases were recorded in the control group. Foreign body sensation was found in 1 case of the observation group and 9 cases in the control group, which showed attractive advantages of non-woven mesh. Preperitoneal tension-free repair for inguinal hernia under local anesthesia using non-woven or woven mesh is available. The hospital cost of using non-woven mesh is higher than that of woven mesh, but the incidence rate of chronic pain and foreign body sensation are lower in the use of non-woven mesh. Therefore, non-woven mesh may be worth using in the clinical setting.

  11. Orchiectomy as a result of ischemic orchitis after laparoscopic inguinal hernia repair: case report of a rare complication

    Directory of Open Access Journals (Sweden)

    Moore John B

    2007-11-01

    Full Text Available Abstract Background Ischemic orchitis is an established complication after open inguinal hernia repair, but ischemic orchitis resulting in orchiectomy after the laparoscopic approach has not been reported. Case presentation The patient was a thirty-three year-old man who presented with bilateral direct inguinal hernias, right larger than left. He was a thin, muscular male with a narrow pelvis who underwent bilateral extraperitoneal mesh laparoscopic inguinal hernia repair. The case was complicated by pneumoperitoneum which limited the visibility of the pelvic anatomy; however, the mesh was successfully deployed bilaterally. Cautery was used to resect the direct sac on the right. The patient was discharged the same day and doing well with minimal pain and swelling until the fourth day after surgery. That night he presented with sudden-onset pain and swelling of his right testicle and denied both trauma to the area and any sexual activity. Ultrasound of the testicle revealed no blood flow to the testicle which required exploration and subsequent orchiectomy. Conclusion Ischemic orchitis typically presents 2–3 days after inguinal hernia surgery and can progress to infarction. This ischemic injury is likely due to thrombosis of the venous plexus, rather than iatrogenic arterial injury or inappropriate closure of the inguinal canal. Ultrasound/duplex scanning of the postoperative acute scrotum can help differentiate ischemic orchitis from infarction. Unfortunately, testicular torsion cannot be ruled out and scrotal exploration may be necessary. Although ischemic orchitis, atrophy, and orhiectomy are uncommon complications, all patients should be warned of these potential complications and operative consent should include these risks irrespective of the type of hernia or the surgical approach.

  12. As in Real Estate, Location Is What Matters: A Case Report of Transplant Ureteral Obstruction Due to an Inguinal Hernia.

    Science.gov (United States)

    Bugeja, Ann; Clark, Edward G; Sood, Manish M; Ali, Sohrab N

    2018-01-01

    Kidney allograft dysfunction is common and often reversible but can lead to allograft loss if not promptly evaluated. Transplant ureteral obstruction in an inguinal hernia is a rare cause of allograft dysfunction, but early recognition may prevent allograft loss. We present a case of a man with acute kidney allograft dysfunction who received a deceased donor kidney transplant 6 years earlier for end-stage kidney disease secondary to polycystic kidney disease. Abdominal ultrasounds revealed hydronephrosis without full visualization of the transplant ureter. Abdominal computed tomography revealed moderate hydronephrosis of the transplant kidney due to obstructed herniation of the transplant ureter in a right inguinal hernia. A stent was inserted into the transplant ureter to prevent further allograft dysfunction and facilitate hernia repair. Transplant ureteral obstruction is a rare cause of acute kidney allograft dysfunction, and its detection can be challenging. The recognition of transplant ureteral obstruction is vital to timely management for preventing allograft loss.

  13. Different types of mesh fixation for laparoscopic repair of inguinal hernia: A protocol for systematic review and network meta-analysis with randomized controlled trials.

    Science.gov (United States)

    Wei, Kongyuan; Lu, Cuncun; Ge, Long; Pan, Bei; Yang, Huan; Tian, Jinhui; Cao, Nong

    2018-04-01

    Laparoscopic inguinal hernia repair has become a valid option for repair of an inguinal hernia. Due to there are several types of mesh fixation for laparoscopic repair of inguinal hernia. The study aims to assess and compare the efficacy of different types of mesh fixation for laparoscopic repair of inguinal hernia using network meta-analysis. We will systematically search PubMed, EMBASE the Cochrane library, and Chinese Biomedical Literature Database from their inception to March 2018. Randomized controlled trials (RCTs) that compared the effect of different types of mesh fixation for laparoscopic inguinal hernia repair will be included. The primary outcomes are chronic groin pain, incidence risk of hernia recurrence, and complications. Risk of bias assessment of the included RCTs will be conducted using to Cochrane risk of bias tool. A network meta-analysis will be performed using WinBUGS 1.4.3 software and the result figures will be generated using R x64 3.1.2 software and STATA V.12.0 software. Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to assess the quality of evidence. The results of this study will be published in a peer-reviewed journal. Our study will generate evidence of laparoscopic repair of mesh fixation for adult patients with inguinal hernia and provide suggestions for clinical practice or guideline.

  14. Laparoscopic Inguinal Hernia Repair With a Novel Hernia Mesh Incorporating a Nitinol Alloy Frame Compared With a Standard Lightweight Polypropylene Mesh.

    Science.gov (United States)

    Bower, Curtis; Hazey, Jeffrey W; Jones, Edward L; Perry, Kyle A; Davenport, Daniel L; Roth, J Scott

    2015-10-01

    Numerous mesh materials are available for laparoscopic inguinal hernia repair. The role of fixation of mesh in laparoscopic inguinal hernia repair remains controversial. Mesh materials have been engineered to anatomically conform to the pelvis to potentially reduce or eliminate the need for fixation. This study evaluates the outcomes of laparoscopic inguinal hernia utilizing a device consisting of a lightweight polypropylene mesh with a nitinol frame (Rebound HRD) compared with repair with lightweight polypropylene mesh with permanent tack fixation. A prospective randomized trial evaluating the outcomes of laparoscopic inguinal hernia repair with a lightweight polypropylene mesh with a nitinol frame (N-LWM) compared with standard lightweight polypropylene mesh (LWM) was conducted. Randomization was performed at an N-LWM to LWM ratio of 2:1. Repairs were standardized to a laparoscopic extraperitoneal approach without fixation for N-LWM and titanium tack fixation for LWM repairs. Follow-up assessments were performed at 7 days, 6 months, and 1 year. Outcome measures include visual analog pain scale (VAS), Short Form 36 (SF-36), Carolinas Comfort Scale (CCS), operative details, complications, and recurrences. There were 47 patients that underwent laparoscopic inguinal hernia repair and adhered to study protocol (31 N-LWM, 16 LWM). The groups did not differ significantly in age, body mass index, ethnicity, or employment. The N-LWM group had bilateral mesh placed in 51.6% and LWM 43.8% (P = .76). Operative duration was similar, 59.6 ± 23.1 minutes for LWM and 62.4 ± 26.7 minutes for N-LWM (P = .705) as was mesh handling time was 5.4 ± 3.1 minutes LWM versus 7.3 ± 3.9 minutes N-LWM (P = .053). VAS, CCS, and SF-36 survey results were similar between groups. There was one recurrence (0.03%) in the N-LWM group. Nitinol-framed lightweight polypropylene mesh may be safely used during laparoscopic inguinal hernia repair with outcomes comparable to LWM at 1 year. N-LWM does

  15. Preparation of a nano- and micro-fibrous decellularized scaffold seeded with autologous mesenchymal stem cells for inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Zhang Y

    2017-02-01

    Full Text Available Yinlong Zhang,1,* Yuanyuan Zhou,1,* Xu Zhou,2,* Bin Zhao,1,* Jie Chai,1 Hongyi Liu,1 Yifei Zheng,1 Jinling Wang,3 Yaozong Wang,4 Yilin Zhao2 1Medical College, Xiamen University, 2Department of Oncology and Vascular Intervention Radiology, 3Department of Emergency, 4Department of Orthopaedics, Zhongshan Hospital, Xiamen University, Xiamen, People’s Republic of China *These authors contributed equally to this work Abstract: Prosthetic meshes used for hernioplasty are usually complicated with chronic pain due to avascular fibrotic scar or mesh shrinkage. In this study, we developed a tissue-engineered mesh (TEM by seeding autologous bone marrow-derived mesenchymal stem cells onto nanosized fibers decellularized aorta (DA. DA was achieved by decellularizing the aorta sample sequentially with physical, mechanical, biological enzymatic digestion, and chemical detergent processes. The tertiary structure of DA was constituted with micro-, submicro-, and nanosized fibers, and the original strength of fresh aorta was retained. Inguinal hernia rabbit models were treated with TEMs or acellular meshes (AMs. After implantation, TEM-treated rabbit models showed no hernia recurrence, whereas AM-treated animals displayed bulges in inguinal area. At harvest, TEMs were thicker, have less adhesion, and have stronger mechanical strength compared to AMs (P<0.05. Moreover, TEM showed better cell infiltration, tissue regeneration, and neovascularization (P<0.05. Therefore, these cell-seeded DAs with nanosized fibers have potential for use in inguinal hernioplasty. Keywords: nanobiomaterial, tissue engineering, inguinal hernia, hernioplasty, decellularized aorta 

  16. Inguinal Hernia

    Science.gov (United States)

    ... Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Diverticular Disease Definition & Facts Symptoms & Causes Diagnosis Treatment Eating, Diet, & Nutrition Clinical Trials Dumping Syndrome ...

  17. Inguinal Hernia

    Science.gov (United States)

    ... 12 mos.) Toddler 1-3yrs. Preschool 3-5yrs Grade School 5-12yrs. Teen 12-18yrs. Young Adult 18-21yrs. Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations ...

  18. Bilateral inguinal hernias detected by peritoneal scintigraphy during the evaluation of scrotal swelling in a patient on continuous ambulatory peritoneal dialysis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seok Tae; Sohn, Myung Hee [School of Medicine, Chonbuk National Univ., Chonju (Korea, Republic of)

    2001-02-01

    A 47-year-old man with end-stage renal disease due to diabetic nephropathy underwent a peritoneal scintigraphy to evaluate the cause of recently developed scrotal swelling. Two liters of dialystate mixed with 111 MBq of Tc-99m sulfur colloid were adminstered into the peritoneal cavity via the dialysis catheter. Various anterior images of the abdomen and pelvis were obtained at 15 min, 2 hr and 4 hr after the tracer instillation. At 15 min, anterior images of the abdomen and pelvis demonstrated linear tracts of activity through both inguinal canals, which were more prominent in the right side (A). Images at 2 hr revealed a passage of the radioactive fluid into the right hemiscrotum. At the same time, there was a considerable accumulation of activity in the right inguinal canal (B). In the delayed image, there was a progressive accumulation of activity in the inguinal canals and a prominent passage of the tracer into the scrotum (C). Both abdominal and inguinal hernias are commonly associated with continuous ambulatory peritoneal dialysis (CAPD). Overall incidence of CAPD-induced hernia ranges from 2.7% to 25%. Inguinal hernias were frequently manifested as scrotal swelling. Leakages f dialysate fluid into the scrotum has been noted in CAPD patients with scrotal swelling, with or without clincal findings of inguinal hernia. In the present case, the right side had leakage from a clinical inguinal hernia and the left side, leakage, from a subclinial inguinal hernia. A subclinical inguinal hernia was easily demonstrable with peritoneal scintigraphy. Peritoneal scintigraphy is extremely helpful in the evaluation of scrotal swelling in a patient on CAPD.

  19. Omental incarceration may cause hydrocele and this hydrocele confused simple or scrotal hydrocele.

    Science.gov (United States)

    Kapisiz, A; Karabulut, R; Turkyilmaz, Z; Sonmez, K; Basaklar, A C

    2011-02-01

    The recommended approach to hydrocele repair in children is inguinal. Recently, a transscrotal approach has been recommended for hydroceles in children. This report describes our experience with hydrocele with omentum incarceration. This retrospective study reviewed the records of ten children who underwent inguinal hydrocele repair with omentum incarceration in our clinic. The mean age of the patients was 4.5 years (range 1.5-16). Hydroceles were located on the right side in all patients. Scrotal erythema, inguinal pain, signs of intestinal obstruction and hernia sac were not determined. Hydrocele repairs were made by inguinal approach in all patients. The procesus vaginalis was rougher than normal and noted as the hernia sac. Thus, the hernia sacs were opened and omental incarceration was defined in all cases. Omentum protruded into the abdomen in all cases. A high ligation was performed and the distal parts of the sacs were fenestrated. In the light of our experience, a scrotal approach to hydrocele repair in children would be difficult in cases of incarceration with hernia. Omental incarceration may cause hydrocele, and this hydrocele can be confused with normal hydrocele. Therefore, we would continue to recommend an inguinal approach for childhood hydroceles.

  20. Uniformity of Chronic Pain Assessment after Inguinal Hernia Repair: A Critical Review of the Literature.

    Science.gov (United States)

    Molegraaf, Marijke; Lange, Johan; Wijsmuller, Arthur

    2017-01-01

    Chronic postoperative inguinal pain (CPIP) is the most common long-term complication of inguinal hernia repair. As such procedures are routinely performed, CPIP can be considered a significant burden to global health care. Therefore, adequate preventative measures relevant to surgical practice are investigated. However, as no gold standard research approach is currently available, study and outcome measures differ between studies. The current review aims to provide a qualitative analysis of the literature to seek out if outcomes of CPIP are valid and comparable, facilitating recommendations on the best approach to preventing CPIP. A systematic review of recent studies investigating CPIP was performed, comprising studies published in 2007-2015. Study designs were analyzed regarding the CPIP definitions applied, the use of validated instruments, the availability of a baseline score, and the existence of a minimal follow-up of 12 months. Eighty eligible studies were included. In 48 studies, 22 different definitions of CPIP were identified, of which the definition provided by the International Association for the Study of Pain was applied most often. Of the studies included, 53 (66%) used 33 different validated instruments to quantify CPIP. There were 32 studies (40%) that assessed both pain intensity (PI) and quality of life (QOL) with validated tools, 41% and 4% had a validated assessment of only PI or QOL, respectively, and 15% lacked a validated assessment. The visual analog scale and the Short Form 36 (SF36) were most commonly used for measuring PI (73%) and QOL (19%). Assessment of CPIP was unclear in 15% of the studies included. A baseline score was assessed in 45% of the studies, and 75% had a follow-up of at least 12 months. The current literature addressing CPIP after inguinal hernia repair has a variable degree of quality and lacks uniformity in outcome measures. Proper comparison of the study results to provide conclusive recommendations for preventive

  1. Tailored anterior tension-free repair for the treatment of recurrent inguinal hernia previously repaired by anterior approach.

    Science.gov (United States)

    Erdas, E; Medas, F; Gordini, L; Licheri, S; Pisano, G; Nicolosi, A; Calò, P G

    2016-06-01

    The purpose of this study is to describe our policy in selecting different types of anaesthesia and anterior tension-free techniques for the repair of recurrent inguinal hernias previously treated by anterior approach and to evaluate early and late outcomes. The medical records of 111 patients who underwent recurrent inguinal hernia repair by anterior approach in the period 2000-2013 were reviewed. Fifty patients (45 %) were over 70 years old and 63 (56.7 %) had one or more co-morbidities. Hernias with large defects were the most frequently observed (59.5 %), and no-mesh techniques were the most frequent failed repair (75.7 %). Different anterior tension-free techniques and types of anaesthesia were used, depending on hernia and patient characteristics. Seventy-three patients (65.8 %) were operated on an outpatient basis. Mean follow-up period was 89 months (range 10-183). No perioperative deaths, medical events, or visceral injuries were recorded. Early postoperative complications occurred in 11 patients: 4 haematomas (3.6 %), 5 seromas (4.5 %), 1 superficial wound infection (0.9 %) and 1 ischemic orchitis (0.9 %). Late complications consisted in 3 cases of chronic moderate pain (3.2 %) and 2 re-recurrences (2.1 %). Recurrent inguinal hernia previously treated by open anterior technique can be repaired using the same approach, often on an outpatient basis, with a low rate of recurrence and postoperative complications. To be safe and effective, the repair should be performed by appropriately trained surgeons, well versed in the use of different types of anaesthesia and surgical techniques depending on patient and hernia characteristics.

  2. Comparación entre la reparación abierta con malla y la técnica de Desarda en la hernia inguinal Comparison between open repair with mesh and the Desarda technique in inguinal hernia

    Directory of Open Access Journals (Sweden)

    Pedro Rolando López Rodríguez

    2009-12-01

    Full Text Available INTRODUCCIÓN. Con el presente trabajo se buscó dar respuesta a algunas controversias en torno de la reparación de las hernias inguinales, así como realizar una valoración sobre el dolor posoperatorio y analizar los costos de las técnicas de reparación protésicas y la técnica que refuerza la pared posterior del canal inguinal con una franja aponeurótica pediculada del músculo oblicuo mayor. MÉTODOS. Se realizó un estudio prospectivo aleatorio de 836 pacientes con hernia inguinal, operados entre septiembre del 2001 y diciembre del 2007. A un grupo se le practicó una hernioplastia anterior con malla y al otro la técnica de Mohan P. Desarda, la cual consiste en una herniorrafia sin malla. RESULTADOS. Ambos grupos de pacientes fueron comparables, sin diferencias con respecto a la edad, la localización y el tipo de hernia. El tiempo quirúrgico fue menor en la hernioplastia con malla y no hubo diferencias significativas en cuanto al dolor durante el primer y tercer día del posoperatorio, pero en el grupo de la hernioplastia éste fue superior al quinto día. En tres pacientes hubo rechazo a la malla de polipropileno. CONCLUSIONES. La técnica de Desarda, al no utilizar malla, fue más económica que la hernioplastia con malla; esta diferencia fue estadísticamente significativa.INTRODUCTION: With present paper we gave response to some controversies around the repair of inguinal hernias as well as to make a valuation on postoperative pain and to analyze the costs of prosthetic repair techniques and the technique reinforcing the posterior wall of inguinal channel with a pediculate aponeurotic band of major obliquus muscle. METHODS: A random prospective study was conducted in 836 patients presenting with inguinal hernia, operated on between September, 2001 and December, 2007. A group underwent anterior hernioplasty with mesh and in the other we used Mohan P. Desarda technique, which is a herniorrhaphy without mesh. RESULTS: Both groups

  3. TORSIÓN SECUNDARIA DEL OMENTO MAYOR: UNA CAUSA POCO FRECUENTE DE DOLOR EN HERNIA INGUINAL COMPLICADA

    OpenAIRE

    Dinu,Laura; Ibáñez M,David; Bernal L,Celia; González G,Jorge

    2014-01-01

    Introducción: La torsión del omento mayor en el interior de un orificio herniario es una entidad muy infrecuente como complicación de una hernia. Caso clínico: Presentamos el caso de un paciente varón de 43 años que acude a Urgencias por cuadro de dolor en fosa ilíaca derecha (FID). El estudio mediante tomo-grafía computarizada muestra un patrón "en remolino" en la grasa mesentérica que se introduce en el orificio inguinal derecho, sugerente de hernia complicada secundaria a torsión de omento...

  4. Self-adhesive mesh for Lichtenstein inguinal hernia repair. Experience of a single center.

    Science.gov (United States)

    Tarchi, P; Cosola, D; Germani, P; Troian, M; De Manzini, N

    2014-06-01

    Lichtenstein tension-free mesh repair is the most frequently performed procedure for inguinal hernioplasty. In the past surgery aimed to control recurrences. Nowadays it is important to avoid postoperative chronic pain and thus several studies have examined the potential role of meshes in causing postoperative pain. The purpose of this study was to retrospectively assess the early and long-term results after Lichtenstein tension-free repair using a self-adhesive mesh (Parietex ProgripTM - Covidien, Germany) in a single center. The study enrolled 211 patients, 199 males (94.3%) and 12 females (5.7%), mean age 62 years (28-90 years), between January 2008 and December 2011. Of these, 206 had primary inguinal hernias while 5 were recurrences following previous tension repair. Ten different general surgeons, including residents, performed Lichtenstein hernia repair using a 12 x 8-cm Parietex ProgripTM mesh. In 88.1% of patients no additional fixation was used, while in 11.9% a single 2-0 polypropylene stitch was placed on the pubic bone. A 1-10 visual analog scale (VAS) was used to assess postoperative pain, evaluating it at 1 week, 1 month and 12, 24 and 36 months. Local paresthesia was assessed at same intervals. Any pain sensation lasting longer than 3 months postoperatively, or requiring injection of analgesics was defined as chronic pain. Mean operating time was 64.1 minutes (SD ± 21.14). There were no intraoperative complications. Early postoperative complications included hematoma-seroma (5.7% cases), superficial wound infection (1%), urinary retention (0.5%), and scrotal swelling (1%). The main follow-up period was 3 years, although patients operated between 2009 and 2011 underwent a shorter follow-up. At one-year follow-up, 17 patients reported groin discomfort, but did not require analgesics. Three patients reported moderate pain, requiring occasional use of oral analgesics, and 2 of these described a discontinuous pain mainly during movement. One patient

  5. [Amyand's hernia and complicated appendicitis; case presentation and surgical treatment choice].

    Science.gov (United States)

    García-Cano, Eugenio; Martínez-Gasperin, José; Rosales-Pelaez, César; Hernández-Zamora, Valeria; Montiel-Jarquín, José Álvaro; Franco-Cravioto, Fernando

    2016-01-01

    A caecal appendix within an inguinal hernia, with or without appendicitis, is defined as Amyand's hernia. In 1% of inguinal hernias an appendix without inflammation can be found, however, the prevalence of appendicitis in a hernia sac is only 0.08-0.13%. Male of 43 years old, began two days before admission with pain in the right inguinal region. He was scheduled for surgery due to a complication of a right inguinal hernia. The surgical findings were Amyand's hernia, necrotic spermatic cord, and perforated appendix. Surgical repair was performed with a favourable outcome, and he was discharged on the fourth postoperative day. Most of Amyand's hernia exhibit characteristics of incarcerated or strangulated inguinal hernia. Even acute appendicitis or perforated appendix within the hernia sac does not reflect specific symptoms or signs, therefore, a preoperative clinical diagnosis of Amyand's hernia is difficult to achieve. In our case, the patient had perforated appendicitis, developing necrosis of the spermatic cord. Orchiectomy, appendectomy, and inguinal hernia repair was performed without placing mesh. Due to the controversy on the use of mesh in contaminated abdominal wall defects, it was not indicated here, due to the high risk of wound infection and appendicular fistula. An extremely rare condition is presented, with a surgical choice that led to a favourable outcome. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  6. Efficacy of tramadol as a preincisional infiltration anesthetic in children undergoing inguinal hernia repair: a prospective randomized study

    OpenAIRE

    Numanoğlu, Kemal Varım; Ayoğlu, Hilal; Er, Duygu TatlıEbubekir

    2014-01-01

    Kemal Varim Numanoğlu,1 Hilal Ayoğlu,2 Duygu Tatli,1 Ebubekir Er11Department of Pediatric Surgery, 2Department of Anesthesiology, Faculty of Medicine, Bülent Ecevit University, Kozlu, Zonguldak, TurkeyBackground: Preincisional local anesthetic infiltration at the surgical site is a therapeutic option for postoperative pain relief for pediatric inguinal hernia. Additionally, tramadol has been used as an analgesic for postoperative pain in children. Recently, the local anesthetic eff...

  7. Success rates and complications of awake caudal versus spinal block in preterm infants undergoing inguinal hernia repair: A prospective study

    Directory of Open Access Journals (Sweden)

    Mahin Seyedhejazi

    2015-01-01

    Full Text Available Background: Inguinal hernia is a common disease in preterm infants necessitating surgical repair. Despite the increased risk of postoperative apnea in preterm infants, the procedure was conventionally performed under general anesthesia. Recently, regional anesthesia approaches, including spinal and caudal blocks have been proposed as safe and efficient alternative anesthesia methods in this group of patients. The current study evaluates awake caudal and spinal blocks in preterm infants undergoing inguinal hernia repair. Materials and Methods: In a randomized clinical trial, 66 neonates and infants (weight <5 kg undergoing inguinal hernia repair were recruited in Tabriz Teaching Children Hospital during a 12-month period. They were randomly divided into two equal groups; receiving either caudal block by 1 ml/kg of 0.25% bupivacaine plus 20 μg adrenaline (group C or spinal block by 1 mg/kg of 0.5% bupivacaine plus 20 μg adrenaline (group S. Vital signs and pain scores were documented during operation and thereafter up to 24 h after operation. Results: Decrease in heart rate and systolic blood pressure was significantly higher in group C throughout the study period (P < 0.05. The mean recovery time was significantly higher in group S (27.3 ± 5.5 min vs. 21.8 ± 9.3 min; P = 0.03. Postoperative need for analgesia was significantly more frequent in group S (75.8% vs. 36.4%; P = 0.001. Failure in anesthesia was significantly higher in group S (24.4% vs. 6.1%; P = 0.04. Conclusion: More appropriate success rate, duration of recovery and postoperative need of analgesics could contribute to caudal block being a superior anesthesia technique compared to spinal anesthesia in awaked preterm infants undergoing inguinal hernia repair.

  8. Amyand´s hernia: Case report

    Directory of Open Access Journals (Sweden)

    Edwin Oveimar Muñoz-Ruiz

    2012-09-01

    Full Text Available Objective: To report an unusual case of Amyand’s hernia in an 87 years old men. Methods: We performed the medical register in emergency service and the patient’ surgery in a three level hospital attention in Popayan Colombia. We consulted the available literature in pubmed data base since 1930’s to the present. Results: 87 years old men was received to the emergency service with a history of three days of inguinal pain associated to sensation of inguinal mass without fever and vomiting, was diagnosed intraoperatory as Amyand’s hernia. This disease is a rare disorder and its clinical diagnostic is difficult by its non specific symptoms. CT- Scan (Computerized Axial Tomography is the most sensible method for diagnostic. Conclusion: Amyand’s hernia must be taken into account a possible diagnostic the acute appendicitis with right incarcerated inguinal hernia.

  9. Long-Term Outcome After Laparoscopic Repair of Primary, Unilateral Inguinal Hernia Using a Self-Adhering Mesh.

    Science.gov (United States)

    Tollens, Tim; Topal, Halit; Lucardie, Alexander; Vermeiren, Koen; Aelvoet, Chris; Devroe, Kurt

    2016-12-16

    Following our previous study about a lightweight self-adhering mesh (Adhesix®, Cousin Biotech, Wervicq-Sud, France; distributed by Davol Inc., subsidiary of C.R. Bard, Inc.), we report the long-term results with the use of this mesh in patients treated for a primary, unilateral inguinal hernia without any other hernias. Prospectively collected data of 100 patients between February 2011 and February 2014 were analyzed. The mean follow-up time was 2.7 years (range 1-4), and mean length of hospital stay was 0.6 days (range 0.5-1). At the time of the last follow-up visit, two patients (2%) had a recurrent inguinal hernia. Compared to preoperative values, patients reported a significant reduction in their pain sensation (visual analogue scale, VAS) after one month (4.61 vs. 1.32; P<0.001). A difference in VAS scores remained significant at the last follow-up visit (1.31 vs. 0.28; P<0.001). Patients reported high quality of life scores. Only one patient (1%) developed a clinically significant seroma that required an evacuating puncture. Two patients (2%) had superficial wound infections. Neither mesh infections nor mortalities occurred. This study, with a long follow-up, confirms our previous results: use of the Adhesix® mesh is safe, feasible, and efficient in laparoscopic hernia repair.

  10. Intestinal blood flow assessment by indocyanine green fluorescence imaging in a patient with the incarcerated umbilical hernia: Report of a case

    Directory of Open Access Journals (Sweden)

    Shunjin Ryu

    2016-06-01

    Full Text Available After reduction of the incarceration during surgery for incarcerated hernia, intestinal blood flow (IBF and the need for bowel resection must be evaluated. We report the case of a patient with incarcerated umbilical hernia in whom the bowel was preserved after evaluating IBF using indocyanine green (ICG fluorescence. A woman in her 40s with a chief complaint of abdominal pain visited our hospital, was diagnosed with incarcerated umbilical hernia and underwent surgery. Laparotomy was performed to reduce bowel incarceration. After reducing the incarceration, IBF was observed using ICG fluorescence detected using a brightfield full-color fluorescence camera. The small bowel that had been incarcerated showed deep-red discoloration on gross evaluation, but intravenous injection of ICG revealed uniform fluorescence of the mesentery and bowel wall. This indicated an absence of irreversible ischemic changes of the bowel, so no resection was performed. The patient showed a good postoperative course, including resumption of eating on day 4 and discharge on day 11. In surgery for incarcerated hernia, ICG fluorescence may offer a useful method to evaluate IBF after reducing the incarceration. This case implied that PINPOINT could be used in open conventional surgery.

  11. Inguinal Hernia Repair Using Self-adhering Sutureless Mesh: Adhesix™: A 3-Year Follow-up with Low Chronic Pain and Recurrence Rate.

    Science.gov (United States)

    Tabbara, Malek; Genser, Laurent; Bossi, Manuela; Barat, Maxime; Polliand, Claude; Carandina, Sergio; Barrat, Christophe

    2016-02-01

    To review our experience and outcomes after inguinal hernia repair using the lightweight self-adhering sutureless mesh "Adhesix™" and demonstrate the safety and efficacy of this mesh. This is a 3-year retrospective study that included 143 consecutive patients who underwent 149 inguinal hernia repairs at our department of surgery. All hernias were repaired using a modified Lichtenstein technique. Preoperative, perioperative, and postoperative data were prospectively collected. Incidence of chronic pain, postoperative complications, recurrence, and patient satisfaction were assessed three years postoperatively by conducting a telephone survey. We had 143 patients with a mean age of 58 years (17-84), who underwent 149 hernia repairs using the Adhesix™ mesh. Ninety-two per cent (131 patients) were males. Only 10 patients (7%) had a postoperative pain for more than three years. In our series, neither age nor gender was predictive of postoperative pain. Only one patient had a hematoma lasting for more than one month and only four patients (2.8%) had a recurrence of their hernia within three years of their initial surgery. Ninety per cent of the patient expressed their satisfaction when surveyed three years after their surgery. In conclusion, the use of the self-adhering sutureless mesh for inguinal hernia repair has been proving itself as effective as the traditional mesh. Adhesix™ is associated with low chronic pain rate, recurrence rate, and postoperative complications rate, and can be safely adopted as the sole technique for inguinal hernia repair.

  12. Type 4 appendiceal diverticulum within a de Garengeot hernia.

    Science.gov (United States)

    Rossi, S H; Coveney, E

    2016-09-01

    A de Garengeot hernia is defined as an incarcerated femoral hernia containing the vermiform appendix. We describe the case of a patient with a type 4 appendiceal diverticulum within a de Garengeot hernia and delineate valuable learning points. A 76-year-old woman presented with a 2-week history of a non-reducible painless femoral mass. Outpatient ultrasonography demonstrated a 36mm × 20mm smooth walled, multiloculated, partially cystic lesion anterior to the right inguinal ligament in keeping with an incarcerated femoral hernia. Intraoperatively, the appendix was found to be incarcerated in the sac of the femoral hernia and appendicectomy was performed. Histopathology demonstrated no evidence of inflammation in the appendix. However, an incidental appendiceal diverticulum was identified. It is widely recognised that a de Garengeot hernia may present with concomitant appendicitis, secondary to raised intraluminal pressure in the incarcerated appendix. Appendiceal diverticulosis is also believed to develop in response to raised pressure in the appendix and may therefore develop secondary to incarceration in a de Garengeot hernia. To our knowledge, only one such case has been described in the literature. A de Garengeot hernia is a rare entity, which poses significant diagnostic challenges. A high index of clinical suspicion is necessary as these hernias are at particularly high risk of perforation and so prompt surgical management is paramount.

  13. MYOMA OF THE ROUND LIGAMENT MIMICKING THE CLINICAL APPEARANCE OF THE INGUINAL HERNIA – A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Aleš Pišek

    2004-12-01

    Full Text Available Background. Myomas are the most frequent gynecological tumors. They first occur during puberty; however, they are most frequent among aged between 35 and 50. In this age group their incidence is 15–20%. They are rare after menopause. The majority of myomas arise in the uterus, but they may arise from other extrauterine sites such as the fallopian tubes, ovaries, round ligament, ligamentum latum, sacrouterine ligament, vagina and even the urethra. Most authors agree that there are numerous causes for the occurrence of myomas; however, they have not yet been clearly proven. They however agree that the myomas appear most frequently in the reproductive age, when the ovarian hormone levels are high and they diminish after menopause. They equally agree that the risk factors for the clinically significant myomas are nulliparity, obesity, a positive family history of myomas and African racial origin.Patients and methods. A 43-year-old patient was referred to our institution for operative treatment by her personal gynaecologist who clinically and sonografically verified a solid tumor situated to the right side of the uterus. The size of the tumor was that of a newborn’s head. The patient, however, had been observing a reponible inguinal hernia the size of a female fist for a period of four years. A solid tumor (22×6×7 cm arising from the right round ligament, was remowed during surgery. Half of its size was situated in the inguinal canal thus mimicking the clinical appearance of the inguinal hernia. After the tumor was removed the inner door of the inguinal canal closed by itself, no surgical repair was necessary. On histological examination the tumor was classified as a leiomyoma.Conclusions. Although the leiomyoma of the round ligament is the most frequent tumor of that region it is a rare gynecological tumor. The described case is especially interesting due to the unusual position of the tumor. It was situated partly intraabdominally and partly

  14. Comparison of post-operative wound infection after inguinal hernia repair with polypropylene mesh and polyester mesh

    International Nuclear Information System (INIS)

    Mughal, M.A.; Ahmed, M.; Sajid, M.T.; Mustafa, Q.U.A.; Shukr, I.; Ahsan, J.

    2012-01-01

    Objective: To compare post operative wound infection frequency after inguinal hernia repair with polypropylene and polyester mesh using standard Lichtenstein hernioplasty technique. Study Design: Randomized controlled trial. Place and Duration: This study was conducted at general surgery department CMH/MH Rawalpindi from 8th April 2007 to 1st Jan 2008 over a period of 09 months. Patients and Materials: Sixty patients received through outpatient department with diagnosis of inguinal hernia satisfying inclusion/exclusion criteria were included. Patients were divided into two groups randomly. Group 1 included those patients in whom polypropylene mesh was used while group II patients were implanted with polyester mesh. Demographic as well as data concerning post operative wound infection was collected and analyzed. Results: Fifty seven patients (95%) were males while remaining (05%) were females. Mean age in group I was 41.17+-9.99 years while in group II was 41.47+-9.79 years (p=0.907). One patient (3.3%) in each group developed wound infection diagnosed by clinical evidence of pain at wound site, redness, induration and purulent discharge. Conclusion: There is no difference in post operative wound infection rate after inguinal Lichtenstein hernioplasty using either polypropylene or polyester mesh. (author)

  15. A systematic review of the association between a single strenuous event and the development of an inguinal hernia: A medicolegal grey area.

    Science.gov (United States)

    Patterson, Timothy; Currie, Peter; Spence, Robert; McNally, Sinead; Spence, Gary

    2018-03-10

    Inguinal hernia is a common surgical presentation. Evidence for its causation regarding occupational and recreational physical exposures is limited. The aim of this study is to conduct a systematic review objectively evaluating the evidence for a causal link between a single strenuous event and the development of an inguinal hernia. A systematic review was carried out in accordance with PRISMA guidelines. PubMed, Ovid Embase, SCOPUS, and Cochrane Library were searched. In addition, the ISRCTN register, ClinicalTrials.gov, ICTR Platform, and EU Clinical Trials Register were searched. Identified publications were collated and both reviewers independently reviewed their contents. 5508 records were identified, resulting in 5 studies being selected. These 5 studies were all case series. Of 957 patients identified, 1003 hernias were described, of which 983 were inguinal hernias which 255 (26%) were attributed by patients to a single strenuous event. Only two of these studies applied Smith's Criteria (causation of a hernia from a single strenuous event): officially reported, severe pain at the time of the event, no prior history of inguinal hernia, and the diagnosis was made by a doctor within 30 days (preferably 3 days). Only 2 of 54 patients (4%) met all four criteria and so could be considered as having an inguinal hernia relating to a single strenuous event. Many patients associate hernias to a single episode, however upon application of more stringent criteria such as Smith's, a much smaller proportion are deemed to be actually attributable to a single strenuous event. Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  16. Cirugía de la hernia inguinal en la tercera edad: ambulatoria y con hospitalización corta Inguinal hernia surgery in third age patients: ambulatory and with a short hospitalization

    Directory of Open Access Journals (Sweden)

    Pablo Gonzalo Pol Herrera

    2011-03-01

    Full Text Available INTRODUCCIÓN. La cirugía de la enfermedad herniaria de la pared abdominal, y en especial de la hernia inguinofemoral, ha sufrido un incremento pero en realidad su prevalencia se desconoce. El objetivo de este estudio fue valorar el resultado del tratamiento quirúrgico de la hernia de la región inguinofemoral en los pacientes de la tercera edad atendidos en el Hospital General Docente «Dr. Enrique Cabrera». MÉTODOS. Se realizó un estudio en 1 093 pacientes de la tercera edad operados de hernia inguinofemoral entre enero de 1999 y diciembre del 2008, en el Hospital General Docente «Dr. Enrique Cabrera». En todos los casos se ofreció al paciente la alternativa de ser operado de forma ambulatoria o con corta estadía. También se incluyeron los pacientes operados de urgencia. De entre los pacientes operados de forma electiva se excluyeron los que padecían enfermedades asociadas, cardiopulmonares o tromboembólicas de tipo ASA-III (clasificación de la American Society of Anesthesiologists. RESULTADOS. La mayor incidencia de la hernia inguinal se encontró en las edades de 60-69 años (59,3 %. La hernia inguinal derecha, indirecta, apareció con mayor frecuencia. La técnica quirúrgica anatómica de Desarda fue la más aplicada en la hernia inguinal, y la técnica protésica de Lichtenstein, con el 32 %, le siguió en frecuencia. Hubo un total de 20 recidivas (1,8 %. Se aplicó anestesia local en el 75,4 % de los pacientes, de forma ambulatoria en el 76,4 %. El total de complicaciones fue de 78 (7,1 %. CONCLUSIONES. El tratamiento quirúrgico de las hernias inguinofemorales, de forma ambulatoria o con corta hospitalización, es un procedimiento adecuado en pacientes de la tercera edad, ya que aumenta la comodidad de los pacientes, disminuye el riesgo de infección hospitalaria, reduce las listas de espera y los costos hospitalarios.INTRODUCTION. The surgery of hernial disease of abdominal wall and especially of the inguinofemoral hernia

  17. Amyand’s Hernia, State of the Art and New Points of View

    Directory of Open Access Journals (Sweden)

    Guido Mantovani

    2017-01-01

    Full Text Available Background. Amyand’s hernia (AH is an inguinal hernia containing the vermiform appendix, with an incidence between 0.4% and 1% of all inguinal hernias. Acute or perforated appendicitis can complicate AH. Case Presentation. A 75-year-old Caucasian man presented with incarceration of vermiform appendix in inguinal hernia sac. Diagnosis was posed preoperatively with computed tomography (CT scan. Patient underwent urgent surgery and simultaneous appendectomy and hernia repair by Bassini’s technique were performed. Conclusions. Preoperative diagnosis of AH is rare; however it could be useful for surgeon to choose operative approach. Treatment of AH depends on grade of appendix inflammation and/or perforation. The technique utilized to repair hernia depends largely on surgeon’s preferences; the presence of inflamed or perforated appendix is not an absolute contraindication for using a prosthetic mesh.

  18. [The history of treatment of groin hernia].

    Science.gov (United States)

    Legutko, Janusz; Pach, Radosław; Solecki, Rafał; Matyja, Andrzej; Kulig, Jan

    2008-01-01

    Hernia (Greek kele/hernios--bud or offshoot) was present in the human history from its very beginning. The role of surgery was restricted to the treatment of huge umbilical and groin hernias and life-threatening incarcerated hernias. The treatment of groin hernia can be divided into five eras. The oldest epoch was ancient era from ancient Egypt to 15th century. The Egyptian Papirus of Ebers contains description of a hernia: swelling that comes out during coughing. Most essential knowledge concerning hernias in ancient times derives from Galen. This knowledge with minor modifications was valid during Middle Ages and eventually in the Renaissance the second era of hernia treatment began. Herniology flourished mainly due to many anatomical discoveries. In spite of many important discoveries from 18th to 19th century the treatment results were still unsatisfactory. Astley Cooper stated that no disease treated surgically involves from surgeon so broad knowledge and skills as hernia and its many variants. Introduction of anesthesia and antiseptic procedures constituted the beginning of modern hernia surgery known as era of hernia repair under tension (19th to middle 20th century). Three substantial rules were introduced to hernia repair technique: antiseptic and aseptic procedures. high ligation of hernia sac and narrowing of the internal inguinal ring. In spite of the progress the treatment results were poor. Recurrence rate during four years was ca. 100% and postoperative mortality gained even 7%. The treatment results were satisfactory after new surgical technique described by Bassini was implemented. Bassini introduced the next rule of hernia repair ie. reconstruction of the posterior wall of inguinal canal. The next landmark in inguinal hernia surgery was the method described by Canadian surgeon E. Shouldice. He proposed imbrication of the transverse fascia and strengthening of the posterior wall of inguinal canal by four layers of fasciae and aponeuroses of oblique

  19. Management of inguinal hernia on peritoneal dialysis: an audit of current Polish practice and call for a standard.

    Science.gov (United States)

    Smietański, M; Renke, M; Bigda, J; Smietańska, I; Rutkowski, B; Witkowski, P; Sledziński, Z

    2006-06-01

    Peritoneal dialysis is becoming more and more common as a method of treating patients at the final stage of renal failure. In the year 2002 the number of patients treated with this method in Poland amounted to 1324. Studies have demonstrated that inguinal and abdominal hernias develop more frequently in chronic renal failure patients. The percentage of patients with hernia diagnosed within the first five years of dialysis is about 10%. Continuation of dialysis with the hernia condition left untreated may result in severe complications which are the third most frequent cause of converting treatment method into hemodialysis in PD patients. Currently in Poland there is no national standard in existence as to the management of hernias, and the only British standard from 1998 does not reflect the present expertise of either surgical treatment or dialysis methods. The aim of the current questionnaire based study investigating Polish peritoneal dialysis centers was to assess the treatment when hernia had been diagnosed in the PD patient. Of 49 dialysis centers in Poland, 39 do have protocols on managing the patient before and after the operation. A considerable diversity has been found as to surgical techniques used and the ways the patients are managed in hospital. Following the need expressed by 33 dialysis centers in Poland for some standard for relevant procedures, the authors formulated principles of modern hernia treatment in PD patients. Accordingly, the main principles include: 1) consulting a surgeon collaborating with the center before qualifying for peritoneal dialysis and when hernia symptoms have manifested; 2) Tension-free methods used in a treatment of choice (recommended by PHS); 3) Application of antibiotic prophylaxis (preferably first generation cephalosporin); 4) Induction of local or epidural anesthesia; 5) Peritoneal dialysis programme does not need to be discontinued but low volume dwells or preferably intermittent APD is recommended immediately

  20. Dolor y costos hospitalarios en la reparación de la hernia inguinal primaria: Lichtenstein frente a Desarda Pain and hospital costs in primary inguinal hernia repair: Lichtensten versus Desarda

    Directory of Open Access Journals (Sweden)

    Pedro López Rodríguez

    2010-09-01

    Full Text Available INTRODUCCIÓN. La hernia inguinal tiene una alta incidencia en la población y representa un problema de salud por sus importantes implicaciones sociales y laborales. El objetivo de este trabajo fue comparar los resultados del tratamiento de la hernia inguinal mediante dos técnicas quirúrgicas distintas: una protésica (técnica de Lichtenstein y otra anatómica (técnica de Desarda, haciendo hincapié en la valoración del dolor posoperatorio y los costos hospitalarios de dichos procedimientos, además de otros factores. MÉTODOS. Se realizó un estudio prospectivo aleatorizado de 625 pacientes intervenidos quirúrgicamente entre enero de 2003 y enero del 2009 en el Hospital General Docente «Dr. Enrique Cabrera» (La Habana. Fueron también estudiadas otras variables, como edad, localización y tipo de hernia, duración de la intervención y complicaciones. RESULTADOS. El tiempo quirúrgico fue menor en la hernioplastia de Lichtenstein y hubo un comportamiento similar en cuanto al dolor posoperatorio entre el primero y tercer día, y en la hernioplastia fue superior al quinto día. Se encontró diferencia estadísticamente significativa en cuanto al costo hospitalario, que fue superior con la técnica protésica. CONCLUSIONES. Con la técnica de Desarda se obtienen los mismos resultados satisfactorios en las hernias no recidivadas que con la técnica de Lichtenstein, y el costo hospitalario es menor.INTRODUCTION. The inguinal hernia has a high incidence in population and represents a health problem due to its significant social and working implications. The objective of present paper was to compare the results of inguinal hernia treatment using two different techniques: a prosthetic one (Lichtenstein technique and other of anatomical type (Desarda's technique emphasizing on evaluation of postoperative pain and the hospital costs due to such procedures in addition to other factors. METHODS. A randomized and prospective study was conducted in

  1. Early assessment of bilateral inguinal hernia repair: A comparison between the laparoscopic total extraperitoneal and Stoppa approaches

    Directory of Open Access Journals (Sweden)

    Edivaldo Massazo Utiyama

    2016-01-01

    Full Text Available Background: The present clinical trial was designed to compare the results of bilateral inguinal hernia repair between patients who underwent the conventional Stoppa technique and laparoscopic total extraperitoneal repair (LTE with a single mesh and without staple fixation. Patients and Methods: This controlled, randomised clinical trial was conducted at General Surgery and Trauma of the Clinics Hospital, Medical School, the University of São Paulo between September 2010 and February 2011. Totally, 50 male patients, with a bilateral inguinal hernia, older than 25 years were considered eligible for the study. The following parameters were analysed during the early post-operative period: (1 The intensity of surgical trauma, operation time, C-reactive protein (CRP levels, white blood cell count, bleeding and pain intensity; (2 quality of life assessment; and (3 post-operative complications. Results: LTE procedure was longer than the Stoppa procedure (134.6 min ± 38.3 vs. 90.6 min ± 41.3; P 0.05. There was no difference in pain during the 1st and 7th post-operative, physical functioning, physical limitation, the impact of pain on daily activities, and the Carolinas Comfort Scale during the 7th and 15th post-operative (P > 0.05. Complications occurred in 88% of Stoppa group (22 patients and 64% in LTE group (16 patients (P < 0.05. Conclusion: The comparative study between the Stoppa and LTE approaches for the bilateral inguinal hernia repair demonstrated that: (1 The LTE approach showed less surgical trauma despite the longer operation time; (2 Quality of life during the early post-operative period were similar; and (3 Complication rates were higher in the Stoppa group.

  2. Reduction and standardization of surgical instruments in pediatric inguinal hernia repair.

    Science.gov (United States)

    Koyle, Martin A; AlQarni, Naif; Odeh, Rakan; Butt, Hissan; Alkahtani, Mohammed M; Konstant, Louis; Pendergast, Lisa; Koyle, Leah C C; Baker, G Ross

    2018-02-01

    To standardize and reduce surgical instrumentation by >25% within a 9-month period for pediatric inguinal hernia repair (PIHR), using "improvement science" methodology. We prospectively evaluated instruments used for PIHR in 56 consecutive cases by individual surgeons across two separate subspecialties, pediatric surgery (S) and pediatric urology (U), to measure actual number of instruments used compared with existing practice based on preference cards. Based on this evaluation, a single preference card was developed using only instruments that had been used in >50% of all cases. A subsequent series of 52 cases was analyzed to assess whether the new tray contained the ideal instrumentation. Cycle time (CT), to sterilize and package the instruments, and weights of the trays were measured before and after the intervention. A survey of operating room (OR) nurses and U and S surgeons was conducted before and after the introduction of the standardized tray to assess the impact and perception of standardization. Prior to creating the standardized tray, a U PIHR tray contained 96 instruments with a weight of 13.5 lbs, while the S set contained 51, weighing 11.2 lbs. The final standardized set comprised 28 instruments and weighed 7.8 lbs. Of 52 PIHRs performed after standardization, in three (6%) instances additional instruments were requested. CT was reduced from 11 to 8 min (U and S respectively) to instrumentation for other common surgeries. Standardization of surgical equipment can be employed across disciplines with the potential to reduce costs and positively impact quality, safety, and efficiencies. Copyright © 2017 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

  3. A multicenter, randomized, controlled study evaluating preventive etanercept on postoperative pain after inguinal hernia repair.

    Science.gov (United States)

    Cohen, Steven P; Galvagno, Samuel M; Plunkett, Anthony; Harris, Diamond; Kurihara, Connie; Turabi, Ali; Rehrig, Scott; Buckenmaier, Chester C; Chelly, Jacques E

    2013-02-01

    Chronic postsurgical pain (CPSP) affects between 5% and 70% of surgical patients, depending on the surgery. There is no reliable treatment for CPSP, which has led to an increased emphasis on prevention. In this study, we sought to determine whether preventive etanercept can decrease the magnitude of postoperative pain and reduce the incidence of CPSP. We performed a multicenter, randomized study in 77 patients comparing subcutaneous etanercept 50 mg administered 90 minutes before inguinal hernia surgery with saline. Patients, surgeons, anesthesiologists, the injecting physician, nursing staff, and evaluators were blinded. The primary outcome measure was a 24-hour numerical rating scale pain score. Secondary outcome measures were postanesthesia care unit pain scores, 24-hour opioid requirements, time to first analgesic, and pain scores recorded at 1 month, 3 months, 6 months, and 12 months. Mean 24-hour pain scores were 3.3 (95% confidence interval [CI], 3.2-4.6) in the etanercept and 3.9 (95% CI, 2.6-4.0) in the control group (P=0.22). The mean number of analgesic pills used in the first 24 hours was 4.0 (SD, 2.8) in the treatment versus 5.8 (SD, 4.2) in the control group (P=0.03). At 1 month, 10 patients (29%) in the treatment group reported pain versus 21 (49%) control patients (P=0.08). The presence of pain at 1 month was significantly associated with pain at 3 months (hazard ratio, 0.74; 99% CI, 0.52-0.97; P=0.03). Although preventive etanercept was superior to saline in reducing postoperative pain on some measures, the effect sizes were small, transient, and not statistically significant. Different dosing regimens in a larger population should be explored in future studies.

  4. Diagnóstico de masa inguinal, más allá de la hernia inguinal

    Directory of Open Access Journals (Sweden)

    María Trigás Ferrin

    2012-12-01

    Full Text Available Caso clínico de mujer de 86 años con masa inguinal izquierda como hallazgo incidental en la exploración física y diagnóstico final de quiste de canal de nuck, una rara entidad en adultos y que obliga a revisar el diagnóstico diferencial de las masas inguinales

  5. Amyand´s hernia presenting as an acute abdomen

    OpenAIRE

    De la Peña-López Jairo; Silgado-Kerguelen Ricardo; Calderón-Morón Hernán

    2011-01-01

    Acute abdomen requiring surgical management is a frequent consultation at emergencydepartment. Acute appendicitis is the most common cause, however the presence ofacute appendicitis in an incarcerated inguinal hernia is rare, and this process is known asthe eponymous Amyand´s hernia. We report a case who presented with acute abdomenand a review of the literature. Our patient had a history of mild mental retardation;he had had clinical manifestations of abdominal pain one week earlier but fami...

  6. Acute appendicitis in an incarcerated crural hernia: analysis of our experience Apendicitis aguda en una hernia crural incarcerada: análisis de nuestra experiencia

    Directory of Open Access Journals (Sweden)

    P. Priego

    2005-10-01

    Full Text Available Introduction: the finding of the vermiform appendix within a crural hernia (Amyand's hernia is a rare entity whose incidence is not described in the literature. Objective: the aim of this study was to report our hospital's experience in this kind of pathology. Material and methods: between 1993 and 2004, 4,572 acute appendicitis and 372 incarcerated crural hernia cases have been operated on in our hospital. We studied 6 cases of incarcerated crural hernia with vermiform appendix inside. We analyzed in retrospect the following parameters: age, sex, personal history, clinical manifestations, preoperative diagnosis, surgical technique, mean hospital stay, and outcome. Results: all patients were women with a mean age of 78.8 years. Most frequent clinical manifestations included pain and a mass in the right inguinocrural region, of variable intensity and duration. No clinical, laboratory, or radiographic signs help in reaching a correct preoperative diagnosis. General anesthesia and a crural approach are used in most surgical operations. In all cases an appendectomy was performed via the hernia sac, thus proving the presence of acute appendicitis in four of them (66.67%. A prosthetic mesh was used in 3 cases, and one case of wound infection was found. In the other cases we sutured the hernia ring using prolene. Conclusion: the finding of the appendix in an incarcerated crural hernia is a rare entity in old women that is difficult to diagnose preoperatively. Treatment includes appendectomy and herniorraphy. The use of prosthetic mesh is controversial.Introducción: la presencia del apéndice vermiforme en el interior de un saco herniario crural (hernia de Amyand constituye una entidad poco frecuente y cuya incidencia no está descrita en la literatura. Objetivo: el objetivo del trabajo es presentar la experiencia de nuestro hospital en este tipo de patología. Material y métodos: entre 1993 y 2004 se han intervenido en nuestro centro 4.572 pacientes

  7. Hernias inguinales bilaterales operadas con anestesia local mediante hernioplastia de Lichtenstein Bilateral inguinal hernias operated on with local anesthesia by Lichtenstein hernioplasty

    Directory of Open Access Journals (Sweden)

    Bárbaro Agustín Armas Pérez

    2009-03-01

    Full Text Available INTRODUCCIÓN. La hernioplastia inguinal bilateral libre de tensión de Lichtenstein es una posibilidad real de tratamiento en pacientes con hernia inguinal bilateral. Este método es en esencia menos costoso para el paciente, la institución y la economía en general, y permite una reincorporación rápida a la sociedad, por lo cual en el presente estudio se presentaron los resultados de este protocolo de tratamiento, con la finalidad de evaluar su efectividad. MÉTODOS. Se realizó un estudio descriptivo transversal con los primeros 38 pacientes operados con la técnica de Lichtenstein mediante anestesia local (técnica combinada de Braun y de Shleider. Los pacientes fueron operados de forma ambulatoria entre enero de 2001 y diciembre del 2007. Se dio el alta en la tarde, si la operación fue en la mañana; y al amanecer del día siguiente, si se operó en la tarde, con el objetivo de evitar la equimosis declive con la movilización precoz. RESULTADOS. Cuatro de los pacientes presentaban hernias recurrentes. El material protésico más empleado fue el polipropileno (86,9 %. Las complicaciones alcanzaron el 9,1 % (referidas no a los 38 pacientes, sino a las 76 hernioplastias; y después de un seguimiento que osciló entre 1 y 36 meses, se presentó un rechazo al material protésico (1,3 % y una recidiva (1,3 %. CONCLUSIONES. Se concluyó que este procedimiento es aplicable a las hernias bilaterales, ya que el estrés, los costos institucionales y las molestias del paciente se reducen, con lo cual demuestra su eficacia.INTRODUCTION. Lichtenstein's tension free bilateral inguinal hernioplasty is a real possibility for treating patients with bilateral inguinal hernia. This method is essentially less expensive for the patient, the institution and the economy in general, and it allows a fast reincorporation to society. Therefore, the results of this treatment protocol were included in the present study aimed at evaluating its effectiveness. METHODS

  8. Inguinal Hernia Repair is Safe in Africa | Warwick | East and Central ...

    African Journals Online (AJOL)

    Methods: .Operation hernia is a charitable organization that has been working in Africa since 2005. We have analyzed patients operated on between 2005 until December 2010 in Ghana, Nigeria and the Ivory Coast. Hernias have been operated on electively in a variety of setting, ranging from well-equipped hernia centre ...

  9. Herniorrafia inguinal em crianças: valor da anestesia local associada Inguinal hernia repair in children: importance of local anesthesia association

    Directory of Open Access Journals (Sweden)

    José Guilherme Minossi

    2002-07-01

    Full Text Available OBJETIVO: Descrever uma técnica de anestesia local no tratamento de hérnias inguinais em crianças. MÉTODO: Foram operadas 48 crianças com hérnias inguinais sob anestesia local na Santa Casa de Misericórdia de Cerqueira César, SP, sendo 34 do sexo masculino e 14 do sexo feminino, com idades entre 3 meses e 12 anos. Apenas quatro crianças tinham hérnia bilateral. A anestesia local foi realizada com lidocaína a 1% na dose de 5 mg/kg de peso através do bloqueio dos nervos abdominogenitais próximos à espinha ilíaca ântero-superior, à altura do anel inguinal externo e na pele ao redor da incisão. A sedação foi feita com cetamina na dose de 1 a 2 mg/kg e diazepam 0,2 a 0,4 mg/kg de peso. RESULTADOS: Todas as cirurgias puderam ser realizadas com tranqüilidade com este método, com exceção de uma criança em que o bloqueio não foi efetivo e a anestesia complementada com inalação de halogenado, sob máscara. Como complicações pós-operatórias, ocorreram três hematomas, sendo um de parede e dois em bolsa escrotal, todos com boa evolução. CONCLUSÕES: O uso da anestesia local associada à sedação é procedimento simples e seguro para realizar herniorrafias inguinais em crianças.AIM: To describe an anesthetic technique, as well as the results of surgical treatment of the inguinal hernia in children. PATIENTS/METHODS: Forty-eight patients were submitted to inguinal hernia repair under local anesthesia at "Santa Casa de Misericórdia de Cerqueira César", State of São Paulo, Brazil. There were 34 male and 14 female patients, range from 3 months to 12 years old. Local anesthesia was performed with a dose of 5 mg/kg body weight of 1% lidocaine through iliohypogastric and ilioinguinal nerve blocks, medially to the anterior superior iliac spine, and at level of the pubic tubercle. Sedation was done with an association of ketamine (1 to 2 mg/kg and diazepam (0,2 to 0,4 mg/kg. RESULTS: In all patients except one the procedure was

  10. Comparison of Porcine Small Intestinal Submucosa versus Polypropylene in Open Inguinal Hernia Repair: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Nie, Xin; Xiao, Dongdong; Wang, Wenyue; Song, Zhicheng; Yang, Zhi; Chen, Yuanwen; Gu, Yan

    2015-01-01

    Background A systematic review and meta-analysis was performed in randomized controlled trials (RCTs) to compare porcine small intestinal submucosa (SIS) with polypropylene in open inguinal hernia repair. Method Electronic databases MEDLINE, Embase, and the Cochrane Library were used to compare patient outcomes for the two groups via meta-analysis. Result A total of 3 randomized controlled trials encompassing 200 patients were included in the meta-analysis. There was no significant difference in recurrence (P = 0.16), hematomas (P = 0.06), postoperative pain within 30 days (P = 0.45), or postoperative pain after 1 year (P = 0.12) between the 2 groups. The incidence of discomfort was significantly lower (P = 0.0006) in the SIS group. However, the SIS group experienced a significantly higher incidence of seroma (P = 0.03). Conclusions Compared to polypropylene, using SIS in open inguinal hernia repair is associated with a lower incidence of discomfort and a higher incidence of seroma. However, well-designed larger RCT studies with a longer follow-up period are needed to confirm these findings. PMID:26252895

  11. Our Results in Patients with Inguinal Hernia in Whom Total Extraperitoneal Preperitoneal (Tepp Method Has Been Used

    Directory of Open Access Journals (Sweden)

    Akgün Çelik

    2012-12-01

    Full Text Available Aim: TEPP (Total extraperitoneal preperitoneal inguinal hernia repair is a laparoscopic technique. In this study, we aimed to evaluate the clinical outcomes of TEPP. Methods: Hospital records of 130 patients who underwent TEPP in Bezm-i Alem Valide Sultan Gureba Training and Research Hospital between January 2005 and January 2010 were retrospectively evaluated. Demographic characteristics, length of hospital stay, return to an active life, complications, and recurrence rates were determined. Results: The mean age was 41 years and 85% of the patients were male. Most of the patients had inguinal hernia type 3B according to Nyhus classification (92. Seven patients had 3C and, type 3A was found in 22 patients. Of the 130 patients, 9 had recurrence. The mean duration of surgery was 30 minutes and the mean length of hospital stay was 1.2 days. The most common complication was accumulation of fluid in the scrotum (24 patients. Major vascular injury, organ injury, and wound infection were not detected. There was no recurrence during 3-60-month-follow-up. Conclusion: Return to an active life, duration of surgery, complication rates, and cosmetic results in TEPP were better than that in other techniques. (The Me di cal Bul le tin of Ha se ki 2012; 50: 119-21

  12. Resultados imediatos da herniorrafia inguinal com anestesia local associada com sedação Immediate results of inguinal hernia repair with local anesthesia associated with sedation

    Directory of Open Access Journals (Sweden)

    Edgar Valente de Lima Neto

    2003-10-01

    Full Text Available OBJETIVO: Avaliar os resultados imediatos da herniorrafia inguinal com anestesia local associada com sedação. MÉTODOS: Foram operados 30 pacientes portadores de hérnia inguinal, sendo 26 (86,6% do sexo masculino e 4 (13,4 do sexo feminino. Os anestésicos utilizados foram lidocaína a 1% e bupivacaína a 0,5% sem adrenalina, tendo sido adicionado 1mL de bicarbonato de sódio para cada 9mL da solução anestésica. A sedação foi realizada com midazolan. As hérnias mais freqüentes, de acordo com a classificação de Nyhus, foram as do tipo I, encontradas em 16 (53,3% pacientes. Praticou-se o reparo da parede posterior a em 17 (56,6% e em 13 (43,2% o reparo com prótese. Para a análise estatística utilizou-se o teste de McNemar para avaliar a correlação entre os escores de dor na escala E.V.A. agrupada. RESULTADOS: Em nenhum paciente houve necessidade de mudança da técnica anestésica. Entre as complicações, observaram-se: 1 (3,3% hematoma; 1 (3,3% sangramento e 1 (3,3% infecção da ferida operatória. A deambulação foi precoce em 28 (93,3% pacientes, assim como a alimentação oral. O tempo de internação médio foi 18 horas, e o escore de dor na escala visual analógica (E.V.A. foi menor ou igual a 3 em 80% dos pacientes. CONCLUSÃO: A anestesia local com sedação é um método seguro, eficaz, com baixos índices de complicações imediatas, e alto índice de satisfação para pacientes selecionados, portadores de hérnia inguinal.PURPOSE: To present the immediate results of the inguinal hernia repair with local anesthesia associated with sedation. METHODS: Thirty patients were operated on of which 26 (86,6% were male. The age varied from 21 to 76, and the average was of 47 years. The anesthetics used were lidocaine and bupivacaine, and the sedation was accomplished with midazolan. RESULTS: Among the complications was observed: 1 (3,3% bruising; 1 (3,3% blood; and 1 (3,3% case of infection of the operative wound. Early rise

  13. INFLUENCE OF TOBACCO, ALCOHOL AND DIABETES ON THE COLLAGEN OF CREMASTER MUSCLE IN PATIENTS WITH INGUINAL HERNIAS.

    Science.gov (United States)

    Módena, Sérgio Ferreira; Caldeira, Eduardo José; Peres, Marco Antonio O; Andreollo, Nelson Adami

    2016-01-01

    New findings point out that the mechanism of formation of the hernias can be related to the collagenous tissues, under activity of aggressive agents such as the tobacco, alcohol and diabetes. To analyze the collagen present in the cremaster muscle in patients with inguinal hernias, focusing the effect of tobacco, alcohol, and diabetes. Fifteen patients with inguinal hernia divided in three groups were studied: group I (n=5) was control; group II (n=5) were smokers and/or drinkers; and group III (n=5) had diabetes mellitus. All subjects were underwent to surgical repair of the inguinal hernias obeying the same pre, intra and postoperative conditions. During surgery, samples of the cremaster muscle were collected for analysis in polarized light microscopy, collagen morphometry and protein. The area occupied by the connective tissue was higher in groups II and III (ptabaco, o álcool e o diabete. Avaliar o colágeno presente no músculo cremaster em pacientes com hérnias inguinais enfocando o efeito do tabaco, álcool e diabete. Foram estudados 15 pacientes com hérnias inguinais divididos em: grupo I (n=5) controles; grupo II (n=5) indivíduos fumantes e/ou etilistas; e grupo III (n=5) indivíduos que apresentavam diabete melito. Todos foram submetidos à correção cirúrgica das hérnias inguinais obedecendo às mesmas condições pré, intra e pós-operatórias. Durante o procedimento cirúrgico, amostras do músculo cremaster foram coletadas para análises em microscopia de luz polarizada, morfometria do colágeno e de proteínas. A área ocupada por tecido conjuntivo foi maior nos grupos II e III (ptabaco, o álcool e o diabete ocasionam remodelação no músculo cremaster, levando à perda de suporte ou alteração estrutural nesta região, podendo intensificar as ocorrências e os danos relacionados às hérnias inguinais.

  14. Laparoscopic Repair of Primary Inguinal Hernia Performed in Public Hospitals or Low-Volume Centers Have Increased Risk of Reoperation for Recurrence

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Friis-Andersen, Hans; Rosenberg, Jacob

    2016-01-01

    of repair, characteristics of patients, and possibly the annual volume of procedures performed by a center. The aim of this study was to test the hypothesis that hospital volume and type of hospital (private vs public) could influence the reoperation rate for recurrence as a marker of surgical quality...... of care. METHODS: This study was based on data from the Danish Hernia Database covering the period from January 1, 1998, to December 31, 2013. Hernia repairs included in this study were laparoscopic repair of primary, inguinal hernias in the elective setting, performed on adult male patients. RESULTS...... repair. Furthermore, private centers performed better than public centers irrespective of volume....

  15. A standardized resident training program in endoscopic surgery in general and in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair in particular

    DEFF Research Database (Denmark)

    Miserez, Marc; Arregui, Maurice; Bisgaard, Thue

    2009-01-01

    . A standardized preclinical resident training program in endoscopic surgery is described. Also, a standardized clinical training program is proposed with systematic dissection in 10 different consecutive steps for totally extraperitoneal inguinal hernia repair. Continuous mentoring by an expert is an absolute...

  16. The role of antibiotic prophylaxis in prevention of wound infection after Lichtenstein open mesh repair of primary inguinal hernia : a multicenter double-blind randomized controlled trial

    NARCIS (Netherlands)

    Aufenacker, Theo J; van Geldere, Dirk; van Mesdag, Taco; Bossers, Astrid N; Dekker, Benno; Scheijde, Edo; van Nieuwenhuizen, Roos; Hiemstra, Esther; Maduro, John H; Juttmann, Jan-Willem; Hofstede, Diederik; van Der Linden, Cunera T M; Gouma, Dirk J; Simons, Maarten P

    2004-01-01

    OBJECTIVE: To determine whether the use of prophylactic antibiotics is effective in the prevention of postoperative wound infection after Lichtenstein open mesh inguinal hernia repair. SUMMARY BACKGROUND DATA: A recent Cochrane meta-analysis (2003) concluded that "antibiotic prophylaxis for elective

  17. The role of antibiotic prophylaxis in prevention of wound infection after lichtenstein open mesh repair of primary inguinal hernia - A multicenter double-blind randomized controlled trial

    NARCIS (Netherlands)

    Aufenacker, Theo J.; van Geldere, Dirk; van Mesdag, Taco; Bossers, Astrid N.; Dekker, Benno; Scheijde, Edo; van Nieuwenhuizen, Roos; Hiemstra, Esther; Maduro, John H.; Juttmann, Jan-Willem; Hofstede, Diederik; van der Linden, Cunera T. M.; Gouma, Dirk J.; Simons, Maarten P.

    2004-01-01

    Objective: To determine whether the use of prophylactic antibiotics is effective in the prevention of postoperative wound infection after Lichtenstein open mesh inguinal hernia repair. Summary Background Data: A recent Cochrane meta-analysis (2003) concluded that "antibiotic prophylaxis for elective

  18. Cono extendido, nueva variante técnica en la cirugía de la hernia inguinal Extended cone a new technical variant in the inguinal hernia surgery

    Directory of Open Access Journals (Sweden)

    Hiram Rodríguez Blanco

    2011-06-01

    Full Text Available INTRODUCCIÓN. El tratamiento de la hernia inguinal continúa siendo un tema controvertido y no existe un punto común de acción en cuanto a la modalidad terapéutica que se emplea. Con el desarrollo de las técnicas protésicas la controversia continúa a pesar de las demostradas ventajas de estas. El objetivo de este estudio fue evaluar los primeros casos intervenidos quirúrgicamente mediante la técnica del cono extendido, una modificación de las técnicas clásicas de Liechtenstein y Rutkow. MÉTODOS. Se realizó un estudio prospectivo lineal en 45 pacientes operados mediante una técnica protésica denominada cono extendido. Los pacientes fueron operados en un período de 2 años en la Clínica Multiperfil de Luanda (Angola y para clasificarlos se utilizó la clasificación de Gilbert modificada. RESULTADOS. Hubo un predominio del sexo masculino. La localización más frecuente fue la región inguinal derecha. Predominaron los pacientes clasificados de grado III según la clasificación de Gilbert. Hubo 6 complicaciones menores y hasta el momento no han ocurrido recidivas. CONCLUSIONES. La técnica del cono extendido es una opción más para el tratamiento de los pacientes que presenten hernias inguinales de grado III y VI de la clasificación de Gilbert.INTRODUCTION. The treatment of the inguinal hernia remains being a controversial subject and there is not a common point of action as regards the therapeutic modality used. With the development of the prosthetic techniques the controversy remains despite their demonstrated advantages. The objective of present study was to assess the first cases operated on with the extended cone technique a modification of the classic Liechtenstein's and Rutkow's techniques. METHODS. A linear and prospective study was conducted in 45 patients operated on by a prosthetic technique called extended cone. The patients were operated on in a period of two years in the Multiprofile Clinic of Luanda (Angola and

  19. Polyester mosquito net mesh for inguinal hernia repair: A feasible option in resource limited settings in Cameroon?

    Science.gov (United States)

    Rouet, J; Bwelle, G; Cauchy, F; Masso-Misse, P; Gaujoux, S; Dousset, B

    2017-11-01

    In developing countries, most inguinal hernia repairs are performed using Bassini or Shouldice techniques resulting in higher recurrence rates than with mesh placement. Our study aimed to evaluate the postoperative course and quality of life of patients undergoing inguinal hernia repair with a polyester mosquito net meshes during non-governmental organization health campaigns in Cameroon. Patients were prospectively included from January to November 2013. Meshes were made from a polyester non-impregnated mosquito net purchased at a local market in Yaounde and sterilized on site. The total cost of a mesh was 0.21 USD. Among the 41 patients included in the study, 33 (80.5%) were men, 30 (72%) were farmers and the median age was 52 (21-80) years. The time between the onset of symptoms and surgery was 24 (3-240) months. Eleven (26.8%) patients had a previous history of hernia repair: 4 (9.7%) had been operated on the contralateral side and 7 (17.1%) had a recurrence. No intraoperative event related to the meshes was recorded. Three patients (7.2%) had a postoperative uninfected scrotal seroma, and 1 patient (2.4%) experienced a superficial skin infection that was treated using local care and oral antibiotics. No allergic rejection or deep infection was observed. Meshes made from sterilized mosquito nets are safe and effective and provide a cost-effective alternative to commercially available meshes in countries with limited resources especially during non-governmental organization health campaigns. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. Acupuncture for post-operative pain after inguinal hernia repair: a placebo controlled, double-blinded clinical trial

    Directory of Open Access Journals (Sweden)

    Raji B

    2007-10-01

    Full Text Available Background: Acupuncture is one of the most effective methods of alleviating pain in different situations including chronic and acute pain management. The aim of this study was to evaluate the effectiveness of acupuncture in the reduction of post-operative pain after hernia repair.Methods: In this placebo-controlled, double-blinded clinical trial, we enrolled 60 male patients aged 30 to 60 years old with an ASA physical status of I or II undergoing elective inguinal hernia repair under general anesthesia in Imam Khomeini Hospital, Tehran, Iran. All patients experienced standard anesthetic and surgical procedures. After completion of the operation and while the patients were still under general anesthesia, they were randomly assigned to two groups: acupuncture (with stimulation of GV2, GV4 and SP6 points with sterile acupuncture needles, and control (with sham acupuncture stimulation. After termination of anesthesia, during the first six hours, the pain intensity was evaluated hourly. Pethidine (25 mg was administered for the patients when necessary. Pain intensity and pethidine use were recorded and compared between the two groups.Results: The mean age of two groups did not differ. Pain intensity was significantly lower in the acupuncture group between the second and fifth postoperative hours. Moreover, pethidine use was significantly lower in the acupuncture group versus the control group during the first six hours after surgery (12.07±7.5 mg vs. 12.91±6.5 mg, respectively; p=0.0001.Conclusion: The application of acupuncture in patients is associated with a marked decrease in pain after inguinal hernia repair and does not have any serious complications. Acupuncture is strongly recommended for all post-operative patients."n 

  1. Gender-related differences of inguinal hernia and asymptomatic patent processus vaginalis in term and preterm infants.

    Science.gov (United States)

    Burgmeier, Christine; Dreyhaupt, Jens; Schier, Felix

    2015-03-01

    The aim of this study was to analyze the gender-related differences of inguinal hernia (IH) and patent processus vaginalis (PPV) in term and preterm infants. Over a nine-year-period 411 infants underwent laparoscopic herniorrhaphy within the first six months of life. 246 term (191 male; 55 female) and 165 preterm (118 male; 47 female) infants were included in this retrospective study. Initial presentation of IH and intraoperative anatomical findings of PPV were reviewed. We found that term boys (58.6%) and girls (58.2%) predominantly presented with right-sided IH whereas preterm boys (36.4%) and girls (44.7%) mostly presented with bilateral IH. Female babies had a higher incidence of initial left-sided IH. Term and preterm girls with initial left-sided hernia were found to have highest incidence of PPV. Male term babies with initial left-sided IH were found to have the lowest incidence of PPV (25.0%). The highest incidence of PPV in male was found in preterm boys with either left- or right-sided IH. Incidence and laterality of IH and PPV differ between term and preterm girls and boys. In open hernia repair decision concerning contralateral groin exploration should consider term/preterm birth as well as gender. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Colocutaneous fistula: a rare postoperative complication after surgical treatment of an irreducible left inguinal hernia Case Report.

    Science.gov (United States)

    Cadariu, Florentina; Enache, Alexandra; Avram, Mihaela; Olariu, Sorin

    2016-02-18

    The colo-cutaneous fistula is an extremely rare post-operative complication of hernias. This type of complication, besides the surgical aspects, raises also a medical-legal problem regarding the production of the fistula and its consequences. The authors present the clinical case of a 65 years old man, J.N., from a rural background, who presented himself in the ambulatory with a colo-cutaneous fistula as a complication which debuted a few weeks after a surgical intervention for an irreducible left inguinal hernia. He was submitted to a surgical reintervention with good results. The main particularity of the present case is the association of the colo-cutaneous fistula with the presence of the oxyuris helmintiasis in the fistulos secretions. Even though it was rather difficult to obtain the patient's consent for the surgical treatment, the intervention had very good results leading to the healing of the patient. Colo-cutaneous fistula, Enterobius vermicularis (oxyuris helmintiasis), Post-operative complications of hernia.

  3. Burden of congenital inguinal hernia and hydrocele in northern and southern Nigeria: an opportunity for awareness creation.

    Science.gov (United States)

    Ibrahim, Musa; Getso, Kabiru Ibrahim; Mohammad, Mohammad Aminu

    2014-01-01

    Nigeria, with a population of >150 million people in which half of the population are children encounters challenges in paediatric surgery practice in rural areas. There are paediatric surgeons in Nigeria, but majority practice in tertiary health facilities in cities. The poor rural dwellers have little or no access to such highly trained specialists. Hence, children with congenital and acquired paediatric surgical pathologies including anterior abdominal wall defects not only grow up with these diseases to adulthood, they are also exposed to various health hazards posed by unqualified personnel. Therefore, we are evaluating the burden of congenital inguinal hernia/hydrocele in northern and southern Nigeria for awareness creation and the way forward. Data obtained from organised free hernia missions to the rural populace from northern and southern Nigeria by the West African Collage of Surgeons in 2010 and Kano State Government in 2013 was analysed. A total of 811 patients aged from 3 months (0.25 years) to 35 years was screened and found to have congenital hernia and/or hydrocele from the two centres. 171 (21.1%) were successfully operated, while the remaining 640 (78.9%) could not benefit from a surgical procedure during the missions. There were n = 46 (26.9%) patients with various forms of genital mutilations/and or surgical mismanagements among the operated patients. The burden of congenital anterior abdominal wall defects among Nigerian children is high. A little effort could bring succor and create awareness among this group of people.

  4. Ureteral Involvement Within an Incarcerated Inguinal Hernia in a Patient With Crossed-fused Renal Ectopia

    Directory of Open Access Journals (Sweden)

    Udit Singhal

    2016-07-01

    Full Text Available Crossed-fused renal ectopy is an uncommon abnormality of the genitourinary tract that results from errors during embryological development. Ureteral herniation represents another rare anatomic event and can often occur from spontaneous, postoperative, and congenital causes (Allam, Johnson, Grewal & Johnson 2015; Pollack, Popky & Blumberg 1975. Here, we discuss the complex clinical course of a patient with crossed-fused renal ectopia who presents with symptoms due to ureteroinguinal herniation and provide a brief overview of the literature. We highlight the clinical considerations in the management of this patient and provide a potential anatomical and embryological explanation for his presentation.

  5. Re-recurrence after operation for recurrent inguinal hernia. A nationwide 8-year follow-up study on the role of type of repair

    DEFF Research Database (Denmark)

    Bisgaard, Thue; Bay-Nielsen, M.; Kehlet, H.

    2008-01-01

    the surgical strategy and results after recurrent inguinal hernia repairs. METHODS: Prospective recording of all primary and subsequent recurrent inguinal hernia repairs from January 1, 1998 to December 31, 2005, in the national Danish Hernia Database, using the reoperation rate as a proxy for recurrence...... = 1124) was significantly reduced after laparoscopic operation for recurrence (1.3% (95% CI: 0.4-3.0)) compared with open repairs for recurrence (Lichtenstein 11.3% (8.2-15.2), nonmesh 19.2% (14.0-25.4), mesh (non-Lichtenstein) 7.2% (4.0 - 11.8)). After primary nonmesh (n = 616), non-Lichtenstein mesh (n...... = 277), and laparoscopic repair (n = 100) there was no significant difference in re-reoperation rates between a laparoscopic repair and all open techniques of repair for recurrence. CONCLUSION: Laparoscopic repair is recommended for reoperation of a recurrence after primary open Lichtenstein repair...

  6. Comparison of Single-Port Percutaneous Extraperitoneal Repair and Three-Port Mini-Laparoscopic Repair for Pediatric Inguinal Hernia.

    Science.gov (United States)

    Korkmaz, Mevlit; Güvenç, B Haluk

    2018-03-01

    Laparoscopy has been widely used in surgical practice in pediatric age, and many techniques for laparoscopic hernia repair have been described till now. In this study, we compared two laparoscopic techniques performed by two surgeons; each surgeon practicing only one of the two techniques. A retrospective analysis was performed on the surgical charts, enrolling 71 patients with uncomplicated inguinal hernia. Patients were divided into two groups according to the type of surgery: (Group A, 24 patients aged 2 months-8 years) laparoscopic percutaneous internal ring suturing technique and (Group B, 47 patients aged 35 days-12 years) three-port mini-laparoscopic technique. The hernia sac was ligated at the level of internal ring, using nonabsorbable 4/0-3/0 suture. Any unexpected contralateral opening was repaired in the same manner for both groups. Follow-up period was 4 months-2 years and 9 months-8 years, respectively. Operative time and complications were analyzed. Operation time (19.58 ± 7.06 minutes versus 35.87 ± 10.34 minutes, P < .001) was shorter in the percutaneous repair group. However, when subdivided by unilateral and bilateral presentation, only unilateral operative time was shorter compared to three-port group. There were no recurrences in Group A, while two recurrences occurred in Group B during the learning curve period. A contralateral opening accompanied the presenting unilateral hernia in 3 cases for Group A and 16 for Group B. One patient had to be converted open resulting from epigastric vessel injury, and postop hydrocele formation was seen in another in Group A. No intraoperative complications were seen in Group B. The overall experience shows that laparoscopic repair is a reliable approach regardless of the chosen technique. Percutaneous repair seems to be a less invasive method with shorter operative time, but it is not free of complications according to this series.

  7. Systematic training model for teaching, development and training of instructors in inguinal hernia treatment using the Lichtenstein technique. Hernia campaign 2014 & 2015.

    Directory of Open Access Journals (Sweden)

    CARLOS JOSÉ LAZZARINI-MENDES

    Full Text Available ABSTRACT Objective: to evaluate the method of training and continuing education of 18 surgeons in 2014, and 28 surgeons in 2015, in the Holy Homes of Ribeirao Preto, Araraquara, Franca and San Carlos of São Paulo, in the performance of Lichtenstein inguinal herniorrhaphy, tutored by the Faculty of Medical Sciences of the São Paulo Holy Home and the organization HERNIA HELP - "Hernia Repair for the Underserved". Methods: the training was tutored and systematized through an active methodology of teaching and learning, aiming to offer competence, skills and attitudes, measured by a previously validated Qualification Form, qualifying leaders in trainees' improvement. Results: in 2014 the outcomes were: the difficulty of the case, direction, incision, dissection, mesh preparation, mesh cutting, mesh setting, closing, instruments, respect to tissues, flow, time and motion, and performance, all presented change in the general rating (p=0.000002; there was greater confidence in the execution of the procedure in 80% of trainees, considered "very valuable" in 93.3% of the interventions. In 2015, 28 surgeons were trained by ten surgeons previously qualified in 2014. The nerve identification rate, a relevant time the Lichtenstein technique, was 95.5% for the Iliohypogastric, 98.5% for the ilioinguinal and 89.4% for the genital branch of the genitofemoral nerve. Conclusion: the applied teaching method is possible, reproducible, reliable and valid. The joint efforts offer enormous opportunity of directed education, reaching underserved populations, revealing the great teacher-student social responsibility.

  8. General endotracheal vs. non-endotracheal regional anesthesia for elective inguinal hernia surgery in very preterm neonates: A single institution experience.

    Science.gov (United States)

    Gurria, Jean; Kuo, Phillip; Kao, Angie; Christensen, Luisa; Holterman, AiXuan

    2017-01-01

    Very pre-term infants (VP) at complications from general endotracheal anesthesia GE during elective inguinal hernia repair. A retrospective cohort study was done to compare pulmonary-related perioperative risks between VP patients undergoing non-emergent inguinal hernia repair prior to NICU discharge under GE (n=58) vs regional anesthesia RA (n=37). Median PMA (RA 26 vs GE 27 weeks), operative weight (RA 2.2 vs GE 2.27 kg), % with BPD, medical and surgical comorbidities, number of concurrent procedures are similar between groups, except for sac laparoscopy (0% RA vs 36% GE). Procedural anesthesia time was 40 minutes for RA vs 69 minutes for GE, (p Oral feeding was fully tolerated in RA (97%) vs GE (72%, p=0.002) by 48h after surgery. The statistical differences hold after regression analysis controlling for sac laparoscopy and procedure time. No difference in intraoperative or postoperative hernia complications is found. RA is safe. RA is associated with early resumption of full feed, avoidance of prolonged mechanical intubation. We recommend a randomized controlled trial comparing the safety and efficacy of GE vs RA in VP infants undergoing elective NICU inguinal hernia repair. II Retrospective study. Copyright © 2017. Published by Elsevier Inc.

  9. Lichtenstein Mesh Repair (LMR) v/s Modified Bassini’s Repair (MBR) + Lichtenstein Mesh Repair of Direct Inguinal Hernias in Rural Population – A Comparative Study

    Science.gov (United States)

    Patil, Santosh M; Kumar, Ashok; Kumar, Kuthadi Sravan; Mithun, Gorre

    2016-01-01

    Introduction Lichtenstein’s tension free mesh hernioplasty is the commonly done open technique for inguinal hernias. As our hospital is in rural area, majority of patients are labourers, open hernias are commonly done. The present study was done by comparing Lichtenstein Mesh Repair (LMR) v/s Modified Bassini’s repair (MBR) + Lichtenstein mesh repair (LMR) of direct Inguinal Hernias to compare the technique of both surgeries and its outcome like postoperative complications and recurrence rate. Materials and Methods A comparative randomized study was conducted on patients reporting to MNR hospital, sangareddy with direct inguinal hernias. A total of fifty consecutive patients were included in this study of which, 25 patients were operated by LMR and 25 patients were operated by MBR+LMR and followed up for a period of two years. The outcomes of the both techniques were compared. Results Study involved 25 each of Lichtenstein’s mesh repair (LMR) and modified bassini’s repair (MBR) + LMR, over a period of 2 years. The duration of surgery for lichtenstein mesh repair is around 34.56 min compared to LMR+MBR, which is 47.56 min which was statistically significant (p-value is MBR group in POD 1, but not statistically significant (p-value is 0.0949) and from POD 7 the pain was almost similar in both groups. The recurrence rate is 2% for LMR and 0% for MBR+LMR. Conclusion LMR+MBR was comparatively better than only LMR in all direct inguinal hernias because of low recurrence rate (0%) and low postoperative complications, which showed in our present study. PMID:27042517

  10. Lichtenstein Mesh Repair (LMR) v/s Modified Bassini's Repair (MBR) + Lichtenstein Mesh Repair of Direct Inguinal Hernias in Rural Population - A Comparative Study.

    Science.gov (United States)

    Patil, Santosh M; Gurujala, Avinash; Kumar, Ashok; Kumar, Kuthadi Sravan; Mithun, Gorre

    2016-02-01

    Lichtenstein's tension free mesh hernioplasty is the commonly done open technique for inguinal hernias. As our hospital is in rural area, majority of patients are labourers, open hernias are commonly done. The present study was done by comparing Lichtenstein Mesh Repair (LMR) v/s Modified Bassini's repair (MBR) + Lichtenstein mesh repair (LMR) of direct Inguinal Hernias to compare the technique of both surgeries and its outcome like postoperative complications and recurrence rate. A comparative randomized study was conducted on patients reporting to MNR hospital, sangareddy with direct inguinal hernias. A total of fifty consecutive patients were included in this study of which, 25 patients were operated by LMR and 25 patients were operated by MBR+LMR and followed up for a period of two years. The outcomes of the both techniques were compared. Study involved 25 each of Lichtenstein's mesh repair (LMR) and modified bassini's repair (MBR) + LMR, over a period of 2 years. The duration of surgery for lichtenstein mesh repair is around 34.56 min compared to LMR+MBR, which is 47.56 min which was statistically significant (p-value is MBR group in POD 1, but not statistically significant (p-value is 0.0949) and from POD 7 the pain was almost similar in both groups. The recurrence rate is 2% for LMR and 0% for MBR+LMR. LMR+MBR was comparatively better than only LMR in all direct inguinal hernias because of low recurrence rate (0%) and low postoperative complications, which showed in our present study.

  11. An Elderly Male with Amyand’s Hernia

    Directory of Open Access Journals (Sweden)

    Saema Said

    2017-09-01

    Full Text Available History of present illness: A 67-year-old male, with a history of diabetes, coronary artery disease, and chronic kidney disease, presented with two weeks of a new right inguinal bulge and right lower quadrant abdominal pain extending to the groin. He denied nausea, vomiting, fever, and changes in bowel movement. His initial vital signs were: temperature 37.4°C, blood pressure 142/100, heart rate 62, and respiratory rate 18. Physical examination revealed mild right lower quadrant abdominal tenderness, right inguinal and testicular tenderness and swelling, and a non-reducible bulging inguinal mass with no overlying skin changes. Lab results showed a leukocytosis of 13.6. Significant findings: Ultrasound of the right scrotum shows a right inguinal hernia with an air-containing loop of bowel (white arrow and a non-compressible appendix (yellow arrow. Coronal and axial views of abdomen-pelvis CT show a right inguinal hernia containing a loop of small bowel (white arrow and appendix (yellow arrow. Discussion: In the case presented above, ultrasound and abdomen and pelvis computed tomography (CT showed an Amyand’s hernia. The patient was taken emergently to surgery, which revealed an incarcerated right inguinal hernia with perforated appendicitis in the hernia sac. The patient underwent an appendectomy and hernia repair, and had no post-surgical complications. Amyand’s hernia is a form of inguinal hernia characterized by the presence of the appendix in the hernia sac. The hernia may be reducible, incarcerated, or strangulated; and the appendix may be normal, inflamed, or perforated.1 The patient presented above had an incarcerated hernia with no overlying skin changes suggestive of strangulation. Amyand’s hernia accounts for 0.4-1% of all inguinal hernias and 0.1% of all cases of appendicitis.2 It is thought to be due to patency of the processus vaginalis, and as such occurs more frequently in young children.1,2,3 Clinical diagnosis of Amyand

  12. Eosinophilic funiculitis initially diagnosed as irreducible inguinal hernia: A case report

    Directory of Open Access Journals (Sweden)

    Kohei Yamada

    2017-01-01

    Conclusion: Eosinophilic funiculitis is very rare; only three cases have been reported to date. We should always consider unusual causes of groin masses during a surgical approach to hernia-like lesions.

  13. Randomized clinical trial of dexamethasone versus placebo in laparoscopic inguinal hernia repair

    DEFF Research Database (Denmark)

    Tolver, M A; Strandfelt, P; Bryld, Clara E

    2012-01-01

    The effect of dexamethasone on recovery and length of convalescence has not been evaluated in patients after laparoscopic groin hernia repair. It was hypothesized that preoperative intravenous dexamethasone would reduce postoperative pain.......The effect of dexamethasone on recovery and length of convalescence has not been evaluated in patients after laparoscopic groin hernia repair. It was hypothesized that preoperative intravenous dexamethasone would reduce postoperative pain....

  14. Reparación protésica en la hernia inguinal con el uso del tapón de Rutkow

    Directory of Open Access Journals (Sweden)

    Jorge Rafael Roselló Fina

    2002-12-01

    Full Text Available Se presentan 35 enfermos operados de hernia inguinal utilizando el método de plug and patch, entre diciembre de 1999 y diciembre del 2000. Los tapones y parches fueron construidos artesanalmente mediante piezas de malla plana de polipropileno. El 77 % de los pacientes fue operado electivamente, y existió un predominio del masculino sobre el femenino en relación de 6:1. En todos los casos se usó anestesia regional y antibioticoterapia profiláctica. La mitad de los pacientes mostraron hernias recidivadas una o varias veces. Según la clasificación de Gilbert modificada, 5 hernias eran tipo 2, 16 tipo 3, 6 tipo 4, 6 tipo 5 y 2 tipo 6 al ser hernias dobles o en pantalón. Sólo se presentaron complicaciones leves en 2 enfermos, recidivas, con un control que oscila entre 6 y 18 meses, y un seguimiento promedio de 12,4 meses del 100 % de los casos35 patients operated on of inguinal hernia by the plug and patch method from December, 1999, to December, 2000, were presented. The plugs and patches were made by hand, using pieces of flat polypropylene mesh. 77 % of the patients underwent elective surgery. There was a predominance of males over females with a ratio of 6:1. Regional anesthesia and prophylactic antibiotic therapy were used in all cases. Half of the patients had hernias that had relapsed one or more times. According to the modified Gilbert’s classification, 5 hernias were type 2; l6, type 3; 6, type 4; 6, type 5; and 2, type 6, on being double hernias. Mild complications were just observed in 2 patients, relapses, with a control that ranges between 6 and 18 months, and an average follow-up of 12.4 months of 100 % of the cases

  15. Burden of congenital inguinal hernia and hydrocele in northern and southern Nigeria: An opportunity for awareness creation

    Directory of Open Access Journals (Sweden)

    Musa Ibrahim

    2014-01-01

    Full Text Available Background: Nigeria, with a population of >150 million people in which half of the population are children encounters challenges in paediatric surgery practice in rural areas. There are paediatric surgeons in Nigeria, but majority practice in tertiary health facilities in cities. The poor rural dwellers have little or no access to such highly trained specialists. Hence, children with congenital and acquired paediatric surgical pathologies including anterior abdominal wall defects not only grow up with these diseases to adulthood, they are also exposed to various health hazards posed by unqualified personnel. Therefore, we are evaluating the burden of congenital inguinal hernia/hydrocele in northern and southern Nigeria for awareness creation and the way forward. Materials and Methods: Data obtained from organised free hernia missions to the rural populace from northern and southern Nigeria by the West African Collage of Surgeons in 2010 and Kano State Government in 2013 was analysed. Results: A total of 811 patients aged from 3 months (0.25 years to 35 years was screened and found to have congenital hernia and/or hydrocele from the two centres. 171 (21.1% were successfully operated, while the remaining 640 (78.9% could not benefit from a surgical procedure during the missions. There were n = 46 (26.9% patients with various forms of genital mutilations/and or surgical mismanagements among the operated patients. Conclusion: The burden of congenital anterior abdominal wall defects among Nigerian children is high. A little effort could bring succor and create awareness among this group of people.

  16. A rare case of Amyand’s hernia presenting as an enterocutaneous fistula

    Directory of Open Access Journals (Sweden)

    L Flood

    2010-09-01

    Full Text Available The finding of the vermiform appendix in an inguinal hernia has an incidence of approximately 1%. The condition is given the eponymous name Amyand’s hernia. However in just 0.08% the condition is complicated by an acute appendicitis. The clinical presentation varies, depending on the extent of inflammation of the appendix and is most often misdiagnosed as an incarcerated inguinal hernia. As such it is rarely recognised prior to surgical exploration. We report a case of Amyand’s hernia in an 85 year old woman, which presented as a right groin enterocutaneous fistula. CT scanning illustrated a fistulous tract in the right groin, which communicated with the caecum and the peritoneal cavity. She underwent laparotomy, which revealed that the appendix appeared inflamed, lay in the inguinal canal and was the origin of the enterocutaneous communication.

  17. Femoral hernia, a rare complication following deep inguinal lymph node dissection

    DEFF Research Database (Denmark)

    Muus Steffensen, Signe; Ahm Sørensen, Jens

    2015-01-01

    A 72-year-old woman underwent complete deep inguinal lymph node dissection on her right side subsequent to metastasis from malignant melanoma. On the second postoperative day, the patient reported of nausea and vomiting. She presented with a mass in the resected area that gradually increased in s...

  18. A 5‑year Review of Darning Technique of Inguinal Hernia Repair

    African Journals Online (AJOL)

    associated with them.[2] Darning technique first introduced by Abrahamson and popularized by Moloney is considered to be a relatively tension free through tissue based method of repair. It entails approximation of the inguinal ligament to the conjoint tendon with monofilament nylon beginning from the pubic tubercle to the ...

  19. The feasibility and safety of single-incision totally extraperitoneal inguinal hernia repair after previous lower abdominal surgery: 350 procedures at a single center.

    Science.gov (United States)

    Wakasugi, Masaki; Suzuki, Yozo; Tei, Mitsuyoshi; Anno, Kana; Mikami, Tsubasa; Tsukada, Ryo; Koh, Masahiro; Furukawa, Kenta; Masuzawa, Toru; Kishi, Kentaro; Tanemura, Masahiro; Akamatsu, Hiroki

    2017-03-01

    To evaluate the feasibility and safety of single-incision laparoscopic surgery for totally extraperitoneal inguinal hernia repair (SILS-TEP) with previous lower abdominal surgery (PLAS). A retrospective analysis of 350 patients undergoing SILS-TEP for a primary inguinal hernia from January 2012 to December 2015 at Osaka Police Hospital was performed, and the outcomes of the patients with and without PLAS were compared. SILS-TEP was performed in 84 patients with PLAS and 266 patients without PLAS. Appendectomy was the most common previous operative procedure. There were more patients with an ASA score of ≥3 in the PLAS group than in the control group (p < 0.05). The mean operative time, and the rates of conversion and postoperative complications were comparable between the two groups. There were no cases of recurrence in either group. SILS-TEP could be safely performed in patients with PLAS and achieved better cosmetic outcomes than conventional laparoscopic surgery.

  20. Single-site laparoscopic percutaneous extraperitoneal closure of the internal ring using an epidural and spinal needle: excellent results in 1464 children with inguinal hernia/hydrocele.

    Science.gov (United States)

    Wang, Furan; Zhong, Hongji; Chen, Yi; Zhao, Junfeng; Li, Yan; Chen, Junxian; Dong, Sheng

    2017-07-01

    Laparoscopic percutaneous extraperitoneal closure (LPEC) of the internal ring is a well-developed procedure for pediatric inguinal hernia and hydrocele. To reduce the skin incisions and improve the cosmesis, single-site LPEC (SLPEC) has been developed with numerous techniques and instruments. In this study, we described our modifications of SLPEC using an epidural and spinal needle in a large pediatric population. From February 2013 to February 2016, 1464 pediatric patients who underwent SLPEC in our hospital were retrospectively reviewed. A 5-mm laparoscope was introduced at the subumbilicus. An 18-gauge epidural needle with a silk suture loop was introduced into the corresponding skin of the internal ring. The needle was advanced extraperitoneally on the medial side of the ring. The suture loop was pushed into peritoneal cavity by the spinal needle. The epidural needle was withdrawn to the roof of the internal ring and then kept advancing along the lateral side. Aided by the spinal needle and laparoscope, a long suture loop was sent into the first loop in peritoneal cavity. The long suture loop was pulled out of the abdominal wall by picking up the first loop, and the internal ring was closed by knotting the suture extracorporeally. The contralateral patent processus vaginalis (CPPV) was simultaneously repaired if present. In total, 981 patients presented with inguinal hernia and 483 with hydrocele. A CPPV was present in 483 patients with unilateral pathology and thus simultaneously repaired. The hydrodissection technique and grasping forceps were used in 290 and 113 patients, respectively. The median operation time was 11 min (7-18 min) and 18 min (10-30 min) for unilateral and bilateral inguinal hernias/hydroceles, respectively. There was no development of intra- or postoperative complications. SLPEC using an epidural and spinal needle can be performed with excellent results in pediatric inguinal hernias and hydroceles.

  1. Systematic training model for teaching, development and training of instructors in inguinal hernia treatment using the Lichtenstein technique. Hernia campaign 2014 & 2015.

    Science.gov (United States)

    Lazzarini-Mendes, Carlos José; Pacheco, Adhemar Monteiro; Destro, Bárbara Bozzoli; Tamaro, Caroline; Nogueira, Fábio Antonio Del Picchia DE Araújo; Chen, David; Reinpold, Wolfgang; Bruscagin, Vitor; Roll, Sergio; Silva, Rodrigo Altenfelder

    2016-01-01

    to evaluate the method of training and continuing education of 18 surgeons in 2014, and 28 surgeons in 2015, in the Holy Homes of Ribeirao Preto, Araraquara, Franca and San Carlos of São Paulo, in the performance of Lichtenstein inguinal herniorrhaphy, tutored by the Faculty of Medical Sciences of the São Paulo Holy Home and the organization HERNIA HELP - "Hernia Repair for the Underserved". the training was tutored and systematized through an active methodology of teaching and learning, aiming to offer competence, skills and attitudes, measured by a previously validated Qualification Form, qualifying leaders in trainees' improvement. in 2014 the outcomes were: the difficulty of the case, direction, incision, dissection, mesh preparation, mesh cutting, mesh setting, closing, instruments, respect to tissues, flow, time and motion, and performance, all presented change in the general rating (p=0.000002); there was greater confidence in the execution of the procedure in 80% of trainees, considered "very valuable" in 93.3% of the interventions. In 2015, 28 surgeons were trained by ten surgeons previously qualified in 2014. The nerve identification rate, a relevant time the Lichtenstein technique, was 95.5% for the Iliohypogastric, 98.5% for the ilioinguinal and 89.4% for the genital branch of the genitofemoral nerve. the applied teaching method is possible, reproducible, reliable and valid. The joint efforts offer enormous opportunity of directed education, reaching underserved populations, revealing the great teacher-student social responsibility. avaliar resultados do método de treinamento e educação continuada de 18 cirurgiões, em 2014, e 28 cirurgiões, em 2015, nas Santas Casas de Ribeirão Preto, Araraquara, Franca e São Carlos do Estado de São Paulo, na realização da Herniorrafia Inguinal à Lichtenstein, tutorados pela Faculdade de Ciências Médicas da Santa Casa de São Paulo e pela organização HERNIA HELP - "Hernia Repair for the Underserved

  2. Open and laparo-endoscopic repair of incarcerated abdominal wall hernias by the use of biological and biosynthetic meshes

    Directory of Open Access Journals (Sweden)

    René H Fortelny

    2016-02-01

    Full Text Available Introduction: Although recently published guidelines recommend against the use of synthetic non-absorbable materials in cases of potentially contaminated or contaminated surgical fields due to the increased risk of infection [1, 2], the use of bio-prosthetic meshes for abdominal wall or ventral hernia repair is still controversially discussed in such cases. Bio-prosthetic meshes have been recommended due to less susceptibility for infection and the decreased risk of subsequent mesh explantation. The purpose of this review is to elucidate if there are any indications for the use of biological and biosynthetic meshes in incarcerated abdominal wall hernias based on the recently published literature.Methods: A literature search of the Medline database using the PubMed search engine, using the keywords returned 486 articles up to June 2015. The full text of 486 articles was assessed and 13 relevant papers were identified including 5 retrospective case cohort studies, 2 case controlled studies, 6 case series.Results: The results of Franklin et al [23, 24, 25] included the highest number of biological mesh repairs (Surgisis® by laparoscopic IPOM in infected fields which demonstrated a very low incidence of infection and recurrence (0,7% and 5,2%. Han et al [26] reported in his retrospective study the highest number of treated patients due to incarcerated hernias by open approach using acellular dermal matrix (ADM® with very low rate of infection as well as recurrences (1,6% and 15,9. Both studies achieved acceptable outcome in a follow up of at least 3,5 years compared to the use of synthetic mesh in this high-risk population [3]Conclusion:Currently there is a very limited evidence for the use of biological and biosynthetic meshes in strangulated hernias in either open or laparo-endoscopic repair. Finally, there is an urgent need to start with randomized controlled comparative trials as well as to support registries with data to achieve more

  3. Efficacy of tramadol as a preincisional infiltration anesthetic in children undergoing inguinal hernia repair: a prospective randomized study

    Directory of Open Access Journals (Sweden)

    Numanoğlu KV

    2014-09-01

    Full Text Available Kemal Varim Numanoğlu,1 Hilal Ayoğlu,2 Duygu Tatli,1 Ebubekir Er11Department of Pediatric Surgery, 2Department of Anesthesiology, Faculty of Medicine, Bülent Ecevit University, Kozlu, Zonguldak, TurkeyBackground: Preincisional local anesthetic infiltration at the surgical site is a therapeutic option for postoperative pain relief for pediatric inguinal hernia. Additionally, tramadol has been used as an analgesic for postoperative pain in children. Recently, the local anesthetic effects of tramadol have been reported. The aim of this study was to determine both the systemic analgesic and the local anesthetic effects of tramadol and to determine how it differs from bupivacaine when administered preincisionally.Methods: Fifty-two healthy children, aged 2–7 years, who were scheduled for elective herniorrhaphy were randomly allocated to receive either preincisional infiltration at the surgical site with 2 mg/kg tramadol (Group T, n=26 or 0.25 mL/kg 0.5% bupivacaine (Group B, n=26. At the time of anesthetic administration, perioperative hemodynamic parameters were recorded. The pain assessments were performed 10 minutes after the end of anesthesia and during the first 6-hour period, using pain scores. The time of first dose of analgesia and need for additional analgesia were recorded.Results: Between T and B groups, the anesthesia time, perioperative hemodynamic changes, and pain scores were not statistically different. However, in group B, the postoperative analgesic requirement was higher than in group T.Conclusion: Tramadol shows equal analgesic effect to bupivacaine and decreases additional analgesic requirement, when used for preincisional infiltration anesthesia in children undergoing inguinal herniorrhaphy.Keywords: bupivacaine, postoperative analgesia, pain scores

  4. Ultrasound-guided transversalis fascia plane block versus anterior transversus abdominis plane block in outpatient inguinal hernia repair.

    Science.gov (United States)

    López-González, J M; López-Álvarez, S; Jiménez Gómez, B M; Areán González, I; Illodo Miramontes, G; Padín Barreiro, L

    2016-11-01

    The aim of the study was to assess the effectiveness of ultrasound-guided transversalis fascia plane block (TFP) compared to anterior transversus abdominis plane block (TAP-A) for post-operative analgesia in outpatient unilateral inguinal hernia repair. Retrospective observational study conducted on ASA I-II patients. Two groups (TAP-A and TFP), which were given 30ml of 0.25% levobupivacaine prior to surgical incision. The primary endpoint was the post-operative pain evaluated by verbal numerical scale (VRN at rest and movement) at 10, 30, 60, 90min, coinciding with ambulation, and 24hours by telephone. An evaluation was also made of the sensory block level reached prior to surgery, the need for additional analgesia, side effects, ease of performing the technique, and the level of satisfaction of patients with the anaesthetic-analgesic technique. A total of 61 patients were included, 30 patients in the TAP-A group and 31 in the TFP group. The analgesic efficacy obtained in both groups was similar, although some higher values were found in the VNR on moving in the TAP-A group, reaching statistical difference at 10minutes (P=.014) and 30minutes (P=.013) post-operatively. A higher level of sensory block was achieved in the TFP group than in the TAP-A group (P<.01). There were no significant differences in additional analgesia requirements, and the cumulative dose of morphine was similar in both groups in the post-operative period. There were no differences in side effects or complications. The technical ease of the block was similar in both groups and the level of satisfaction of patients very high. Both blocks with a multimodal approach achieve good post-operative analgesia of inguinal hernia repair, are easy to perform and have few complications. TFP achieves the highest sensory level, but there are no differences in the requirements for additional analgesia. Copyright © 2016 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado

  5. The efficacy of laparoscopic intracorporeal linear suture technique as a strategy for reducing recurrences in pediatric inguinal hernia.

    Science.gov (United States)

    Lee, S R; Choi, S B

    2017-06-01

    Pediatric laparoscopic herniorrhaphy has rare complications, but recurrence might occur. The purpose of this manuscript is to evaluate the efficacy of linear suture technique of laparoscopic pediatric herniorrhaphy in reducing recurrences. Laparoscopic surgery was performed on 2223 pediatric patients (under 10 years old) from September 2012 to December 2014 in Damsoyu Hospital, Seoul, Republic of Korea. The causes of recurrence were investigated case by case. The patients were categorized into two groups according to the suture method used in closing the hernia orifice: Group 1 (purse-string suture, 1009 patients) and Group 2 (linear suture, 1214 patients). There were 1413 (63.6%) male and 810 (36.4%) female patients. Mean age was 30.5 ± 29.2 months. A significantly higher proportion of male patients, contralateral patent processus vaginalis, and less proportion of recurrence were observed in Group 2. There were ten cases of recurrence in Group 1 because the internal ring suture could not endure the tension. One recurrence occurred in Group 2. The suture technique and age were found to be a significant risk factor for recurrence. Linear suture technique had a lower recurrence rate (odds ratio = 0.07, with 95% confidence interval 0.01-0.53, and p = 0.004). Purse-string suture technique causes significantly higher occurrence of hernia recurrences than linear suture technique. Linear suture technique can reduce recurrence by increasing the endurance to tension around the internal ring by distributing pressure to a wider area along the linear suture line. Linear suture technique can effectively reduce recurrence in pediatric inguinal herniorrhaphy.

  6. RIVES AND LICHTENSTEIN REPAIR IN INGUINAL HERNIA- A COMPARISON OF POSTOPERATIVE COMPLICATIONS TO KNOW WHETHER RIVES REPAIR IS AS SAFE AS THE GOLD STANDARD LICHTENSTEIN REPAIR

    Directory of Open Access Journals (Sweden)

    John S. Kurien

    2018-02-01

    Full Text Available BACKGROUND Hernia repair surgeries underwent a lot of modifications over time. These modifications were an attempt to reduce the recurrence rate and post-operative complications. Current techniques for Inguinal hernia show similar recurrence rate. Therefore, recurrence is no longer the main issue discussed when considering improving the current standards for groin hernia repair. Post-surgical chronic pain presents a major, largely unrecognized clinical problem. Consequently, there is a need to not only decrease an extensive dissection in the inguinal canal but also to minimize the interaction between the mesh and major surrounding structures. As a result, placing a mesh in the preperitoneal space is a viable option. Likewise, studies have shown that return to normal activity and return to work is comparatively quicker in Rives. In this study I am comparing the post op period complications in Rives and Lichtenstein hernia surgeries to know whether Rives is superior to Lichtenstein’s repair. MATERIALS AND METHODS After obtaining approval for the study from Institutional Review Board, written informed consent from 100 male patients planning to undergo elective hernia repair surgery at the General Surgery wards in Government Medical College, Kottayam & who were willing to participate in the study were obtained and randomly allocated into two groups, 50 undergoing Rives hernia repair & 50 Lichtenstein hernia repair. The patients were evaluated and followed up according to the protocol. In early postop period, patients were assessed for pain using a numeric rating scale. Complications like haematoma, seroma, wound infection and early recurrence were compared. Chronic inguinal pain/Inguinodynia is a significant, though under reported problem. Moderate to severe pain persisting more than 3 months should be considered pathological. Inguinodynia, if present was assessed using a numerical scale. Another parameter that was assessed was testicular atrophy

  7. Mesh fixation methods in open inguinal hernia repair: a protocol for network meta-analysis and trial sequential analysis of randomised controlled trials.

    Science.gov (United States)

    Ge, Long; Tian, Jin-hui; Li, Lun; Wang, Quan; Yang, Ke-hu

    2015-11-19

    Randomised clinical trials (RCTs) have been used to compare and evaluate different types of mesh fixation usually employed to repair open inguinal hernia. However, there is no consensus among surgeons on the best type of mesh fixation method to obtain optimal results. The choice often depends on surgeons' personal preference. This study aims to compare different types of mesh fixation methods to repair open inguinal hernias and their role in the incidences of chronic groin pain, risk of hernia recurrence, complications, operative time, length of hospital stay and postoperative pain, using Bayesian network meta-analysis and trial sequential analysis of RCTs. A systematic search will be performed using PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM) and Chinese Journal Full-text Database, to include RCTs of different mesh fixation methods (or fixation vs no fixation) during open inguinal hernia repair. The risk of bias in included RCTs will be evaluated according to the Cochrane Handbook V.5.1.0. Standard pairwise meta-analysis, trial sequential analysis and Bayesian network meta-analysis will be performed to compare the efficacy of different mesh fixation methods. Ethical approval and patient consent are not required since this study is a meta-analysis based on published studies. The results of this network meta-analysis and trial sequential analysis will be submitted to a peer-reviewed journal for publication. PROSPERO CRD42015023758. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  8. Use of antibiotic prophylaxis in elective inguinal hernia repair in adults in London and south-east England: a cross-sectional survey.

    Science.gov (United States)

    Aiken, A M; Haddow, J B; Symons, N R A; Kaptanis, S; Katz-Summercorn, A C; Debnath, D; Dent, H; Tayeh, S; Kung, V; Clark, S; Gahir, J; Dindyal, S; Farag, S; Lazaridis, A; Bretherton, C P; Williams, S; Currie, A; West, H; Davies, J; Arora, S; Kheraj, A; Stubbs, B M; Yassin, N; Mallappa, S; Garrett, G; Hislop, S; Bhangu, A; Abbey, Y; Al-Shoek, I; Ahmad, U; Sharp, G; Memarzadeh, A; Patel, A; Ali, F; Kaderbhai, H; Knowles, C H

    2013-10-01

    Evidence regarding whether or not antibiotic prophylaxis is beneficial in preventing post-operative surgical site infection in adult inguinal hernia repair is conflicting. A recent Cochrane review based on 17 randomised trials did not reach a conclusion on this subject. This study aimed to describe the current practice and determine whether clinical equipoise is prevalent. Surgeons in training were recruited to administer the Survey of Hernia Antibiotic Prophylaxis usE survey to consultant-level general surgeons in London and the south-east of England on their practices and beliefs regarding antibiotic prophylaxis in adult elective inguinal hernia repair. Local prophylaxis guidelines for the participating hospital sites were also determined. The study was conducted at 34 different sites and received completed surveys from 229 out of a possible 245 surgeons, a 93 % response rate. Overall, a large majority of hospital guidelines (22/28) and surgeons' personal beliefs (192/229, 84 %) supported the use of single-dose pre-operative intravenous antibiotic prophylaxis in inguinal hernia repair, although there was considerable variation in the regimens in use. The most widely used regimen was intravenous co-amoxiclav (1.2 g). Less than half of surgeons were adherent to their own hospital antibiotic guidelines for this procedure, although many incorrectly believed that they were following these. In the south-east of England, there is a strong majority of surgical opinion in favour of the use of antibiotic prophylaxis in this procedure. It is therefore likely to be extremely difficult to conduct further randomised studies in the UK to support or refute the effectiveness of prophylaxis in this commonly performed procedure.

  9. Effect of cooled hyperbaric bupivacaine on unilateral spinal anesthesia success rate and hemodynamic complications in inguinal hernia surgery.

    Science.gov (United States)

    Tomak, Yakup; Erdivanli, Basar; Sen, Ahmet; Bostan, Habib; Budak, Ersel Tan; Pergel, Ahmet

    2016-02-01

    We hypothesized that cooling hyperbaric bupivacaine from 23 to 5 °C may limit the intrathecal spread of bupivacaine and therefore increase the success rate of unilateral spinal anesthesia and decrease the rate of hemodynamic complications. A hundred patients scheduled for elective unilateral inguinal hernia surgery were randomly allocated to receive 1.8 ml of 0.5 % hyperbaric bupivacaine intrathecally at either 5 °C (group I, n = 50) or at 23 °C (group II, n = 50). Following spinal block at the L2-3 interspace, the lateral decubitus position was maintained for 15 min. Unilateral spinal anesthesia was assessed and confirmed at 15 and 30 min. The levels of sensory and motor block on the operative side were evaluated until complete resolution. The rate of unilateral spinal anesthesia at 15 and 30 min was significantly higher in group I (p = 0.015 and 0.028, respectively). Hypotensive events and bradycardia were significantly rarer in group I (p = 0.014 and 0.037, respectively). The density and viscosity of the solution at 5 °C was significantly higher than at 23 °C (p bupivacaine to 5 °C increased the density and viscosity of the solution and the success rate of unilateral spinal anesthesia, and decreased the hemodynamic complication rate.

  10. A pin in appendix within Amyand's hernia in a six-years-old boy: case report and review of literature

    Directory of Open Access Journals (Sweden)

    Jashari Hysni J

    2010-05-01

    Full Text Available Abstract Introduction Presence of vermiform appendix (non-inflamed or inflamed in inguinal hernia is called Amyand's hernia in honor to surgeon C. Amyand who published the first case of perforated appendicitis within inguinal hernia in a boy caused by ingested pin. This presentation of foreign body Amyand's hernia appendicitis is very rare, and here we present such a case. Case presentation A 6-year-old boy, white Kosovar ethnicity, presented with right groin pain, swelling and redness. Two days before admission the patient was injured by football during a children game in the right lower abdomen and the next day he complained of pain in the right inguinal area. On admission patient had a painful non-reducible mass in the right inguinal region and cellulitis. Plain abdominal x-ray showed no fluid-air levels, but a metallic foreign body (pin under right superior pubic ramus was apparent. With preoperative diagnosis of suspect incarcerated inguinal hernia with cellulitis the patient was operated on under general anaesthesia in December 2, 2006. Intraoperatively we found the inflamed vermiform appendix perforated by a pin in the hernial sac. Appendectomy and herniotomy were performed. The wound was primary closed, without any post-operative complications and follow up for the patient is three years long. Conclusion Foreign body (pin Amyand's hernia appendicitis seems to be extremely rare, maybe once in a century (Amyand 1735, Hall 1886, and our case in 2006. In patients with clinical signs of incarcerated inguinal hernia, with locally inflammatory signs, but without signs of intestinal obstruction Amyand's hernia appendicitis in differential diagnosis must be considered. In our case, it is possible that the injury during the football game might have induced perforation of the vermiform appendix with the foreign body in it.

  11. A pin in appendix within Amyand's hernia in a six-years-old boy: case report and review of literature

    Science.gov (United States)

    2010-01-01

    Introduction Presence of vermiform appendix (non-inflamed or inflamed) in inguinal hernia is called Amyand's hernia in honor to surgeon C. Amyand who published the first case of perforated appendicitis within inguinal hernia in a boy caused by ingested pin. This presentation of foreign body Amyand's hernia appendicitis is very rare, and here we present such a case. Case presentation A 6-year-old boy, white Kosovar ethnicity, presented with right groin pain, swelling and redness. Two days before admission the patient was injured by football during a children game in the right lower abdomen and the next day he complained of pain in the right inguinal area. On admission patient had a painful non-reducible mass in the right inguinal region and cellulitis. Plain abdominal x-ray showed no fluid-air levels, but a metallic foreign body (pin) under right superior pubic ramus was apparent. With preoperative diagnosis of suspect incarcerated inguinal hernia with cellulitis the patient was operated on under general anaesthesia in December 2, 2006. Intraoperatively we found the inflamed vermiform appendix perforated by a pin in the hernial sac. Appendectomy and herniotomy were performed. The wound was primary closed, without any post-operative complications and follow up for the patient is three years long. Conclusion Foreign body (pin) Amyand's hernia appendicitis seems to be extremely rare, maybe once in a century (Amyand 1735, Hall 1886, and our case in 2006). In patients with clinical signs of incarcerated inguinal hernia, with locally inflammatory signs, but without signs of intestinal obstruction Amyand's hernia appendicitis in differential diagnosis must be considered. In our case, it is possible that the injury during the football game might have induced perforation of the vermiform appendix with the foreign body in it. PMID:20482877

  12. [Treatment of neuralgia after surgical repair of inguinal hernia. Apropos of 47 cases].

    Science.gov (United States)

    Gatt, M T; Chevrel, J P

    1991-01-01

    A semiologic study is performed and therapeutic proposals are made on the basis of the anatomical and physiopathological data relating to residual neuralgia after the cure of a hernia. A series of 47 patients, 41 of whom were treated at the Multidisciplinary Pain Treatment Center of Avicenne Hospital (Bobigny) is analysed. The results are the following: 16 cures, 22 improvements, 6 failures, 3 patients lost to follow-up. The authors emphasize the difficulties of treatment, the poor effectiveness of second surgery as a rule, and the necessity of a general management.

  13. A case of combined laparoscopic reduction and open preperitoneal mesh repair for incarcerated small bowel in a retroperitoneal hernia between the external and internal iliac vessels.

    Science.gov (United States)

    Morisue, R; Inaba, M; Shoji, R; Kawamoto, H

    2017-08-01

    We report a rare case of an incarcerated retroperitoneal hernia with or involving the small bowel through the orifice between the right external and internal iliac vessels. A 39-year-old woman was admitted to our hospital because of vomiting and abdominal pain. She had a history of right oophorocystectomy and appendectomy. Abdominal computed tomography revealed small bowel obstruction resulting from an incarcerated retroperitoneal hernia. The small bowel herniated into the retroperitoneal fossa through the orifice between the right external and internal iliac vessels. Laparoscopic reduction of the small bowel was performed, followed by ligation of the sac and placement of a mesh prosthesis through the preperitoneal approach, using a lower midline incision along the previous laparotomy scar. Her postoperative course was uneventful and no recurrence has been observed after surgery.

  14. Randomized Clinical Trial Comparing Low DensityversusHigh Density Meshes in Patients with Bilateral Inguinal Hernia.

    Science.gov (United States)

    Carro, Jose Luis Porrero; Riu, Sol Villar; Lojo, Beatriz Ramos; Latorre, Lucia; Garcia, Maria Teresa Alonso; Pardo, Benito Alcaide; Naranjo, Oscar Bonachia; Herrero, Alberto Marcos; Cabezudo, Carlos Sanchez; Herreras, Esther Quiros

    2017-12-01

    We present a randomized clinical trial to compare postoperative pain, complications, feeling of a foreign body, and recurrence between heavyweight and lightweight meshes in patients with bilateral groin hernia. Sixty-seven patients with bilateral hernia were included in our study. In each patient, the side of the lightweight mesh was decided by random numbers table. Pain score was measured by visual analogue scale, on 1st, 3rd, 5th, and 7th postoperative day, and one year after the surgery. There were no statistically significative differences between both meshes in postoperative complications. About differences of pain average, there were statistically significant differences only on the 1st postoperative day (P <0.01) and the 7th postoperative day (P <0.05). In the review after a year, there were no statistically significative differences in any parameter. In our study, we did not find statistically significative differences between lightweight and heavyweight meshes in postoperative pain, complications, feeling of a foreign body, and recurrence, except pain on 1st and 7th postoperative day.

  15. Chronic pain after mesh versus nonmesh repair of inguinal hernias: A systematic review and a network meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Öberg, Stina; Andresen, Kristoffer; Klausen, Tobias W; Rosenberg, Jacob

    2018-03-13

    Chronic pain affects 10%-12% of patients after inguinal hernia repairs. Some have suggested that less foreign material may theoretically prevent pain. If the prevalence of chronic pain is less after nonmesh repairs, selected hernias might be repaired without mesh. Our aim was to clarify if nonmesh repairs are superior to mesh repairs regarding chronic pain. For this systematic review, searches were conducted in five databases. The main outcome was chronic pain reported a minimum of six months after mesh and nonmesh repair in adult patients with a primary inguinal hernia. Only randomized controlled trials (RCTs) were included. A total of 23 RCTs with 5,444 patients were included. The median follow up was 1.4 years (range 0.5-10). Twenty-one studies reported crude chronic pain rates, and when considering moderate and severe pain, the prevalences of pain after nonmesh repairs and mesh repairs were similar: median 3.5% (0%-16.2%) versus median 2.9% (0%-27.6%), respectively. Both the meta-analyses and the network meta-analysis indicated no difference in chronic pain rates when comparing nonmesh repairs with open- and laparoscopic mesh repairs. Mesh may be used without fear of causing a greater rate of chronic pain. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Neuroendocrine tumor of the appendix inside an incarcerated Amyand’s hernia

    Directory of Open Access Journals (Sweden)

    Khaled Y. Elbanna

    2015-01-01

    An incidental finding of neuroendocrine tumor of the appendix in a patient with s hernia is extremely rare. A high index of suspicion is the key to diagnose such a coincidence in order to safely and optimally treat such a condition.

  17. Sir Ganga Ram Hospital classification of groin and ventral abdominal wall hernias

    Directory of Open Access Journals (Sweden)

    Chowbey Pradeep

    2006-01-01

    Full Text Available Background: Numerous classifications for groin and ventral hernias have been proposed over the past five to six decades. The old, simple classification of groin hernia in to direct, inguinal and femoral components is no longer adequate to understand the complex pathophysiology and management of these hernias. The most commonly followed classification for ventral hernias divide them into congenital, acquired, incisional and traumatic, which also does not convey any information regarding the predicted level of difficulty. Aim: All the previous classification systems were based on open hernia repairs and have their own fallacies particularly for uncommon hernias that cannot be classified in these systems. With the advent of laparoscopic/ endoscopic approach, surgical access to the hernia as well as the functional anatomy viewed by the surgeon changed. This change in the surgical approach and functional anatomy opened the doors for newer classifications. The authors have thus proposed a classification system based on the expected level of intraoperative difficulty for endoscopic hernia repair. Classification: In the proposed classification higher grades signify increasing levels of expected intraoperative difficulty. This functional classification grades groin hernias according to the: a Pre -operative predictive level of difficulty of endoscopic surgery, and b Intraoperative factors that lead to a difficult repair. Pre operative factors include multiple or pantaloon hernias, recurrent hernias, irreducible and incarcerated hernias. Intraoperative factors include reducibility at operation, degree of descent of the hernial sac and previous hernia repairs. Hernial defects greater than 7 cm in diameter are categorized one grade higher. Conclusion: Though there have been several classification systems for groin or inguinal hernias, none have been described for total classification of all ventral hernias of the abdomen. The system proposed by us includes

  18. A comparison of preoperative and postoperative testicular volume and blood flow in patients with inguinal hernia, hydrocele, and cord cyst: A prospective cohort study.

    Science.gov (United States)

    Tuncer, Ahmet Ali; Peker, Tamer; Acar, Mehtap Berke; Embleton, Didem Baskin; Cetinkursun, Salih

    2017-01-01

    To evaluate the effect of inguinal operations performed with a modified Ferguson technique upon testicular volume and blood flow. This study involved 23 children receiving surgery for inguinal hernia, hydrocele, and cord cyst. This was a prospective study performed between April 2016 and June 2016 in a medical faculty pediatric surgery unit. The color Doppler ultrasound (CDUS) was used to assess testicular volume and blood flow before and after a modified Ferguson technique surgery. The pre- and post operative testicular volume and blood flow were compared with the contralateral testes. SPSS software was used to statistically analyze the data arising; the Mann-Whitney U test and Friedman test were used to compare samples, and P<0.05 was accepted as statistically significant. Preoperative and postoperative testicular volumes were not statistically different when compared to contralateral testes. In patients with right sided inguinal pathology, testicular blood flow on the right side was significantly lower than that on the left side (P=0.023). The testicular blood flow was not statistically different compared with the contralateral testes during the first week evaluation and first month evaluation. The blood flow, probably reduced due to the pressure caused by inguinal pathology, was normalized through surgery. The modified Ferguson technique do not change the testes volume and blood flow.

  19. The analgesic effect of Magnesium Sulfate in postoperative pain of inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Mehraein A

    2007-08-01

    Full Text Available Background: Magnesium Sulfate (MgSO4 has been used as a pharmacologic agent in different situations for many years in the treatment of tachyarrhythmias, myocardial ischemia, preeclampsia, and tocolysis among others. The analgesic effect of MgSO4 for postoperative pain has been used since the 1990s. Postoperative pain is one of the most common complications in the perioperative period and can result in serious consequences in different organs if left untreated. Inguinal herniorrhaphy is among the most common surgeries and is almost always accompanied by severe pain. The object of this study is to determine the effect of a pre-induction infusion of MgSO4 on the reduction of postsurgical pain after herniorrhaphy. Methods: This double-blind, randomized clinical trial included 105 ASA class I and class II herniorrhaphy patients at Shariati Hospital in years 2004 and 2005. For statistical analysis, the 2 and T tests were used. The patients were divided into three groups based on block randomization. Patients in the following groups received: Group A, 200 ml of normal saline infusion (placebo; Group B, 25 mg/kg MgSO4 in 200 ml of normal saline; Group C, 50 mg/kg MgSO4 in 200 ml of normal saline. All groups were infused twenty minutes before induction of anesthesia using identical methods and dosage in all three groups. Heart rate and mean arterial pressure (MAP at pre- and postintubation and so at skin incision time were charted. Visual analog scale (VAS pain score, nausea, vomiting and the amount of morphine used before recovery room discharge and in six, twelve and twenty-four hours after recovery discharge was recorded. Results: The average age for the different groups was as follows: Group A: 33.6, Group B: 37.37, Group C: 32.74. Nausea and vomiting between the case and control groups were not statistically different (60% vs. 71.4%, p=0.0499, nor was the amount of Morphine used. On recovery room discharge, the VAS scores were 8.1, 7.2, and 5

  20. Ultrasound-guided transversus abdominis plane block in patients undergoing open inguinal hernia repair: 0.125% bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine.

    Science.gov (United States)

    Erdoğan Arı, Dilek; Yıldırım Ar, Arzu; Karadoğan, Firdevs; Özcabı, Yetkin; Koçoğlu, Ayşegül; Kılıç, Fatih; Akgün, Fatma Nur

    2016-02-01

    To evaluate the effectiveness of 0.125% bupivacaine compared to 0.25% bupivacaine for ultrasound-guided transversus abdominis plane (TAP) block in patients undergoing open inguinal hernia repair. Randomized, double-blind study. Educational and research hospital. Forty adult patients of American Society of Anesthesiologists physical status I-III undergoing elective primary unilateral open inguinal hernia repair under spinal anesthesia. Patients in group I received 20 mL of 0.25% bupivacaine, whereas patients in group II received 20 mL of 0.125% bupivacaine for TAP block at the end of the surgery. Pain intensity was assessed at rest and during coughing using 10-cm visual analog scale score at 5, 15, 30, and 45 minutes and 1, 2, 4, 6, 12, and 24 hours after TAP block. Morphine consumption and time to first morphine requirement were recorded. Visual analog scale scores at rest and during coughing were not significantly different between groups at all time points measured. Twenty-four hours of morphine consumption (7.72±7.33 mg in group I and 6.06±5.20 mg in group II; P=.437) and time to first morphine requirement (182.35±125.16 minutes in group I and 143.21±87.28 minutes in group II; P=.332) were not different between groups. 0.125% Bupivacaine provides similar analgesic effect compared to 0.25% bupivacaine for ultrasound-guided TAP block in patients undergoing open inguinal hernia repair. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Biologic response of inguinal hernia prosthetics: a comparative study of conventional static meshes versus 3D dynamic implants.

    Science.gov (United States)

    Amato, Giuseppe; Romano, Giorgio; Agrusa, Antonino; Marasa, Salvatore; Cocorullo, Gianfranco; Gulotta, Gaspare; Goetze, Thorsten; Puleio, Roberto

    2015-01-01

    Despite improvements in prosthetics and surgical techniques, the rate of complications following inguinal hernia repair remains high. Among these, discomfort and chronic pain have become a source of increasing concern among surgeons. Poor quality of tissue ingrowth, such as thin scar plates or shrinking scars-typical results with conventional static implants and plugs-may contribute to these adverse events. Recently, a new type of 3D dynamically responsive implant was introduced to the market. This device, designed to be placed fixation-free, seems to induce ingrowth of viable and structured tissue instead of regressive fibrotic scarring. To elucidate the differences in biologic response between the conventional static meshes and this 3D dynamically responsive implant, a histological comparison was planned. The aim of this study was to determine the quality of tissue incorporation in both types of implants excised after short, medium, and long periods post-implantation. The results showed large differences in the biologic responses between the two implant types. Histologically, the 3D dynamic implant showed development of tissue elements more similar to natural abdominal wall structures, such as the ingrowth of loose and well-hydrated connective tissue, well-formed vascular structures, elastic fibers, and mature nerves, with negligible or absent inflammatory response. All these characteristics were completely absent in the conventional static implants, where a persistent inflammatory reaction was associated with thin, hardened, and shrunken fibrotic scar formation. Consequently, as herniation is a degenerative process, the 3D dynamic implants, which induce regeneration of the typical groin components, seem to address its pathogenesis. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  2. How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair

    DEFF Research Database (Denmark)

    Öberg, Stina; Andresen, Kristoffer; Rosenberg, Jacob

    2016-01-01

    A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh...... for slender patients. The aim of this study was to illustrate an easy procedure that alleviates/removes the pain. A male patient had persistent pain six months after the Onstep operation and therefore had a ring removal operation. The procedure is presented as a video and a protocol. At the eleven......-month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated...

  3. How to Surgically Remove the Permanent Mesh Ring after the Onstep Procedure for Alleviation of Chronic Pain following Inguinal Hernia Repair

    Directory of Open Access Journals (Sweden)

    Stina Öberg

    2016-01-01

    Full Text Available A promising open inguinal hernia operation called Onstep was developed in 2005. The technique is without sutures to the surrounding tissue, causing minimal tension. A specific mesh is used with a memory recoil ring in the border, which may cause pain superficial to the lateral part of the mesh for slender patients. The aim of this study was to illustrate an easy procedure that alleviates/removes the pain. A male patient had persistent pain six months after the Onstep operation and therefore had a ring removal operation. The procedure is presented as a video and a protocol. At the eleven-month follow-up, the patient was free of pain, without a recurrence. It is advised to wait some months after the initial hernia repair before removing the ring, since the mesh needs time to become well integrated into the surrounding tissue. The operation is safe and easy to perform, which is demonstrated in a video.

  4. Técnica de Moran, reparación protésica en la hernia inguinal con malla preperitoneal: Reporte preliminar

    Directory of Open Access Journals (Sweden)

    Jorge Rafael Roselló Fina

    2002-12-01

    Full Text Available Se presentan los 10 primeros pacientes que presentaron hernias inguinales, operados en el Hospital Universitario "Comandante Manuel Fajardo", con la técnica descrita por Robert Moran en 1992, la cual consiste en la colocación de una pieza lineal de malla de polipropileno en posición preperitoneal por vía transinguinal con la ulterior fijación de ésta y cierre de la pared posterior con los 2 primeros planos de la técnica de Shouldice. Se utilizó la clasificación de Gilbert modificada por Rutkow y Robbins, se operaron hernias tipo 3,4 y 6 de esta clasificación. En 6 casos se trató de hernias reproducidas y 7 fueron operados electivamente, con la utilización como métodos de anestesia en orden descendente de la regional, local y acupuntural. No se encontraron complicaciones, ni sepsis de la herida. No ocurrió recidiva herniaria en nuestra serie, con un seguimiento que osciló entre 6 y 9 mesesThe first 10 patients with inguinal hernias operated on at Comandante Manuel Fajardo Teaching Hospital by using the technique described by Robert Moran, in 1992, were presented. This technique consists in placing a lineal piece of polypropylene in preperitoneal position via transinguinal with its further fixation and the closure of the posterior wall with the first 2 planes of Shouldice’s technique. Gilbert’s classification modified by Rutkow and Robbins was used. Type 3, 4 and 6 hernias according to this classification were operated on. 6 cases were relapsed hernias and 7 underwent elective surgery. Regional and local anesthesia and acupuncture were used in descending order. No complications or wound sepsis were observed. There was no hernial relapse in our series, with a follow-up that ranges from 6 to 9 months

  5. Ultrasonographic diagnosis of ovary-containing hernias of the canal of Nuck

    International Nuclear Information System (INIS)

    Yang, Dal Mo; Kim, Hyun Cheol; Kim, Sang Won; Lim, Sung Jig; Park, Seung Jin; Lim, Joo Won

    2014-01-01

    The purpose of this study is to describe the ultrasonographic findings of ovary-containing hernias of the canal of Nuck. This was a retrospective analysis of 22 hernia cases of the canal of Nuck. The following gray scale and color Doppler ultrasonographic features were analyzed: the site and the size of the hernia, the texture of the hernia contents, and the presence or absence of blood flow in the hernia contents. All of the patients had swelling of the right inguinal region (n=10), left inguinal region (n=8), or both (n=2). On ultrasonography, the hernias appeared as either solid masses (n=17) or solid masses containing cysts (n=5). The mean anteroposterior diameter of the hernia sac of the canal of Nuck was 9.1 mm (range, 5 to 18 mm). The mean anteroposterior diameters of the hernia sac were 11.6 mm (range, 7.6 to 18 mm) for hernias containing an ovary, and 8.3 mm (range, 5 to 13 mm) for hernias containing omental fat. During surgery, among the 17 cases with solid-appearing hernia contents on ultrasonography, omental fat was identified in the hernia sac in four cases, but no structure was identified in 13 cases. All five cases that appeared as solid masses containing cysts on ultrasonography contained ovary tissue in the hernia sac. Among the four cases of ovary-containing hernias, color Doppler ultrasonography identified blood flow within the ovary in three cases, but no flow signal was seen in one case of incarcerated hernia. Ultrasonography may be helpful for the diagnosis of ovary-containing hernias of the canal of Nuck by detecting solid masses containing small cysts.

  6. Bladder hernia: Multidetector computed tomography findings

    Directory of Open Access Journals (Sweden)

    Ankur Gadodia

    2011-01-01

    Full Text Available Herniation of bladder in inguinal hernia is rare, with most cases diagnosed intraoperatively. Preoperative diagnosis is even rarer. We report a case of bladder as content of inguinal hernia diagnosed using multidetector computed tomography.

  7. Feasibility of a new approach for creating a preperitoneal space in transabdominal preperitoneal repair inguinal hernia repair: using a sandwich approach.

    Science.gov (United States)

    Nagahisa, Yoshio; Homma, Shusaku; Chen, Kai; Sakurai, Reo; Hattori, Nobuaki; Kawamoto, Yusuke; Hashida, Kazuki; Okabe, Michio; Itou, Tadashi

    2017-05-01

    In Japan, transabdominal preperitoneal (TAPP) inguinal hernia repair is performed by firmly pulling the peritoneum inwards to lift it from the underlying deep layer of subperitoneal fascia. It decreases the postoperative pain and discomfort in the inguinal area. The aim of this study was to evaluate the feasibility of the sandwich approach, which is a new technique for creating a preperitoneal space. The operation was performed via the sandwich approach. We made sure to protect the preperitoneal fascia areolar layer when making the preperitoneal space. We performed TAPP in 745 patients (876 hernias) treated between October 2006 and April 2015 at Himeji Medical Center and Kurashiki Central Hospital. Before October 2010, we did not use the sandwich approach, and recurrence was observed in three patients. From October 2010, we always used the sandwich approach and never experienced any cases of recurrence. Clavien-Dindo classification Grade 3 or higher postoperative complications occurred in 6 patients (0.8%) between October 2006 and April 2015. Mesh-related ileus was the most frequently observed morbidity. There were no cases of vas differentia or spermatic vessel injury, postoperative chronic pain, or urinary retention. The sandwich approach is feasible as another standard dissective procedure for TAPP.

  8. COMPARISON OF POSTOPERATIVE ANALGESIC EFFECT OF US-GUIDED TRANSVERSES ABDOMINIS PLANE BLOCK WITH PARAVERTEBRAL BLOCK FOR UNILATERAL INGUINAL HERNIA REPAIR IN ADULT PATIENTS UNDER GENERAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Girish Sharma

    2017-10-01

    Full Text Available BACKGROUND Both Transverse Abdominis Plane (TAP block and Paravertebral Block (PVB can be used to provide postoperative analgesia in inguinal hernia surgeries. Present study was done to evaluate the postoperative analgesic effect of USG-guided TAP block with USG-guided PVB for unilateral inguinal hernia repair under general anaesthesia. MATERIALS AND METHODS Sixty, American Society of Anesthesiologist (ASA grade 1 and 2 adult patients undergoing inguinal hernia repair under general anaesthesia were randomly allocated to TAP (Gp I and PVB (Gp II group of 30 each. In Gp I patients received local anaesthetic mixture of 0.5% bupivacaine (15 mL and 2% Xylocaine with adrenaline (15 mL in TAP plane under real time USG. In Gp II, the same anaesthetic mixture was injected 1 cm deep to superior surface of transverse process of T10,12 and L2 vertebra under ultrasound guidance. The postoperative pain using the Visual Analogue Scale (VAS, the number of analgesic doses and total drug requirement in the first 24 hours of postoperative period was noted. Statistical Analysis Used- SPSS version 14.0 (SPSS Inc., Chicago, IL, Chi-square test, Student’s t-test. P ˂0.05 was taken as statistically significant. RESULTS VAS scores were statistically significantly lower in Gp II as compared to Gp1 at 1, 2, 4 and 6 hours postoperative time interval (p value <0.05. The difference in VAS scores became insignificant at 12 and 24 hours of postoperative period. Mean time to first analgesic in postoperative period in Gp I was 5:06 hrs. (range 2-10 hrs. and in Gp II was 7.7 hrs. (range 5-10 hrs. (p value ˂0.001. Twenty two patients in Gp I and ten patients in Gp II required analgesic in postoperative period (p ˂0.001. Total number of diclofenac doses required in postoperative period was significantly lower in Gp II than in Gp I (10 v/s 25. Total dose of diclofenac consumed in first 24 hrs. was significantly lower in Gp II (750 mg than in Gp I (1875 mg (p value ˂0

  9. A systematic review and meta-analysis concerning single-site laparoscopic percutaneous extraperitoneal closure for pediatric inguinal hernia and hydrocele.

    Science.gov (United States)

    Chen, Yi; Wang, Furan; Zhong, Hongji; Zhao, Junfeng; Li, Yan; Shi, Zhan

    2017-12-01

    Single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) of hernia sac/processus vaginalis has been widely performed for repair of inguinal hernia/hydrocele in children. However, a variety of surgical instruments and techniques were used, and significant differences existed among the SLPEC reports. A literature search was performed for all available studies concerning SLPEC for pediatric inguinal hernia/hydrocele in PubMed, Embase and Cochrane library. The surgical details and operative outcomes were pooled and analyzed with software StataSE 12.0. 49 studies fulfilled the predefined inclusion criteria of this review and 37 studies were finally included in the meta-analysis. The mean incidence of CPPV was 29.1% (range 5.73-43.0%). The average of mean operative time was 19.56 min (range 8.30-41.19 min) for unilateral SLPEC and 27.23 min (range 12.80-48.19 min) for bilateral SLPEC. The total incidence of injury, conversion, recurrence, hydrocele formation, knot reaction, severe pain, and scrotal swelling was 0.32% (range 0-3.24%), 0.05% (range 0-0.89%), 0.70% (range 0-15.5%), 0.23% (range 0-3.57%), 0.33% (range 0-3.33%), 0.05% (range 0-4.55%), and 0.03% (range 0-1.52%), respectively. There was no development of testicular atrophy. Subgroup analyses showed an inverse correlation between the injury incidence and adoption of assisted forceps, hydrodissection, and blunt puncture device, between the conversion rate and adoption of hydrodissection, between the recurrence/hydrocele incidence and adoption of assisted forceps, hydrodissection, nonabsorbable suture and the preventive measures to avoid ligating the unnecessary subcutaneous tissues, and between the rate of knot reaction and adoption of assisted forceps, hydrodissection, and the preventive measures. SLPEC was a well-developed procedure for repair of pediatric inguinal hernia/hydrocele. Adoption of assisted forceps, hydrodissection, nonabsorbable suture, and the preventive measures to avoid

  10. Amyand’s hernia: A case report

    Science.gov (United States)

    Anagnostopoulou, Sofia; Dimitroulis, Dimitrios; Troupis, Theodore G; Allamani, Maria; Paraschos, Alexandros; Mazarakis, Antonios; Nikiteas, Nikolaos I; Kostakis, Alkiviadis

    2006-01-01

    The presence of vermiform appendix in inguinal hernia is rare and is known as Amyand’s hernia. We report an Amyand’s hernia, where the appendix was found in a right inguinal hernia in one male cadaver aged ninety two years. PMID:16937454

  11. Large sliding inguino-scrotal hernia of the urinary bladder: A case report and literature review.

    Science.gov (United States)

    Wang, Ping; Huang, Yonggang; Ye, Jing; Gao, Guodong; Zhang, Fangjie; Wu, Hao

    2018-03-01

    Sliding inguinal hernias of the urinary bladder are protrusions of the bladder through the internal inguinal ring, most of which are insignificant and diagnosed intra-operatively. Large inguino-scrotal bladder hernias commonly present with lower urinary tract symptoms and may cause severe complications, including bladder incarceration or necrosis, bladder hemorrhage, obstructive or neurogenic bladder dysfunction, and even renal failure. We describe and discuss the clinical findings and management of a 59-year-old man who complained of a decrease in scrotal size after voiding and 2-stage voiding requiring pressure to the scrotum. The patient was diagnosed preoperatively as massive, bilateral, inguinoscrotal hernias, and a large, left-sided, sliding bladder hernia. The patient underwent a timely open re-peritoneal inguinal herniorrhaphy using a mesh. The surgical outcomes were good, and no surgical site infection, chronic postoperative inguinal pain or recurrence were recorded during the follow-up. Better knowledge of this rare condition of large inguino-scrotal sliding bladder hernia could help in making a correct diagnosis preoperatively and provide proper surgical management timely, so as to reduce delay in treatment and avoid potential complications.

  12. Laparoscopic Inguinal Hernia Repair

    Science.gov (United States)

    ... Training Guidelines, Statements, and Standards of Practice TAVAC – Technology and Value Assessments Surgical Endoscopy and Other Journal Information SAGES Manuals SCOPE – The SAGES Newsletter Troubleshooting Guides ...

  13. Patient perceptions of acute pain and activity disruption following inguinal hernia repair: a propensity-matched comparison of robotic-assisted, laparoscopic, and open approaches.

    Science.gov (United States)

    Bittner Iv, James G; Cesnik, Lawrence W; Kirwan, Thomas; Wolf, Laurie; Guo, Dongjing

    2018-02-16

    Few publications describe the potential benefit of robotic-assisted inguinal hernia repair on acute postoperative groin pain (APGP). This study compared patients' perceptions of APGP, activity limitation, and overall satisfaction after robotic-assisted- (R), laparoscopic (L), or open (O) inguinal hernia repair (IHR). Random samples of patients from two web-based research panels and surgical practices were screened for patients who underwent IHR between October 28, 2015 and November 1, 2016. Qualified patients were surveyed to assess perceived APGP at 1 week postoperatively, activity disruption, and overall satisfaction. Three cohorts based on operative approach were compared after propensity matching. Propensity scoring resulted in 83 R-IHR matched to 83 L-IHR respondents, while 85 R-IHR matched with 85 O-IHR respondents. R-IHR respondents recalled less APGP compared to respondents who had O-IHR (4.1 ± 0.3 vs 5.6 ± 0.3, p disruption 1 week postoperatively after R-IHR versus O-IHR (6.1 ± 0.3 vs. 7.3 ± 0.2, p disruption after R-IHR and L-IHR (6.0 ± 0.3 vs. 6.6 ± 0.27, p = 0.32). At the time of the survey, respondents perceived less physical activity disruption after R-IHR compared to O-IHR (1.4 ± 0.2 vs. 2.8 ± 0.4, p disruption differ by approach, suggesting a potential advantage of a minimally invasive technique over open for IHR. Further studies are warranted to determine long-term outcomes regarding pain and quality of life after IHR.

  14. [Reconstruction of the inguinal ligament with fascia lata sling. First reported case in Hungary].

    Science.gov (United States)

    Bognár, Gábor; Barabás, Loránd; Tóth, Enikő; Schöller, Andrea; István, Gábor

    2017-06-01

    A technique of reconstructing the inguinal ligament using pedicled fascia lata flap is described. A 66-year-old woman was referred with massive incarcerated left inguinal hernia, following acute surgery on a femoral vein leasion and numerous attempts at repair and subsequent recurrences. There was complete absence of the left inguinal ligament. The inguinal ligament was reconstructed using a strip of fascia lata, pedicled on the anterior superior iliac spine. This was transposed to cover the external iliac vessels, and sutured to the pubic tubercle. The musculoaponeurotic abdominal wall was reconstructed with 15×13 cm sheet of polypropylene mesh, placed preperitoneal and sutured to the remaining abdominal wall muscles and to the neo-Pouoart ligament. Complete destruction of the inguinal ligament is rare but can occur following multiple operative procedures or trauma. Published reports of inguinal ligament reconstruction have been performed using synthetic mesh. The use of autologous tissue should reduce the risk of erosion into the neurovascular bundle, seroma formation, and enhance integration into surrounding tissues. This new technique for autologous reconstruction of the inguinal ligament provides a safe alternative to the use of synthetic mesh in the operative armamentarium of plastic and general surgeons. This is the first reported case in Hungary.

  15. Preoperative diagnosis of Amyand's hernia by ultrasound and computed tomography

    Directory of Open Access Journals (Sweden)

    Husam Vehbi

    2016-06-01

    Full Text Available Inguinal hernia is the most common seen groin hernias which mostly contain bowel. The incidence of vermiform appendix in an inguinal hernia is seen in 1% of all inguinal hernia. This is known as Amyand's hernia. Appendix within a hernia can be normal or complicated by appendicitis. Most of these cases are not diagnosed preoperatively and managed during surgery. Preoperative diagnosis of these cases is so rare. Very few cases have been reported so far.In our case, we diagnosed an inflamed appendix in a 49 years old female within right inguinal hernia by using ultrasound and confirmed it by CT scan. Keywords: Amyand's hernia, Appendicitis

  16. An elective detection of an Amyand's hernia with an adhesive caecum to the sac: Report of a rare case

    Science.gov (United States)

    Sengul, Ilker; Sengul, Demet; Aribas, Duygu

    2011-01-01

    Context: Existence of non-inflamed or inflamed vermiform appendix in an inguinal hernia is named Amyand's hernia in honor to the surgeon Claudius Amyand who successfully performed first perforated appendicitis. Case Report: A 69-year-old Turkish male patient with a slight right groin pain and swelling was presented to our clinic, and found to have a slightly tender and reducible right inguinal hernia. He underwent surgery under general anesthesia, and a adhesive caecum and an inflamed appendix were explored within the hernia sac. Adhesions were divided by sharp dissection and appendectomy was performed. After carrying out a Lichtenstein hernioplasty, a broad-spectrum antibiotic was postoperatively admitted for 3 days. He recovered uneventfully, and neither complication nor recurrence was detected during 52 months of follow-up. Conclusions: Although occurrence of an appendicitis in an inguinal hernia is rare, a surgeon should be vigilant for facing with it even in elective cases. Treatment can be provided only surgically, but surgical treatment is not standard except from appendectomy. In our opinion, application of mesh hernia repair should depend on the degree of inflammation of appendix and the presence of incarceration of hernia sac with a suitable antibiotic admission for 3-5 days postoperatively. PMID:22171249

  17. Clinical features and therapeutic strategies of obstructive azoospermia in patients treated by bilateral inguinal hernia repair in childhood

    Directory of Open Access Journals (Sweden)

    Xiang-Feng Chen

    2014-10-01

    Full Text Available Childhood inguinal herniorrhaphy is one common cause of seminal tract obstruction. Vasovasostomy (VV can reconstruct seminal deferens and result in appearance of sperm and natural pregnancy in some patients. Secondary epididymal obstruction caused by a relatively long-term vasal obstruction is a common cause of lower patency compared with VV due to vasectomy in adults. From July 2007 to June 2012, a total of 62 patients, with history of childhood inguinal herniorrhaphy and diagnosed as obstructive azoospermia were treated in our center. The overall patency rate and natural pregnancy rate were 56.5% (35/62 and 25.8% (16/62, respectively. 48.4% (30/62 of the patients underwent bilateral VV in the inguinal region, with a patency rate of 76.7% (23/30 and a natural pregnancy rate of 36.7% (11/30, respectively. 30.6% (19/62 of the patients underwent bilateral VV and unilateral or bilateral vasoepididymostomies due to ipsilateral epididymal obstruction with the patency and natural pregnancy rate decreasing to 63.2% (12/19 and 26.3% (5/19. 21.0% (13/62 of the patients merely underwent vasal exploration without reconstruction due to failure to find distal vasal stump, etc. Our study indicate that microsurgical reanastomosis is an effective treatment for some patients with seminal tract obstruction caused by childhood inguinal herniorrhaphy.

  18. Hernia de Amyand: presentación de dos casos Amyand's hernia: report of two cases

    Directory of Open Access Journals (Sweden)

    Pedro López Rodríguez

    2005-03-01

    Full Text Available Encontrar una apendicitis en el interior de una hernia inguinal encarcelada es algo inusual y se conoce en la literatura como hernia de Amyand. Cuando ocurre, casi siempre es diagnosticada como una hernia inguinal encarcelada. Realizamos la presentación de dos casos y revisamos la literaturaFinding appendicitis in the interior of an arrested inguinal hernia is something unusual known as Amyand's hernia. When it occurs, it is usually diagnosed as an arrested inguinal hernia. Two cases are reported and the literature on this topic is reviewed

  19. Infiltration of wounds and extraperitoneal space with local anesthetic in patients undergoing laparoscopic totally extraperitoneal repair of unilateral inguinal hernias: a randomized double-blind placebo-controlled trial.

    Science.gov (United States)

    Abbas, M H; Hamade, A; Choudhry, M N; Hamza, N; Nadeem, R; Ammori, B J

    2010-01-01

    The potential analgesic benefit of infiltration of the wounds and extraperitoneal space with local anesthetic in patients undergoing laparoscopic totally extraperitoneal (TEP) repair of inguinal hernias remains unclear. Consenting adults scheduled to undergo laparoscopic TEP repair of unilateral inguinal hernias were recruited to this randomized double-blind placebo-controlled clinical trial of 0.25% bupivacaine (Group I) versus saline (Group II) infiltration of abdominal wounds and the extraperitoneal space. Pain scores were assessed at 4 and 24 hours postoperatively using the short-form McGill pain questionnaire (SF-MPQ), the Present Pain Index (PPI) score and the visual analogue scale (VAS). The intravenous and oral analgesic requirements were recorded. Each patient completed questionnaire to assess their satisfaction with the postoperative analgesia. 40 patients were randomized (Group I, n = 20; Group II, n = 20). The two groups were comparable for age, gender, body mass index, and operating time. Minor complications occurred in one patient in each group. There were no significant differences in the postoperative SF-MPQ scores, PPI and VAS at 4 hours (p = 0.413, p = 0.631, p = 0.615 respectively) and 24 hours (p = 0.116, p = 0.310, p = 0.100 respectively) post-operatively. The parenteral and oral analgesics consumed post-surgery were comparable (p = 0.605, p = 0.235). No difference was ob-served in the patient satisfaction scores. Infiltration of abdominal wounds and extraperitoneal space with bupivacaine in patients undergoing laparoscopic TEP repair of unilateral inguinal hernias does not appear to offer analgesic benefits.Key words: Laparoscopic; extraperitoneal; inguinal hernia; repair; pain; bupivacaine; analgesia; satisfaction; day case; randomized.

  20. Hernia surgery, South Africa 2015

    African Journals Online (AJOL)

    Abdominal hernia repair is one of the most common operations in general surgery. Abdominal wall hernias include inguinal, incisional, ventral and femoral hernias. The repair rate ranges from 10 per. 100 000 population in the UK to 28 per 100 000 in the US.[1,2] More than one million hernia repairs are performed.

  1. Coagulation, inflammatory, and stress responses in a randomized comparison of open and laparoscopic repair of recurrent inguinal hernia

    DEFF Research Database (Denmark)

    Rahr, H B; Bendix, J; Ahlburg, P

    2006-01-01

    BACKGROUND: In previous comparisons of inflammatory and stress responses to open (OR) and laparoscopic (LR) hernia repair, all operations were performed under general anesthesia. Since local anesthesia is widely used for OR, a comparison of this approach with LR seemed relevant. METHODS: Patients...

  2. PRE-OPERATIVE HAIR REMOVAL WITH TRIMMERS AND RAZORS AND ITS IMPACT ON SURGICAL SITE INFECTIONS IN ELECTIVE INGUINAL HERNIA REPAIR

    Directory of Open Access Journals (Sweden)

    John S. Kurien

    2018-02-01

    Full Text Available BACKGROUND Despite major advances in infection control interventions, health care-associated infections (HAI remain a major public health problem and patient safety threat worldwide. The global data suggests that the SSI incidence rate varies from 0.5 to 20% depending upon the type of operation and underlying patient status. Several factors preoperative, intraoperative & postoperative, determine the occurrence of surgical site infections, Preoperative hair removal is considered as a risk for the development of surgical site infections. The objective of the study is to find out the difference in the incidence of surgical site infections in patients undergoing pre-operative hair removal by shaving with Razor blades and hair trimmers prior to elective inguinal hernia surgery. MATERIALS AND METHODS Written informed consent from 160 patients with no significant comorbidities planning to undergo elective inguinal hernia surgery at the general surgery wards in Government Medical College Kottayam and who were willing to participate in the study were to be obtained. 80 of them to undergo pre-operative hair removal with hair trimmers and 80 to undergo preoperative hair removal by shaving with razor blades on the day prior to the surgery randomised into two groups. During their stay in the postoperative ward the surgical wounds of the patients were examined daily for the development of erythema, pain, discharge, induration and gaping of the wound. The daily findings were noted down till the patient was discharged from the ward. The patients were again reassessed 2 weeks later, when they came for review in the Surgery OPD after their discharge from the ward; finally the patients were examined on the 30th day post-surgery to look for the clinical features of surgical site infections. RESULTS Out of the total 160 patients who were studied, 29 (18.1% of them had post-operative infection within 30 days, in the form of erythema, induration, discharge and gaping

  3. The effects of unilateral and bilateral spinal anaesthesia on hemodynamic parameters in patients surgically treated for inguinal hernia: Hemodynamic parameters and spinal anesthesia

    Directory of Open Access Journals (Sweden)

    Milosavljević Snežana

    2016-01-01

    Full Text Available Introduction: Conventional bilateral spinal anaesthesia is commonly used for surgical treatment of inguinal hernia because it causes fast development of block with relatively small dosage of local anaesthetic; furthermore, it is easily administered, reduces the level of metabolic response to stress, reduces the incidence of deep venous thrombosis and respiratory depression. On the other hand, the main side effect is hypotension Objective: The goal of the research was to determine which of the two methods of spinal anaesthesia (conventional bilateral, achieved with regular dosage of long-lasting bupivacaine or hypobaric unilateral, achieved with combined application of bupivacaine and fentanyl ensures higher hemodynamic stability during tension-free hernioplasty in patients from group I and II of ASA classification system. Methods: The research was conducted as a prospective, controlled clinical study with the total amount of 50 patients, males and females, and within the age span ranging from 17 to 77, who all had indications for surgical treatment of one-sided inguinal hernia under spinal anaesthesia. The hemodynamic parameters (heart rate, systolic, diastolic and mean arterial pressure were measured during following intervals: T1 - during preanaesthetic visit, T2 - after premedication and the iv administration of Ringer's lactate solution, T3 - 15 minutes after the administration of spinal anaesthesia, T4 - after the surgical incision, T5 - intraoperatively, T6 - during the placement of the last surgical stitch on the skin, T7 - one hour postoperatively. Results: The results showed that the frequency of clinically relevant hypotension was statistically much higher in patients with bilateral spinal anaesthesia (24 % when compared to patients administered with unilateral spinal anaesthesia (4%. Ten minutes after the application of spinal anaesthesia the mean arterial pressure has decreased by 20% when compared to basic values in group BB, and by

  4. [Inguinal herniation in foals. Literature review and a case report].

    Science.gov (United States)

    van der Velden, M A; van der Harst, M R

    2004-05-01

    A literature review is given concerning the occurrence, clinical signs and possible treatment of the different types of inguinal herniation in foals. A six-week old filly with a reducible inguinal hernia is described in detail.

  5. Sonographic findings of inguinal herniation of the ovary

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Kyung; Lee, Sun Wha [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2003-09-01

    To describe the sonographic findings of inguinal herniation of the ovary. Forty-five girls aged 1-12 (mean, 4.7) months with a groin mass underwent sonographic examination, and in seven of the 45, inguinal herniation of the ovary was detected, and confirmed at surgery. Gray-scale and color Doppler sonographic examinations were performed to evaluated the size, echo pattern, and blood flow of the mass. Sonography of the pelvis and contralateral groin was also performed. In all seven cases, sonography revealed an oval-shaped complex mass 15-25 mm in maximal diameter and composed of heterogeneous hypoechoic portions and one to seven small internal cysts, each 2-9 mm in diameter. Blood flow was observed in all cases, though was subtly decreased in one. In two there was associated herniation of the salpinx, and in two others, incarceration. In four, contralateral inguinal hernia was present. Sonographic findings of an oval-shaped heterogeneous hypoechoic mass with internal small cysts, present in the groin, indicate inguinal herniation of the ovary.

  6. Incarcerated internal hernia of the small intestine through a re-approximated peritoneum after a trans-abdominal pre-peritoneal procedure--apropos of two cases: review of the literature.

    Science.gov (United States)

    Agresta, F; Mazzarolo, G; Bedin, N

    2011-06-01

    A description of two cases of internal herniation caused by a defect in the closure of the peritoneal flap during a trans-abdominal pre-peritoneal procedure is presented here. They were both successfully treated laparoscopically. This rare condition should be considered when patients who have had recent trans-abdominal surgery for inguinal hernia repair present with colicky lower abdominal pain--its aetiology may well be due to technical error. It is already established that laparoscopy is useful as a diagnostic and therapeutic tool in emergency cases, but it is also true that it is useful in case of early post-operative period complications following any laparoscopic procedure, such as the laparoscopic inguinal hernia repair.

  7. The Amyand's Hernia: A Rare Clinical Entity Diagnosed by Computed Tomography.

    Science.gov (United States)

    Keskin, Suat; Simşek, Cihan; Keskin, Zeynep

    2013-01-01

    Amyand's hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyand's hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT) scans. CT of the abdomen may help in guiding the diagnosis.

  8. Randomized comparison of the feasibility of three anesthetic techniques for day-case open inguinal hernia repair.

    Science.gov (United States)

    Pere, Pertti; Harju, Jukka; Kairaluoma, Pekka; Remes, Veikko; Turunen, Päivi; Rosenberg, Per H

    2016-11-01

    Comparison of local anesthetic infiltration (LAI), spinal anesthesia (SPIN) and total intravenous anesthesia (TIVA) for open inguinal herniorrhaphy. We hypothesized that patients receiving LAI could be discharged faster than SPIN and TIVA patients. Randomized, prospective trial. University hospital day-surgery center. 156 adult male patients (ASA 1-3) undergoing day-case open inguinal herniorrhaphy. Patients were randomized to either LAI (lidocaine+ropivacaine), SPIN (bupivacaine+fentanyl) or TIVA (propofol+remifentanil). Perioperative Ringer infusion was 1.5mL/h. Urinary bladder was scanned before and after surgery. Interviews were performed on postoperative days 1, 7 and 90. Duration of surgery, duration of the patients' stay in the operating room and time until their readiness for discharge home. Patient satisfaction and adverse effects were registered. Surgery lasted longer in LAI group (median 40min) than in SPIN group (35min) (P=.003) and TIVA group (33min) (Pinfiltration was given to 32 LAI patients, and IV fentanyl to 29 LAI and 4 SPIN patients. Ephedrine was required in 34 TIVA, 5 LAI and 5 SPIN patients. One SPIN and three LAI patients had to be given TIVA and another SPIN patient LAI to complete the operations. Urinary retention was absent. Discomfort in the scar (26%) three months postoperatively was not anesthesia-related. Logistically, LAI was superior because of the fastest recovery postoperatively. The anesthetic techniques were adequate for surgery in all but a few LAI and SPIN patients. Lack of urinary retention was probably related to the small IV infusion volumes. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Migration of a ventriculoperitoneal shunt catheter through the processus vaginalis in infants: how serious inguinal hernia and hydrocele might be.

    Science.gov (United States)

    Fernandez-Ibieta, Maria; Villamil, Vanesa; Martinez-Lage, Juan

    2017-08-01

    Migration of the catheter tip of a ventriculoperitoneal shunt (VPS) through a patent processus vaginalis (PV) has seldom being reported. In this series, we analyzed all cases of inguinoscrotal migration of an VPS catheter at our center. Between 1975 and 2015, 295 VPS insertions were performed. In seven infants (2.3%), migration of the catheter through a patent PV was demonstrated. Cases with hydroceles had associated VPS malfunction, but cases with hernias were not associated with it. The current recommendation is to delay a PV closure until 2 years of age in cases of infants with hydrocele without further radiological examinations, but this might not be the case in infants with VPS.

  10. Shouldice Versus Lichtenstein Hernia Repair Techniques: A ...

    African Journals Online (AJOL)

    Lichtenstein), and the 4-layer tissue repair (Shouldice) techniques of inguinal hernia surgery and to determine to what extent doctors in a general surgical unit were able to reproduce the excellent results reported from specialist hernia centres.

  11. Bullhorn Hernia: A Rare Traumatic Abdominal Wall Hernia

    African Journals Online (AJOL)

    laparotomy. Finally, occult hernias may be managed expectantly. Traumatic abdominal wall hernia caused by bullhorn is commonly found in the lower abdomen such as inguinal region.[9] However, in our case the hernia was in the upper abdomen. Clinically, abdominal pain and locally bulging soft tissue at the ecchymotic.

  12. Evaluating the Adjuvant Effect of Dexamethasone to Ropivacaine in Transversus Abdominis Plane Block for Inguinal Hernia Repair and Spermatocelectomy: A Randomized Controlled Trial.

    Science.gov (United States)

    Wegner, Robert; Akwar, Duane; Guzman-Reyes, Sarah; Pednekar, Greesha; Chaudhry, Rabail; Grewal, Navneet; Kukreja, Naveen; Mancillas, Omar L; Williams, George W; Nwokolo, Omonele

    2017-07-01

    The transversus abdominis plane (TAP) block is a relatively straightforward regional technique used for postoperative analgesia in patients undergoing abdominal surgeries. Various adjuvants have been used in past to prolong the duration of action of analgesia in peripheral nerve blocks. Several studies investigating the analgesic efficacy of dexamethasone added to local anesthetic agents, such as bupivacaine, have shown promising results. However, there are few studies comparing the efficacy of dexamethasone with ropivacaine. To determine if the addition of dexamethasone 8 mg to ropivacaine 0.2% in a TAP block would prolong the analgesic effect when compared with ropivacaine 0.2% alone after inguinal hernia repair and spermatocelectomy. A randomized, double blinded, placebo-controlled, prospective study. Teaching hospital. A total of 82 patients undergoing inguinal hernia repair or spermatocelectomy were enrolled in the study, of which 41 patients received TAP block with ropivacaine with saline, and the other 41 received ropivacaine with dexamethasone immediately following surgery. Both the proceduralist (resident) and the patient were blinded to the solution used. Visual analog pain scores (0 - 10) were obtained pre-block and immediately post block. Our primary endpoint was visual analog pain score at 12 hours, with 24 and 48-hour pain scores as the secondary endpoints. The averaged pre-block pain score was 7.6 ± 1.7 in the saline group and 7.7 ± 2.2 in the dexamethasone group. There was an improvement in the pain scores from the baseline, at 12 hours after the administration of the block in both the groups. Although the dexamethasone group had a greater change in pain score (-3.2) than the saline group (-2.2), the difference between the 2 groups was not statistically significant (0.08). We did not observe significant differences in change from baseline at 24 hours and 48 hours between the 2 groups (P value = 0.74 and 0.44, respectively). We did not assess the

  13. The DQB1 *03:02 HLA haplotype is associated with increased risk of chronic pain after inguinal hernia surgery and lumbar disc herniation.

    Science.gov (United States)

    Dominguez, Cecilia A; Kalliomäki, Maija; Gunnarsson, Ulf; Moen, Aurora; Sandblom, Gabriel; Kockum, Ingrid; Lavant, Ewa; Olsson, Tomas; Nyberg, Fred; Rygh, Lars Jørgen; Røe, Cecilie; Gjerstad, Johannes; Gordh, Torsten; Piehl, Fredrik

    2013-03-01

    Neuropathic pain conditions are common after nerve injuries and are suggested to be regulated in part by genetic factors. We have previously demonstrated a strong genetic influence of the rat major histocompatibility complex on development of neuropathic pain behavior after peripheral nerve injury. In order to study if the corresponding human leukocyte antigen complex (HLA) also influences susceptibility to pain, we performed an association study in patients that had undergone surgery for inguinal hernia (n=189). One group had developed a chronic pain state following the surgical procedure, while the control group had undergone the same type of operation, without any persistent pain. HLA DRB1genotyping revealed a significantly increased proportion of patients in the pain group carrying DRB1*04 compared to patients in the pain-free group. Additional typing of the DQB1 gene further strengthened the association; carriers of the DQB1*03:02 allele together with DRB1*04 displayed an increased risk of postsurgery pain with an odds risk of 3.16 (1.61-6.22) compared to noncarriers. This finding was subsequently replicated in the clinical material of patients with lumbar disc herniation (n=258), where carriers of the DQB1*03:02 allele displayed a slower recovery and increased pain. In conclusion, we here for the first time demonstrate that there is an HLA-dependent risk of developing pain after surgery or lumbar disc herniation; mediated by the DRB1*04 - DQB1*03:02 haplotype. Further experimental and clinical studies are needed to fine-map the HLA effect and to address underlying mechanisms. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  14. Abdominal adiposity is the main determinant of the C-reactive response to injury in subjects undergoing inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Irkulla Sashidhar

    2013-02-01

    Full Text Available Abstract Background Obesity and serum C-reactive protein (CRP (a sensitive marker of inflammatory activity are associated with most chronic diseases. Abdominal adiposity along with age is the strongest determinant of baseline CRP levels in healthy subjects. The mechanism of the association of serum CRP with disease is uncertain. We hypothesized that baseline serum CRP is a marker of inflammatory responsiveness to injury and that abdominal adiposity is the main determinant of this responsiveness. We studied the effect of abdominal adiposity, age and other environmental risk factors for chronic disease on the CRP response to a standardised surgical insult, unilateral hernia repair to not only test this hypothesis but to inform the factors which must be taken into account when assessing systemic inflammatory responses to surgery. Methods 102 male subjects aged 24-94 underwent unilateral hernia repair by a single operator. CRP was measured at 0, 6, 24 and 48 hrs. Response was defined as the peak CRP adjusted for baseline CRP. Results Age and waist:hip ratio (WHR were associated both with basal CRP and CRP response with similar effect sizes after adjustment for a wide-range of covariates. The adjusted proportional difference in CRP response per 10% increase in WHR was 1.50 (1.17-1.91 p = 0.0014 and 1.15(1.00-1.31 p = 0.05 per decade increase in age. There was no evidence of important effects of other environmental cardiovascular risk factors on CRP response. Conclusion Waist:hip ratio and age need to be considered when studying the inflammatory response to surgery. The finding that age and waist:hip ratio influence baseline and post-operative CRP levels to a similar extent suggests that baseline CRP is a measure of inflammatory responsiveness to casual stimuli and that higher age and obesity modulate the generic excitability of the inflammatory system leading to both higher baseline CRP and higher CRP response to surgery. The mechanism for

  15. Effect of Preoperative Inflammatory Status and Comorbidities on Pain Resolution and Persistent Postsurgical Pain after Inguinal Hernia Repair

    Science.gov (United States)

    Lavand'homme, Patricia; Ambrosoli, Andrea Luigi; Cappelleri, Gianluca; Saccani Jotti, Gloria MR; Fanelli, Guido; Allegri, Massimo

    2016-01-01

    Poor acute pain control and inflammation are important risk factors for Persistent Postsurgical Pain (PPSP). The aim of the study is to investigate, in the context of a prospective cohort of patients undergoing hernia repair, potential risk factors for PPSP. Data about BMI, anxious-depressive disorders, neutrophil-tolymphocyte ratio (NLR), proinflammatory medical comorbidities were collected. An analysis for correlation between comorbidities and PPSP was performed in those patients experiencing chronic pain at 3 months after surgery. Tramadol resulted less effective in pain at movement in patients with a proinflammatory status. Preoperative hypertension and NLR > 4 were correlated with PPSP intensity. Regional anesthesia was significantly protective on PPSP when associated with ketorolac. Patients with pain at 1 month were significantly more prone to develop PPSP at 3 months. NSAIDs or weak opioids are equally effective on acute pain and on PPSP development after IHR, but Ketorolac has better profile in patients with inflammatory background or undergoing regional anesthesia. Drug choice should be based on their potential side effects, patient's profile (comorbidities, preoperative inflammation, and hypertension), and type of anesthesia. Close monitoring is necessary to early detect pain conditions more prone to progress to a chronic syndrome. PMID:27051077

  16. Canal of Nuck hernia: a multimodality imaging review

    Energy Technology Data Exchange (ETDEWEB)

    Rees, Mitchell A. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Squires, James E. [Children' s Hospital of Pittsburgh of UPMC, Department of Gastroenterology, Pittsburgh, PA (United States); Tadros, Sameh; Squires, Judy H. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Children' s Hospital of Pittsburgh of UPMC, Department of Radiology, Pittsburgh, PA (United States)

    2017-07-15

    Canal of Nuck abnormalities are a rare but important cause of morbidity in girls, most often those younger than 5 years of age. The canal of Nuck, which is the female equivalent of the male processus vaginalis, is a protrusion of parietal peritoneum that extends through the inguinal canal and terminates in the labia majora. The canal typically obliterates early in life, but in some cases the canal can partially or completely fail to close, potentially resulting in a hydrocele or hernia of pelvic contents. Recognition of this entity is especially important in cases of ovarian hernia due to the risk of incarceration and torsion. We aim to increase awareness of this condition by reviewing the embryology, anatomy and diagnosis of canal of Nuck disorders with imaging findings on US, CT and MRI using several cases from a single institution. (orig.)

  17. Unusual Presentation of Maydl's Hernia

    African Journals Online (AJOL)

    Ganesaratnam M. Maydl's hernia: Report of a Series of Seven Cases and Review of Literature. Brit J Surg. 1985;72:737-8. 12. Weledji EP, Mokake M, Ngowe MN. A Rare. Presentation of Maydl's Hernia. Case Rep Surg. 2014. 13. Zachariah K. Incarcerated Sliding Colonic Maydl's. Hernia-Dealing with This Rare Emergency.

  18. A Giant Aggressive Angiomyxoma of the Pelvis Misdiagnosed as Incarcerated Femoral Hernia: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Alper Sozutek

    2016-01-01

    Full Text Available Aggressive angiomyxoma (AA is an uncommon mesenchymal tumor that is mostly derived from the female pelvic and perineal regions. AA is a locally infiltrative slow growing tumor with a marked tendency to local recurrence. Painless swelling located around the genitofemoral region is the common symptom; thus, it is often misdiagnosed as a gynecological malignancy or a groin hernia. A 35-year-old female patient who previously underwent surgery for left femoral hernia operation resulting in surgical failure was reoperated for a giant AA located in the pelvis. The tumor was completely excised with free margins. Histopathologic examination revealed an AA. The tumor size was measured as 24 × 12 × 6 cm with a weight of 4.2 kg. Immunohistochemically, the cells show positive staining with vimentin, desmin, estrogen, and progesterone receptor. S100, MUC4, CD34, and SMA were negative in the tumor cells. AA should be considered in the differential diagnosis of any painless swelling located in the genitofemoral region, particularly in women of reproductive age. The principle treatment should be complete surgical excision with tumor-free margins. Long-term follow-up and careful monitoring are essential due to its high tendency of local recurrence in spite of wide excision of the tumor. Adjuvant antihormonal therapy yields promising results for preventing recurrence.

  19. Lichtenstein Versus Total Extraperitoneal Patch Plasty Versus Transabdominal Patch Plasty Technique for Primary Unilateral Inguinal Hernia Repair: A Registry-based, Propensity Score-matched Comparison of 57,906 Patients.

    Science.gov (United States)

    Köckerling, Ferdinand; Bittner, Reinhard; Kofler, Michael; Mayer, Franz; Adolf, Daniela; Kuthe, Andreas; Weyhe, Dirk

    2017-09-26

    Outcome comparison of the Lichtenstein, total extraperitoneal patch plasty (TEP), and transabdominal patch plasty (TAPP) techniques for primary unilateral inguinal hernia repair. For comparison of these techniques the number of cases included in meta-analyses of randomized controlled trials is limited. There is therefore an urgent need for more comparative data. In total, 57,906 patients with a primary unilateral inguinal hernia and 1-year follow up from the Herniamed Registry were selected between September 1, 2009 and February 1, 2015. Using propensity score matching, 12,564 matched pairs were formed for comparison of Lichtenstein versus TEP, 16,375 for Lichtenstein versus TAPP, and 14,426 for TEP versus TAPP. Comparison of Lichtenstein versus TEP revealed disadvantages for the Lichtenstein operation with regard to the postoperative complications (3.4% vs 1.7%; P comparison of Lichtenstein versus TAPP showed disadvantages for the Lichtenstein operation with regard to the postoperative complications (3.8% vs 3.3%; P = 0.029), complication-related reoperations (1.2% vs 0.9%; P = 0.019), pain at rest (5% vs 4.5%; P = 0.029), and on exertion (10.2% vs 7.8%; P < 0.001). TEP and TAPP were found to have advantages over the Lichtenstein operation.

  20. An Unusual Situation Causing Voiding Dysfunction: Inguinal Herniation of the Bladder

    Directory of Open Access Journals (Sweden)

    Sadi Turkan

    2013-10-01

    Full Text Available Inguinal hernia repair is one of the most commonly performed surgical procedures. Intestinal loops are often found in hernia suc during hernia repair. In rare cases, lipoma, ovaries, appendix can be found. We presented that inguinal herniation of the bladder cause filling and emptying disorders symptoms.

  1. Unusual presentation of Maydl's hernia | Wamalwa | Annals of ...

    African Journals Online (AJOL)

    Maydl's hernia is an uncommon presentation of inguinal hernia whereby predominantly right sided afferent and efferent loops of bowel herniate into the sac with an intervening intra-abdominal loop of bowel that is prone to strangulation. This could be missed if hernia repair is performed with inguinal approach only.

  2. Prospective study on the effects of a polypropylene prosthesis on testicular volume and arterial flow in patients undergoing surgical correction for inguinal hernia Estudo prospectivo dos efeitos da prótese de polipropileno sobre o volume e o fluxo arterial testicular em pacientes submetidos à correção cirúrgica de hérnia inguinal

    Directory of Open Access Journals (Sweden)

    Edgar Valente de Lima Neto

    2007-08-01

    Full Text Available PURPOSE: To evaluate testicular volume and arterial flow in patients undergoing surgical correction for inguinal hernia, with polypropylene prosthesis. METHODS: This was an observational prospective clinical study on 39 male patients with unilateral inguinal hernia of types III A and III B according to the Nyhus classification who underwent surgical correction with implantation of a polypropylene prosthesis by means of the Lichtenstein technique. The patients were evaluated using Doppler ultrasound before the operation and selectively at the third and sixth months after the operation. The variables studied were testicular volume, systolic and diastolic velocity, resistance index and pulsatility index. RESULTS: No statistically significant alterations in the variables studied were observed over the course of time: testicular volume (p= 0.197; systolic velocity (p= 0.257; diastolic velocity (p= 0.554; resistance index (p= 0.998; and pulsatility index (p= 0.582. CONCLUSION: No alteration in testicular volume and arterial flow over a six-month period was observed among patients who underwent surgical correction for inguinal hernia using a polypropylene prothesis.OBJETIVO: Avaliar o volume testicular e o fluxo na artéria testicular em pacientes operados de inguinal com prótese de polipropileno. MÉTODOS: Estudo clínico prospectivo observacional em 39 pacientes do sexo masculino portadores de hérnia inguinal tipo III A e III B na classificação de Nyhus os quais foram submetidos a hernioplastia inguinal com implantação de prótese de polipropileno com a técnica de Lichtenstein. Os pacientes foram avaliados com ultra-sonografia Doppler no pré-operatório; no 3º mês e no 6º mês de pós-operatório. As variáveis estudadas foram: volume testicular; velocidade sistólica e diastólica, o índice de resistividade e o índice de pulsatilidade. RESULTADOS: Não se observou alterações estatisticamente significantes nas variáveis ao longo do

  3. Amyand's hernia complicated with acute appendicitis: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Mehmet Hanifi Okur

    2015-06-01

    Full Text Available Amyand's hernia is the presence of the appendix within an inguinal hernia sac. It is a rare condition, occurring in 1% of inguinal hernia patients. The clinical presentation varies depending on the extent of appendix inflammation. Amyand's hernia is difficult to diagnose clinically. However, imaging studies are valuable for both its diagnosis and detection of the associated complications. Here, we report a case of Amyand's hernia in a 3-year-old male child who presented with a history of right inguinal tenderness, pain, and swelling. An operation revealed a hernia sac containing the inflamed appendix; hence, an appendectomy was performed along with a right inguinal herniotomy.

  4. The efficacy of the semi-blind approach of transversus abdominis plane block on postoperative analgesia in patients undergoing inguinal hernia repair: a prospective randomized double-blind study

    Directory of Open Access Journals (Sweden)

    Salman AE

    2013-01-01

    Full Text Available A Ebru Salman,1 Fahri Yetisir,2 Banu Yürekli,3 Mustafa Aksoy,1 Murat Yildirim,2 Mehmet Kiliç21Anesthesiology and Reanimation Department, 2General Surgery Department, Atatürk Research and Training Hospital, Ankara, Turkey; 3Endocrinology Department, Bozyaka Research and Training Hospital, Izmir, TurkeyPurpose: In this prospective, randomized, double-blind study, our aim was to compare the analgesic efficacy of the semi-blind approach of transversus abdominis plane (TAP block with a placebo block in patients undergoing unilateral inguinal hernia repair.Methods: After receiving hospital ethical committee approval and informed patient consents, American Society of Anesthesiologists (ASA I–III patients aged 18–80 were enrolled in the study. Standard anesthesia monitoring was applied to all patients. After premedication, spinal anesthesia was administered to all patients with 3.5 mL heavy bupivacaine at the L3-L4 subarachnoid space. Patients were randomly allocated into 2 groups. Group I (n = 32 received a placebo block with 20 mL saline, Group II (n = 32 received semi-blind TAP block with 0.25% bupivacaine in 20 mL with a blunt regional anesthesia needle into the neurofascial plane via the lumbar triangle of Petit near the midaxillary line before fascial closure. At the end of the operation, intravenous (IV dexketoprofen was given to all patients. The verbal analog scale (VAS was recorded at 2, 4, 6, 12, and 24 hours postoperatively. Paracetamol IV was given to patients if their VAS score > 3. A rescue analgesic of 0.05 mg/kg morphine IV was applied if VAS > 3. Total analgesic consumption and morphine requirement in 24 hours were recorded.Results: TAP block reduced VAS scores at all postoperative time points (P < 0.001. Postoperative analgesic and morphine requirement in 24 hours was significantly lower in group II (P < 0.01.Conclusion: Semi-blind TAP block provided effective analgesia, reducing total 24-hour postoperative analgesic

  5. A giant inguinoscrotal hernia associated with other abdominal wall defects A case report.

    Science.gov (United States)

    Iovino, Francesco; Auriemma, Pasquale Pio; Dani, Luca; Giordano, Giovanni; Barbarisi, Alfonso

    2016-04-29

    Giant inguinoscrotal hernias are unusual in developed countries and rarely associated with other wall hernias, such as controlateral inguinal hernia, umbilical hernia. The presence of more parietal defects can facilitate reinstatement of giant hernia content without respiratory and circulatory compromise, but the risk of occlusion and bowel strangulation results increased. Here, we report an unusual case of an asymptomatic giant inguinal hernia associated with controlateral inguinal and umbilical hernia in a 60 years old Caucasian male treated with sequential surgical approach. In particular, the Lichtenstein's technique under spinal anesthesia was performed and it could be considered the gold standard for this disease. Giant inguinal hernia and abdomen wall defects should not be repaired at the same time. It is more useful to be less aggressive, monitoring the progressive and natural adaptation of the viscera into the abdomen. Anyway, thereby literature results very poor and additional reports are required. Giant inguinoscrotal hernia, Hernia, Hernia treatment, Wall defects.

  6. A comparative study to evaluate ultrasound-guided transversus abdominis plane block versus ilioinguinal iliohypogastric nerve block for post-operative analgesia in adult patients undergoing inguinal hernia repair

    Directory of Open Access Journals (Sweden)

    Kirti Kamal

    2018-01-01

    Full Text Available Background and Aims: Both transversus abdominis plane (TAP block and combined ilioinguinal-iliohypogastric (IIN/IHN blocks are used routinely under ultrasound (USG guidance for postoperative pain relief in patients undergoing inguinal hernia surgery. This study compares USG guided TAP Vs IIN/IHN block for post-operative analgesic efficacy in adults undergoing inguinal hernia surgery. Methods: Sixty adults aged 18 to 60 with American Society of Anesthesiologsts' grade I or II were included. After general anaesthesia, patients in Group I received USG guided unilateral TAP block using 0.75% ropivacaine 3 mg/kg (maximum 25 mL and those in Group II received IIN/IHN block using 10 mL 0.75% ropivacaine. Postoperative rescue analgesia was with tramadol (intravenous IV ± diclofenac IV in the first 4 h followed by oral diclofenac subsequently. Total analgesic consumption in the first 24 h was the primary objective, intraoperative haemodynamics, number of attempts and time required for performing the block as well as the postoperative pain scores were also evaluated. Results: Time to first analgesic request was 319.8 ± 115.2 min in Group I and 408 ± 116.4 min in Group II (P = 0.005. Seven patients (23.33% in Group I and two (6.67% in Group II required tramadol in first four hours. No patient in either groups received diclofenac IV. The average dose of tablet diclofenac was 200 ± 35.96 mg in Group I and 172.5 ± 34.96 mg in Group II (P = 0. 004. Conclusion: USG guided IIN/IHN block reduces the postoperative analgesic requirement compared to USG guided TAP block.

  7. ADULT ABDOMINAL WALL HERNIA IN IBADAN.

    African Journals Online (AJOL)

    INTRODUCTION. Abdominal wall hernia repair accounts, in the average surgical unit, for 15-18% of all surgical procedures1,2. Indeed hernias are a leading cause of morbidity and mortality in various parts of Africa1,3,4,5,6. Approximately 7 in 10 cases of all abdominal wall hernias occur in the groin, thus making inguinal ...

  8. Spontaneous rupture: An uncommon complication of ventral hernia ...

    African Journals Online (AJOL)

    BACKGROUND: Literature is scarce about spontaneous rupture of hernia because spontaneous rupture of here is uncommon (1). Reported cases are complications of incisional hernias, recurrent inguinal hernia, and umbilical hernias. It is potentially life threatening (1) because the ensuing entrapment and tension on ...

  9. Intracorporeal suture closure of the internal inguinal and vaginal rings in foals and horses.

    Science.gov (United States)

    Caron, John P; Brakenhoff, Jeffrey

    2008-02-01

    To report a technique for repair or prevention of inguinal hernia in horses using intracorporeal suture closure of the internal inguinal and vaginal rings. Case series. Foals (n=6) and geldings (n=2). After selection of a peri-umbilical telescope portal, instrument portals were made unilaterally or bilaterally, as needed. Herniated viscera was reduced, castration (foals) or spermatic cord remnant transection at the internal inguinal ring (adults) performed, and then simple interrupted intracorporeal sutures of synthetic absorbable suture material were used to close the internal inguinal and vaginal rings. There was no recurrence of inguinal hernia. Postoperative morbidity was minimal and cosmetic outcome was comparable to that achieved with conventional, open techniques. Laparoscopic, primary closure of the internal inguinal ring by use of intracorporeal sutures provides a secure barrier to herniation and costs considerably less than using endoscopic staples. Laparoscopic suture closure of the internal inguinal and vaginal rings provides safe and effective repair of inguinal hernia in horses.

  10. [Celioscopic treatment of inguinal hernias by intraperitoneal patch of ePTFE according to Spaw. Preliminary results of a prospective study of 162 hernioplasties in 135 patients. Groupe CHIC (Cure des hernies inquinocrurales sous coelioscopie)].

    Science.gov (United States)

    Gillion, J F; Elhadad, A; Balique, J G; Begin, G F; Fourtanier, G

    1994-01-01

    Spaw's (original and modified) was technique evaluated in a prospective, multicentre study: from november 1992 to september 1993, 162 intraperitoneal laparoscopic herniorraphies were carried out in 135 patients for recurrent hernias or for hernias associated with a high risk of recurrence. Three needed an open procedure. Three early complications (2 periprosthetic hematomas, 1 microscopic bladder injury) were treated by another laparoscopy; a bowel loop retained in a trocar orifice was reintegrated under local anesthesia; dysesthesias of the lateral cutaneous nerve of the thigh in 1 patient and nonspecific parietal pain in 2 patients resolved within three weeks. Three seromas resolved after only one percutaneous aspiration. The mean post operative pain, evaluated by a visual analogic scale graduated from 1 to 10 was 1.8 (0 to 6) at D1, 05 (0 to 2) at D2 and the mean duration of analgesic requirments was 1.7 (0 to 15) days. The mean hospital stay was 2 (1 to 17) days for unilateral herniorraphies and the mean time to return to work or normal activity was 10 (2 to 44) days, even in heavy workers (35 patients). All patients were reviewed. The mean follow-up was 4 (1 to 10) months. Two complications needed further laparoscopic treatment: 1 recurrence at the internal edge of the patch, easily restapled with a stronger stapler, 1 bowel adhesion between patch and bladder revealed by pain without obstruction. The recurrence rate was 0.6% (1/162). The conversion rate was 2% (3/162) and the overall morbidity was 7.5% (12/162), decreasing respectively to 0 and 4% after the learning curve. This study confirms that Spaw's technique and its variant are feasible, and allows us to continue this study, and suggest these techniques would be useful in the treatment of some recurrent inguinal hernias.

  11. Groin hernia subtypes are associated in patients with bilateral hernias

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Andresen, Kristoffer; Pommergaard, Hans-Christian

    2015-01-01

    BACKGROUND: To investigate the relation between groin hernia subtypes in patients operated for bilateral hernias. METHODS: With data from the Danish Hernia Database, we identified all patients operated for primary groin hernias from 1998 to 2012. Within this cohort all patients that were...... bilaterally operated were analyzed. Risk factors for bilateral groin hernia operation as well as the relationship between groin hernia subtypes bilaterally, were analyzed using multivariate Cox proportional hazards analysis and Kappa statistics. RESULTS: A total of 108, 775 persons with primary groin hernia...... repair (89.9% males) were registered, and of those were 12,041 persons operated bilaterally (94.9% males). Females and males operated for a unilaterally direct inguinal hernia (DIH) had increased Hazard Ratios (HR) of 3.85 (CI 95% 2.14-6.19) and 4.46 (CI 95% 2.57-7.88) of being contralaterally operated...

  12. The Amyand’s Hernia: A Rare Clinical Entity Diagnosed by Computed Tomography

    Directory of Open Access Journals (Sweden)

    Suat Keskin

    2013-01-01

    Full Text Available Amyand’s hernia, named for the first person to describe an inguinal hernia containing the vermiform appendix, is an uncommon variant of an inguinal hernia. Amyand’s hernia is an extremely rare condition and is often misdiagnosed. Traditionally, these hernias have been diagnosed at surgery but are increasingly diagnosed by abdominal computed tomography (CT scans. CT of the abdomen may help in guiding the diagnosis.

  13. Unusual complications of incisional hernia | Emegoakor | Annals of ...

    African Journals Online (AJOL)

    The patient with ruptured hernia and eviscerated gut presented immediately and was resuscitated and the hernia repaired with polypropylene mesh. The patient with incarcerated uterus had caesarean section and mesh repair of the hernia. Incisional hernia can present with unusual complications. The management is very ...

  14. Sportsman's hernia? An ambiguous term.

    Science.gov (United States)

    Dimitrakopoulou, Alexandra; Schilders, Ernest

    2016-04-01

    Groin pain is common in athletes. Yet, there is disagreement on aetiology, pathomechanics and terminology. A plethora of terms have been employed to explain inguinal-related groin pain in athletes. Recently, at the British Hernia Society in Manchester 2012, a consensus was reached to use the term inguinal disruption based on the pathophysiology while lately the Doha agreement in 2014 defined it as inguinal-related groin pain, a clinically based taxonomy. This review article emphasizes the anatomy, pathogenesis, standard clinical assessment and imaging, and highlights the treatment options for inguinal disruption.

  15. A cadaveric exposure of an oblique inguinoscrotal hernia | Joshua ...

    African Journals Online (AJOL)

    Even though inguinal hernia is a common finding, the challenge lies in its surgical reduction. Present report not only emphasizes on the content of the hernia sac but also on the morphological and structural alterations occurring in the abdominal cavity to accommodate a longstanding, untreated, non-obstructed inguinal ...

  16. Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques

    OpenAIRE

    Demirci, Abdurrahman; Efe, Esra Mercanoglu; Türker, Gürkan; Gurbet, Alp; Kaya, Fatma Nur; Anil, Ali; Çimen, İlker

    2014-01-01

    Objectives:The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy.Methods:40 patients, ASA I-II status were randomized into two groups equally: in Group AN (anatomical landmark technique) and in Group ultrasound (ultrasound guided technique), iliohypogastric/ilioinguinal nerve block was performed with ...

  17. [Infrequent etiology inguinal tumor: Nuck channel cyst].

    Science.gov (United States)

    Cabistany-Esqué, A C; Martinez-Medel, J; Royo-Arilla, B; Sanz-Asín, O; Aísa-Rivera, G

    2016-04-01

    Cyst of Nuck is an infrequent disease originated in the inadequate obliteration of the processus vaginalis during the embrionary life of the woman. Clinically usually appears as a slowly growth inguinal tumor, painless, smooth, soft, fluctuant and irreducible. Differential diagnosis must include inguinal hernia and other etiologies of inguinal tumor, for which echography is the main diagnostic test. Treatment consists on surgical extirpation and local reparation. It is exposed a case of a patient with cyst of Nuck clinically typical. It is made a review of clinical, diagnostic and therapeutic approach of this disease.

  18. Inguinal herniation with hydrometra/mucometra in a poodle bitch

    OpenAIRE

    Sontas, B. Hasan; Toydemir, F.T. Seval; Erdogan, Özge; Şennazli, Gülbin; Ekici, Hayri

    2013-01-01

    A 5-year-old, sexually intact poodle bitch was presented with a 2-year history of inguinal mass. A tentative diagnosis of hydrometra/mucometra with inguinal herniation was made and ovariohysterectomy with hernia repair was performed. Both fluid-filled uterine horns, both broad ligaments, and the uterine body were observed to be herniated through the inguinal ring. On histopathology, marked edema and diffuse hemorrhage were diagnosed in the uterus.

  19. Chronic Post Inguinal Herniorraphy Pain: Prevalence and Risk Factors

    African Journals Online (AJOL)

    Background: Inguinal hernia is a common surgical condition. Whereas complications associated with hernia repair are well documented, chronic postoperative groin pain has received less attention. Objective: To review the frequency and associated risk factors for chronic post herniorrhaphy groin pain at a tertiary urban ...

  20. Ultrasonic diagnosis of strangulated Richter's hernia

    International Nuclear Information System (INIS)

    Aakhus, S.; Roeysland, P.; Husby, O.S.

    1990-01-01

    Ultrasonography may show early pathological changes in an obstructed intestine and also identify abnormal structures in the abdominal wall and inguinal region. A patient with intestinal obstruction due to a femoral hernia of Richter's type, is described. The hernia was well shown by ultrasonography. Ultrasonic examination of the abdomen, including the inguinal regions, may facilitate earlier diagnosis in patients with acute abdominal disease. 9 refs., 2 figs

  1. Team Training (Training at Own Facility versus Individual Surgeon’s Training (Training at Trainer’s Facility When Implementing a New Surgical Technique: Example from the ONSTEP Inguinal Hernia Repair

    Directory of Open Access Journals (Sweden)

    Jacob Rosenberg

    2014-01-01

    Full Text Available Background. When implementing a new surgical technique, the best method for didactic learning has not been settled. There are basically two scenarios: the trainee goes to the teacher’s clinic and learns the new technique hands-on, or the teacher goes to the trainee’s clinic and performs the teaching there. Methods. An informal literature review was conducted to provide a basis for discussing pros and cons. We also wanted to discuss how many surgeons can be trained in a day and the importance of the demand for a new surgical procedure to ensure a high adoption rate and finally to apply these issues on a discussion of barriers for adoption of the new ONSTEP technique for inguinal hernia repair after initial training. Results and Conclusions. The optimal training method would include moving the teacher to the trainee’s department to obtain team-training effects simultaneous with surgical technical training of the trainee surgeon. The training should also include a theoretical presentation and discussion along with the practical training. Importantly, the training visit should probably be followed by a scheduled visit to clear misunderstandings and fine-tune the technique after an initial self-learning period.

  2. A técnica de Lichtenstein nas hérnias inguinais primárias e recidivadas - cirurgia ambulatorial em hospital universitário Lichtenstein hernia repair in primary and recurrent inguinal hernias - ambulatory surgery in a university hospital

    Directory of Open Access Journals (Sweden)

    Marco Antonio de Oliveira Peres

    2007-12-01

    üente nos ambulatórios.BACKGROUND: Lichtenstein hernia repair is gold standard in inguinal hernia surgeries, allowing a tension-free polypropylene mesh, low recurrence, wide applicability, easy teaching to young surgeons, early discharge and lower costs. AIM: A retrospective analysis was made using the results in the ambulatory surgery of primary inguinal hernias and recurrences, performing the Lichtenstein technique in a University Hospital. METHODS: From August of 1994 to December of 2001, 343 inguinal hemioplasties were performed in 326 patients with primary and recurrent inguinal hernias. Three hundred and four (88.6% were male, with ages ranging between 19 to 85 years. Concomitant diseases were observed in 196 cases (60.1%, were hypertension, smoking and cardiopathy were predominant. Regarding the side of the hernias, 232 were on the right and 94 on the left side; seventeen male patients (7.3% showed bilateral presentation. Among the 38 (11.1% recurrent hernias, 27 were on the right side. The classic Lichtenstein technique was indicated in all, using polypropylene mesh, of 15 x 7.5 cm. RESULTS: Local anesthesia was the first choice in 55.9% of cases. Anesthetist intervention and the conversion of the local anesthesia for general was necessary in only one case (0.3%. Four patients needed single day hospital admissions. Early local complications were of seroma: 15 cases; superficial infection of operative wound: 11 (3.3%; hematoma: 5 cases and venous thrombosis of the spermatic cord : 2 cases. After a five year follow-up, hernia recurrences were observed in three cases (0.87%. CONCLUSION: The technique revealed to be of easy application, could be performed under local anesthesia and as an outpatient, with low rates of complications and recurrences. It also allowed students and residents to learn the technique, as well as to attend to such demanding and frequent disease in daily clinics.

  3. Pain control following inguinal herniorrhaphy: current perspectives

    Directory of Open Access Journals (Sweden)

    Bjurstrom MF

    2014-05-01

    Full Text Available Martin F Bjurstrom,1,* Andrea L Nicol,2,* Parviz K Amid,3 David C Chen3 1Department of Anesthesiology, UCLA, Los Angeles, CA, USA; 2Department of Anesthesiology, University of Kansas, Kansas City, KS, USA; 3Department of Surgery, Lichtenstein Amid Hernia Clinic at UCLA, UCLA, Los Angeles, CA, USA *These authors contributed equally to this work Abstract: Inguinal hernia repair is one of the most common surgeries performed worldwide. With the success of modern hernia repair techniques, recurrence rates have significantly declined, with a lower incidence than the development of chronic postherniorrhaphy inguinal pain (CPIP. The avoidance of CPIP is arguably the most important clinical outcome and has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. The etiology of CPIP is multifactorial, with overlapping neuropathic and nociceptive components contributing to this complex syndrome. Treatment is often challenging, and no definitive treatment algorithm exists. Multidisciplinary management of this complex problem improves outcomes, as treatment must be individualized. Current medical, pharmacologic, interventional, and surgical management strategies are reviewed. Keywords: inguinodynia, chronic postherniorrhaphy inguinal pain, inguinal hernia

  4. Pain related sexual dysfunction after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Aasvang, Eske Kvanner; Møhl, Bo; Bay-Nielsen, Morten

    2006-01-01

    To determine the incidence of pain related sexual dysfunction 1 year after inguinal herniorrhaphy and to assess the impact pain has on sexual function. In contrast to the well-described about 10% risk of chronic wound related pain after inguinal herniorrhaphy, chronic genital pain, dysejaculation......, and sexual dysfunction have only been described sporadically. The aim was therefore to describe these symptoms in a questionnaire study. A nationwide detailed questionnaire study in September 2004 of pain related sexual dysfunction in all men aged 18-40 years undergoing inguinal herniorrhaphy between October...... 2002 and June 2003 (n=1015) based upon the nationwide Danish Hernia Database collaboration. The response rate was 68.4%. Combined frequent and moderate or severe pain from the previous hernia site during activity was reported by 187 patients (18.4%). Pain during sexual activity was reported by 224...

  5. Iliohypogastric/ilioinguinal nerve block in inguinal hernia repair for postoperative pain management: comparison of the anatomical landmark and ultrasound guided techniques

    Directory of Open Access Journals (Sweden)

    Abdurrahman Demirci

    2014-09-01

    Full Text Available Objectives: The purpose of this study is to compare the efficacy of iliohypogastric/ilioinguinal nerve blocks performed with the ultrasound guided and the anatomical landmark techniques for postoperative pain management in cases of adult inguinal herniorrhaphy. Methods: 40 patients, ASA I-II status were randomized into two groups equally: in Group AN (anatomical landmark technique and in Group ultrasound (ultrasound guided technique, iliohypogastric/ilioinguinal nerve block was performed with 20 ml of 0.5% levobupivacaine prior to surgery with the specified techniques. Pain score in postoperative assessment, first mobilization time, duration of hospital stay, score of postoperative analgesia satisfaction, opioid induced side effects and complications related to block were assessed for 24 h postoperatively. Results: VAS scores at rest in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.01 or p < 0.001. VAS scores at movement in the recovery room and all the clinical follow-up points were found significantly less in Group ultrasound (p < 0.001 in all time points. While duration of hospital stay and the first mobilization time were being found significantly shorter, analgesia satisfaction scores were found significantly higher in ultrasound Group (p < 0.05, p < 0.001, p < 0.001 respectively. Conclusion: According to our study, US guided iliohypogastric/ilioinguinal nerve block in adult inguinal herniorrhaphies provides a more effective analgesia and higher satisfaction of analgesia than iliohypogastric/ilioinguinal nerve block with the anatomical landmark technique. Moreover, it may be suggested that the observation of anatomical structures with the US may increase the success of the block, and minimize the block-related complications.

  6. Mesh repair of hernias of the abdominal wall

    NARCIS (Netherlands)

    W.W. Vrijland (Wietske)

    2003-01-01

    textabstractA hernia of the abdominal wall is a permanent or intermittent protrusion of abdominal contents outside the abdominal cavity through a defect in the abdominal wall. Approximately 75% of all hernias occur in the inguinal region. Other types of hernias of the ventral abdominal wall are

  7. Groin hernia repair in young males: mesh or sutured repair?

    DEFF Research Database (Denmark)

    Bisgaard, T; Bay-Nielsen, M; Kehlet, H

    2010-01-01

    Large-scale data for the optimal inguinal hernia repair in younger men with an indirect hernia is not available. We analysed nationwide data for risk of reoperation in younger men after a primary repair using a Lichtenstein operation or a conventional non-mesh hernia repair....

  8. Abdominal Wall Hernia: new perspectives for clinical research

    NARCIS (Netherlands)

    H.H. Eker (Hasan)

    2014-01-01

    markdownabstract__Abstract__ Abdominal wall surgery is a broad term, covering different treatment strategies for all different types of abdominal wall hernias. For example, an inguinal hernia is a totally different entity than an incisional hernia and requires a different treatment strategy.

  9. Abdominal wall hernia and pregnancy

    DEFF Research Database (Denmark)

    Jensen, K K; Henriksen, N A; Jorgensen, L N

    2015-01-01

    PURPOSE: There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. METHODS: A literature search was undertaken in Pub......Med and Embase in combination with a cross-reference search of eligible papers. RESULTS: We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery...... of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported...

  10. International guidelines for groin hernia management.

    Science.gov (United States)

    2018-02-01

    waiting is suggested in pregnant women as groin swelling most often consists of self-limited round ligament varicosities. Timely mesh repair by a laparo-endoscopic approach is suggested for femoral hernias provided expertise is available. All complications of groin hernia management are discussed in an extensive chapter on the topic. Overall, the incidence of clinically significant chronic pain is in the 10-12% range, decreasing over time. Debilitating chronic pain affecting normal daily activities or work ranges from 0.5 to 6%. Chronic postoperative inguinal pain (CPIP) is defined as bothersome moderate pain impacting daily activities lasting at least 3 months postoperatively and decreasing over time. CPIP risk factors include: young age, female gender, high preoperative pain, early high postoperative pain, recurrent hernia and open repair. For CPIP the focus should be on nerve recognition in open surgery and, in selected cases, prophylactic pragmatic nerve resection (planned resection is not suggested). It is suggested that CPIP management be performed by multi-disciplinary teams. It is also suggested that CPIP be managed by a combination of pharmacological and interventional measures and, if this is unsuccessful, followed by, in selected cases (triple) neurectomy and (in selected cases) mesh removal. For recurrent hernia after anterior repair, posterior repair is recommended. If recurrence occurs after a posterior repair, an anterior repair is recommended. After a failed anterior and posterior approach, management by a specialist hernia surgeon is recommended. Risk factors for hernia incarceration/strangulation include: female gender, femoral hernia and a history of hospitalization related to groin hernia. It is suggested that treatment of emergencies be tailored according to patient- and hernia-related factors, local expertise and resources. Learning curves vary between different techniques. Probably about 100 supervised laparo-endoscopic repairs are needed to

  11. Predicting 30-day postoperative mortality for emergent anterior abdominal wall hernia repairs using the American College of Surgeons National Surgical Quality Improvement Program database.

    Science.gov (United States)

    Chung, P J; Lee, J S; Tam, S; Schwartzman, A; Bernstein, M O; Dresner, L; Alfonso, A; Sugiyama, G

    2017-06-01

    Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous. Only emergent cases occurring within two days of admission and admitted as inpatients were included. Univariate and multivariable analysis was performed. A risk score was also created. There were 4298 cases of emergent anterior abdominal wall hernia surgery. The most common was inguinal (25.3 %), followed by incisional (23.8 %), umbilical (23.5 %), ventral (12.1 %), femoral (8.8 %), and epigastric (6.5 %) hernias. Multivariable analysis demonstrated six statistically significant predictors of short-term mortality, including history of congestive heart failure (CHF) [odds ratio (OR) 8.24, 95 % confidence interval (CI) 4.05-16.75), age (OR 5.52, 95 % CI 3.48-8.77), history of peripheral vascular disease (PVD) (OR 4.98, 95 % CI 2.08-11.92), presence of ascites (OR 3.16, 95 % CI 1.64-6.08), preoperative blood urea nitrogen (OR 1.35, 95 % CI 1.22-1.49), and preoperative white blood cell count (OR 1.22, 95 % CI 1.02-1.45). The C-statistic for the risk model was 0.858. We present a large study on short-term mortality following emergent anterior abdominal wall hernia repairs based on the ACS NSQIP with a derived risk model that demonstrates excellent discriminative ability.

  12. An Unusual Trocar Site Hernia after Prostatectomy

    Directory of Open Access Journals (Sweden)

    Ryan K. Schmocker

    2016-01-01

    Full Text Available Trocar site hernias are rare complications after laparoscopic surgery but most commonly occur at larger trocar sites placed at the umbilicus. With increased utilization of the laparoscopic approach the incidence of trocar site hernia is increasing. We report a case of a trocar site hernia following an otherwise uncomplicated robotic prostatectomy at a 12 mm right lower quadrant port. The vermiform appendix was incarcerated within the trocar site hernia. Subsequent appendectomy and primary repair of the hernia were performed without complication.

  13. Herniographic appearance of the lateral inguinal fossa

    International Nuclear Information System (INIS)

    Ekberg, O.; Kesek, P.

    1987-01-01

    Herniography frequently reveals clinically undetected groin hernia. Thereby herniography contributes to the clinical work-up in patients with obscure groin pain. However, the distinction between clinically important and unimportant abnormalities within the lateral inguinal fossa can be difficult. This study was therefore designed in order to elucidate the herniographic appearance of the lateral inguinal fossa in patients with obscure groin pain. Herniographic findings were compared with laterality of the patients' symptoms. The lateral umbilical fold was visible in only 47% of the groins. A triangular shaped outpouching from the lateral inguinal fossa and a patent processus vaginalis were found with equal frequency on the left and right side. They were five times as frequent in men as in women. Their presence did not correlate with laterality of the patients' symptoms. Indirect hernias were almost twice as common on the symptomatic side as compared with the asymptomatic side. On the left side they were found twice as often in men as in women while there was no significant sex difference on the right side. Our results show that neither a patent processus vaginalis nor a triangular outpouching from the lateral inguinal fossa correlate with the laterality of the patients' symptoms while true indirect hernias do. (orig.)

  14. Sportsman’s hernia? An ambiguous term

    Science.gov (United States)

    Dimitrakopoulou, Alexandra; Schilders, Ernest

    2016-01-01

    Groin pain is common in athletes. Yet, there is disagreement on aetiology, pathomechanics and terminology. A plethora of terms have been employed to explain inguinal-related groin pain in athletes. Recently, at the British Hernia Society in Manchester 2012, a consensus was reached to use the term inguinal disruption based on the pathophysiology while lately the Doha agreement in 2014 defined it as inguinal-related groin pain, a clinically based taxonomy. This review article emphasizes the anatomy, pathogenesis, standard clinical assessment and imaging, and highlights the treatment options for inguinal disruption. PMID:27026822

  15. SAFETY OF DAYCARE HERNIA REPAIR IN JOS, NIGERIA V.M. ...

    African Journals Online (AJOL)

    hi-tech

    2000-06-06

    Jun 6, 2000 ... Objective: To evaluate the safety of day surgery for inguinal hernia. Design: A randomised prospective study of patients presenting for elective inguinal hernia repair. Setting: Jos University Teaching, Jos, Nigeria. Subjects: One hundred and twenty one patients who completed a six-week follow up period.

  16. Safety of daycare hernia repair in Jos, Nigeria | Ramyil | East African ...

    African Journals Online (AJOL)

    Objective: To evaluate the safety of day surgery for inguinal hernia. Design: A randomised prospective study of patients presenting for elective inguinal hernia repair. Setting: Jos University Teaching, Jos, Nigeria. Subjects: One hundred and twenty one patients who completed a six-week follow up period. Interventions: Sixty ...

  17. Topical versus caudal ketamine/bupivacaine combination for postoperative analgesia in children undergoing inguinal herniotomy

    Directory of Open Access Journals (Sweden)

    Hala Saad Abdel-Ghaffar

    2017-01-01

    Conclusion: Wound instillation of bupivacaine/ketamine is a simple, noninvasive, and effective technique that could be a safe alternative to CK for postoperative analgesia in children undergoing inguinal hernia repair.

  18. Experience of Varicocele Management During Ipsilateral Inguinal Herniorrhaphy: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Shiou-Sheng Chen

    2010-05-01

    Conclusion: Simultaneous herniorrhaphy and varicocelectomy are suggested for patients who have inguinal hernia and ipsilateral varicocele, but the average operation time is significantly longer and there is a higher rate of hydrocele than with herniorrhaphy only.

  19. Peritoneography for diagnosis of non-palpable herniae

    International Nuclear Information System (INIS)

    Schumacher, K.H.

    1981-01-01

    The detection of non-palpable hernia by means of peritoneography is mostly unknown in the German-speaking areas. By injection of an iodine-containing contrast medium into the abdominal cavity, and with the corresponding positioning of the patient, a hernia can certainly be diagnosed or excluded. This method is indicated in cases of inguinal pain with undetected genesis, particularly in adipose patients, for detecting recidivous herniae with postoperative complaints, for the diagnosis of traumatic herniae or abdominal wall herniae. Between July 1, 1979 and December 31, 1980 peritoneography was performed in 154 patients in Bruchsal Hospital in order to detect herniae. (orig./MG) [de

  20. Pain control following inguinal herniorrhaphy: current perspectives

    Science.gov (United States)

    Bjurstrom, Martin F; Nicol, Andrea L; Amid, Parviz K; Chen, David C

    2014-01-01

    Inguinal hernia repair is one of the most common surgeries performed worldwide. With the success of modern hernia repair techniques, recurrence rates have significantly declined, with a lower incidence than the development of chronic postherniorrhaphy inguinal pain (CPIP). The avoidance of CPIP is arguably the most important clinical outcome and has the greatest impact on patient satisfaction, health care utilization, societal cost, and quality of life. The etiology of CPIP is multifactorial, with overlapping neuropathic and nociceptive components contributing to this complex syndrome. Treatment is often challenging, and no definitive treatment algorithm exists. Multidisciplinary management of this complex problem improves outcomes, as treatment must be individualized. Current medical, pharmacologic, interventional, and surgical management strategies are reviewed. PMID:24920934

  1. Unusual Complications of Incisional Hernia

    African Journals Online (AJOL)

    Incisional hernia (IH) represent a breakdown or loss of continuity of a fascia closure.[1] IH occur in 11-23% of laparotomies.[2] It enlarges over time and can give rise to such complications as pain, discomfort, bowel obstruction, incarceration and strangulation. Furthermore, IHs reduce the quality-of-life and the chances of ...

  2. Internal inguinal ring closure by laparoscopy using homologous pericardium grafts in horses

    OpenAIRE

    Spagnolo, Julio David; Sinhorini, Idercio Luis; Baccarin, Raquel Yvonne Arantes; Ambrosio, Aline Magalhães; Souto, Maria Teresa de Mello; Ida, Keila Kazue; Silva, Luis Claudio Lopes Correia da

    2016-01-01

    ABSTRACT: The occlusion of inguinal ring is the treatment to avoid the inguinal hernia in horses. The aim of this study is evaluate the efficacy of homologous pericardium grafts for internal inguinal ring closure in horses, comparing mechanical or manual laparoscopic suture. Cross over study, using six healthy intact male Mangalarga breed horses aged between 3 and 12 years. Horses were operated under general anesthesia in 25º Trendelenburg position. Five laparoscopic portals were employed. Pe...

  3. Pinzamiento femoroacetabular: Conceptos básicos en una nueva causa de dolor inguinal

    OpenAIRE

    MARDONES R,RODRIGO; BARRIENTOS C,VÍCTOR; NEMTALA U,FERNANDO; TOMIC,ALEXANDER; SALINEROS U,MATÍAS

    2010-01-01

    Femoro-acetabular impingement is an anatomical disturbance of the hip, caused by a deformity of the acetabulum, femur or both that causes an abnormal contact between both structures during certain movements. Its prevalence is 10 to 15% and causes chronic inguinal pain. It can be confused with several other causes of inguinal pain such as hernias, facet syndromes, a renal colic, etc. Patients with this condition are usually young individuals with inguinal pain that may appear after a minor tra...

  4. Colon Perforations Causing Morgagni Hernia Case

    Directory of Open Access Journals (Sweden)

    Mustafa Ugur

    2014-08-01

    Full Text Available Herniation of the intraabdominal organs through a diaphragmatic defect that occurs due to the joining anomaly of the sternal and costal segments of diaphragm is known as Morgagni Hernia. Although most of the patients with Morgagni Hernia are asymptomatic, intestinal obstruction, incarceration and strangulation can rarely occur. An 83 years old female patient admitted with acute abdomen to our clinic. Morgagni hernia was detected with preoperative thoracic and abdominal computed tomography. We aimed to present our management in Morgagni Hernia in this study.

  5. Amyand’s Hernia: an Up-to-Date Review of the Literature

    Directory of Open Access Journals (Sweden)

    Dimitrios Patoulias

    2018-02-01

    Full Text Available Amyand’s hernia is defined as an inguinal hernia, containing the appendix within the hernia sac. Incidence of this rare condition rises up to 1% (0.19–1.7% of all inguinal hernia cases. Inflammation of the appendix within the inguinal sac is even rarer, as it corresponds to 0.1% (0.07–0.13% of all Amyand’s hernia cases. After a comprehensive review of the limited relevant literature, we aim through this review study to describe the pathophysiology of inflammation of the appendix – contained in the hernia sac – and present the latest data about the diagnostic approach and surgical treatment of Amyand’s hernia.

  6. Transperitoneal robotic-assisted laparoscopic radical prostatectomy and inguinal herniorrhaphy.

    Science.gov (United States)

    Finley, David S; Savatta, Dominic; Rodriguez, Esequiel; Kopelan, Adam; Ahlering, Thomas E

    2008-01-01

    Patients undergoing radical prostatectomy are at increased risk of development of post-operative inguinal hernias (IH). We present the largest series of transperitoneal combined robotic-assisted laparoscopic prostatectomy (RALP) and IH. After IRB approval, data from patients undergoing RALP at two centers were prospectively entered into a database and analyzed. IH were repaired robotically via a transperitoneal route with mesh. Between June 2002 and May 2007, 837 RALPs were performed, 80 of which included combined IH repair (9.6%), by two surgeons, T.A. and D.S. Forty-two patients (52.5%) had IH on pre-operative exam. Twenty-four hernias were left, 32 right, and 24 bilateral. Twenty-two patients had prior ipsilateral or contralateral herniorrhaphy. After dissection of the hernia sac, a swatch of flat Marlex mesh (n = 22), a polypropylene mesh plug (n = 19), an Ultrapro hernia system (n = 7), a Proceed coated mesh (n = 19), a 3D-Max (n = 37), a combination of both umbrella and flat mesh (n = 3), or suture alone (n = 2) was used. Inguinal herniorrhaphy added approximately 15 min of operative time in all cases. There was one hernia recurrence over an average follow-up period of 12.5 months (0.2-52 months). There was one complication attributable to IH repair-a urine leak which was attributed to anastomotic stretch due to reperitonealization. Urological surgeons should perform a thorough inguinal exam during preoperative evaluation and intraoperatively to detect subclinical inguinal hernias. Inguinal herniorrhaphy at the time of RALP is safe and should be routinely performed.

  7. Contemporary hernia smartphone applications (apps).

    Science.gov (United States)

    Connor, K; Brady, R R W; de Beaux, A; Tulloh, B

    2014-08-01

    Smartphone technology and downloadable applications (apps) have created an unprecedented opportunity for access to medical information and healthcare-related tools by clinicians and their patients. Here, we review the current smartphone apps in relation to hernias, one of the most common operations worldwide. This article presents an overview of apps relating to hernias and discusses content, the presence of medical professional involvement and commercial interests. The most widely used smartphone app online stores (Google Play, Apple, Nokia, Blackberry, Samsung and Windows) were searched for the following hernia-related terms: hernia, inguinal, femoral, umbilical, incisional and totally extraperitoneal. Those with no reference to hernia or hernia surgery were excluded. 26 smartphone apps were identified. Only 9 (35 %) had named medical professional involvement in their design/content and only 10 (38 %) were reviewed by consumers. Commercial interests/links were evident in 96 % of the apps. One app used a validated mathematical algorithm to help counsel patients about post-operative pain. There were a relatively small number of apps related to hernias in view of the worldwide frequency of hernia repair. This search identified many opportunities for the development of informative and validated evidence-based patient apps which can be recommended to patients by physicians. Greater regulation, transparency of commercial interests and involvement of medical professionals in the content and peer-review of healthcare-related apps is required.

  8. A rare case of a groin hernia: the Hesselbach's hernia.

    Science.gov (United States)

    van den Heuvel, B; Munoz Brands, R M; Beuerle, E Y; Dwars, B J

    2015-06-01

    A 61-year-old woman presented with pain in the left groin. The pain radiated from the groin to the knee. At physical examination, a non-reducible swelling was found lateral to the femoral vessels. A CT-scan showed herniation of fatty tissue through the lacuna musculorum. A laparoscopic repair was carried out. A large adipose structure was found herniating through the lacuna musculorum and originating from the Bogros area. It ran along the iliopsoas muscle, suppressing the femoral cutaneous nerve. The tissue was reduced and excised, and a polypropylene mesh was placed to cover the defect. Inguinal hernias are categorized as medial, lateral or femoral hernias. We describe a case in which a hernia through the lacuna musculorum was found, which is very rare and referred to as a Hesselbach's hernia.

  9. The Inguinal Herniation of the Ovary in the Newborn: Ultrasound and Color Doppler Ultrasound Findings

    Directory of Open Access Journals (Sweden)

    Omer Kaya

    2014-01-01

    Full Text Available Inguinal hernias in the newborn age group are seldom encountered. In the affected female patient, the ovaries, fallopian tubes, and the intestines may settle in the hernia sac. The early diagnosis of torsion in cases in which the ovary is herniated into the inguinal canal is of utmost importance in order to give surgery the chance of reduction and correction. In this paper, a case of an ovarian herniation into the inguinal canal without the presence of torsion is being presented, and the place of US and CDUS in the differential diagnosis of the situation is being discussed.

  10. Hernia of canal of nuck: Some considerations

    Directory of Open Access Journals (Sweden)

    Mirat Dholakia

    2015-01-01

    Full Text Available Hernia of canal of Nuck is an extension of peritoneal fold through the inguinal canal up to the labia majora. Defective obliteration of this peritoneal fold leads to herniation of abdominal content into the inguinal canal. Incidence of ovary and fallopian tube as contents of henia is rare overall and very rare in middle age women. This hernia would require surgical intervention once diagnosed, but type of intervention may vary. Although mesh repair is acceptable worldwide with low recurrence rate, nonmesh repair still has a place specifically in developing countries wherein cost consideration without significantly affecting outcome will be an important factor. Two cases treated with nonmesh repair are reported.

  11. Laparoscopic Hernia Repair in Infancy and Childhood; Evaluation of ...

    African Journals Online (AJOL)

    xp

    for the repair of congenital hernia in infancy and childhood with less recurrence rate. So, we conducted this prospective randomized study to compare RN technique with TNH technique for repair of congenital inguinal hernia in infancy and childhood as regards operative time, hospital stay, postoperative hydrocele formation ...

  12. Neonatal perforated Amyand's hernia presenting as an enterocutaneous scrotal fistula

    Directory of Open Access Journals (Sweden)

    Antonios Panagidis

    2015-07-01

    Full Text Available Perforation of the vermiform appendix in a septic neonate with an Amyand's hernia resulted in the formation of a scrotal enterocutaneous fistula. In conclusion from this exceptional complication, active parental awareness for any neonatal scrotal swelling is required, and an early operative policy for the neonatal inguinal hernia is significant.

  13. Chronic Post Inguinal Herniorraphy Pain: Prevalence and Risk Factors

    African Journals Online (AJOL)

    risk factors for chronic post herniorrhaphy groin pain at a tertiary urban hospital. Methods: A retrospective descriptive study using data retrieved from patient files and theatre logs was conducted. Only inguinal herniae patients 13 years and above were considered. Pain was self reported at least 3months to 2 years.

  14. Establishment and initial experiences from the Danish Ventral Hernia Database

    DEFF Research Database (Denmark)

    Helgstrand, F; Rosenberg, J; Bay-Nielsen, M

    2010-01-01

    , use of mesh or no mesh, type of suture material, and placement of the mesh. A total of 5,629 elective and 661 acute ventral hernia repairs were registered. After the first 2 years the registration rate was 70%. CONCLUSION: The first national ventral hernia database has been established. Preliminary...... of the Danish Ventral Hernia Database (DVHD). Furthermore, the first 2-year data from 2007 to 2008 are presented. METHODS: Registrations were based on surgeons' web registrations and validated by cross checking with data from the Danish National Patient Register. RESULTS: The DVHD was established in June 2006......% of all hernia repairs as in the Danish Inguinal Hernia Database....

  15. Resterilized Polypropylene Mesh for Inguinal Hernia Repair

    African Journals Online (AJOL)

    2018-04-19

    Apr 19, 2018 ... Cost, availability of mesh, and perhaps reluctance to adopt a new technique are factors which prevent widespread ..... critical to preventing postoperative surgical site infection which potentially increases the cost of ... not recorded in 10 years of practice an incident of wound infection. In vitro bacteriological ...

  16. The MRI findings of a de Garengeot hernia.

    LENUS (Irish Health Repository)

    Halpenny, D

    2012-03-01

    The presence of the appendix within a femoral hernia is rare. It was first described by the French surgeon Jacques Croissant de Garengeot in 1731. This phenomenon accounts for 0.8-1% of all femoral hernias. Acute appendicitis occurring within a femoral hernia is even rarer and is difficult to diagnose pre-operatively. This type of hernia is termed a de Garengeot hernia. The ultrasonographic and CT imaging features of de Garengeot hernias have been described previously. We report a case of a 57-year-old female who presented with a painful right-sided groin mass. She underwent MRI of the inguinal region, which successfully diagnosed this rare hernia pre-operatively. To our knowledge, this is the first description of a de Garengeot hernia diagnosed using MRI.

  17. Laparoscopic repair of abdominal wall hernia: one-year experience

    Science.gov (United States)

    Kavic, Michael S.

    1993-05-01

    In this study, 101 consecutive laparoscopic transabdominal preperitoneal hernia repairs (LTPR) were performed in 62 patients by a single surgeon. The series was begun in April 1991, and involved repair of 49 direct, 41 indirect, 4 femoral, 3 umbilical, 3 sliding, and 1 incisional hernias. Twelve cases were bilateral, eleven hernias were incarcerated, and fifteen hernias were recurrent. There were no intraoperative complications, and none of the procedures required conversion to open surgery. Patients experienced the following postoperative complications: transient testicular pain (1), transient anterior thigh paresthesias (2), urinary retention requiring TURP (1), and hernia recurrences (2). Follow up has ranged from 4 - 15 months and initial results have been encouraging.

  18. Standing laparoscopic inguinal hernioplasty using cyanoacrylate for preventing recurrence of acquired strangulated inguinal herniation in 10 stallions.

    Science.gov (United States)

    Rossignol, Fabrice; Mespoulhes-Rivière, Céline; Vitte, Amélie; Lechartier, Antoine; Boening, Karl Joseph

    2014-01-01

    To describe a technique for standing inguinal hernioplasty in horses using cyanoacrylate glue, and to evaluate its effect on prevention of recurrent inguinal herniation in stallions that had previous acquired strangulated inguinal hernia (SIH). Case series. Stallions (n = 10) with a history of SIH. Hernioplasty was performed in standing horses using 4 laparoscopic portals. The mesorchium was retracted caudomedially using Babcock forceps. A flexible polyethylene extension tube was introduced through the sheath of a laparoscopic needle and n-butyl-2-cyanoacrylate (2 mL) was injected into the inguinal canal including its margins while a 2nd Babcock forceps prevented deep ventral diffusion of the cyanoacrylate. The craniolateral parts of the vaginal ring were compressed until full adhesion between the visceral and parietal walls was achieved. In 2 horses, the lateral part of the vaginal ring was sutured before gluing. A contralateral approach was used to check the caudomedial part of the vaginal ring. No recurrence (1-4 years) of inguinal hernia was reported. No major complications occurred and cosmetic outcome was excellent. All horses were used for their intended purpose and 7 horses being used as breeding stallions remained fertile. Standing inguinal hernioplasty using cyanoacrylate seems to provide efficient and secure closure of the vaginal ring in stallions. © Copyright 2013 by The American College of Veterinary Surgeons.

  19. Rare abdominal wall hernias in South Sudan

    African Journals Online (AJOL)

    1. Ordinary direct inguinal hernias which are less frequent in Africa and seldom strangulate (as one has in Figure 6). They may cause no symptoms, remain the same size for long periods and may not need surgery. 2. The BH which is caused by a narrow defect in the conjoint tendon or transversalis fascia and consequently.

  20. Diagnosis and treatment of obturator hernia

    Energy Technology Data Exchange (ETDEWEB)

    Nakayama, Takamori; Kobayashi, Seiji; Shiraishi, Kou; Nishiumi, Takao; Mori, Syunji; Isobe, Kiyoshi; Furuta, Yoshiaki [Shizuoka Red Cross Hospital (Japan)

    2002-09-01

    Obturator hernia is a rare type of hernia, but it is a significant cause of intestinal obstruction due to the associated anatomy. Correct diagnosis and treatment of obturator hernia is important, because delay can lead to high mortality. Twelve patients with obturator hernia were managed during a 11-year period, including 11 women and 1 man with a mean age of 82 years. We compared our experience with the previously published data to establish standards for the diagnosis and treatment of this hernia. All 12 patients presented with intestinal obstruction. The median interval from admission to operation was 2 days. The Howship-Romberg sign was positive in 5 patients. A correct diagnosis was made in all 8 patients who underwent pelvic CT scanning. Surgery was performed via an abdominal approach (n=7) or an inguinal approach (n=5). The hernial orifice was closed using the uterine fundus (n=6), a patch (n=5), and direct suture (n=1). Mean follow-up time was 33 months, and no recurrence has been detected. The poor physical condition of patients might have led to a delay in diagnosis and treatment. In troubled patients with nonspecific intestinal obstruction, CT scanning is useful for the early diagnosis of obturator hernia. Correct CT diagnosis of obturator hernia allows us to select the inguinal approach combined with patch repair, which is minimally invasive surgery. (author)

  1. Pain following the repair of an abdominal hernia

    DEFF Research Database (Denmark)

    Hansen, Mark Berner; Andersen, Kenneth Geving; Crawford, Michael Edward

    2010-01-01

    Pain and other types of discomfort are frequent symptoms following the repair of an abdominal hernia. After 1 year, the incidence of light to moderate pain following inguinal hernia repair is as high as 10% and 2% for severe disabling chronic pain. Postoperative chronic pain not only affects the ......, the paper provides an update on the diagnostic and treatment routines for postoperative pain.......Pain and other types of discomfort are frequent symptoms following the repair of an abdominal hernia. After 1 year, the incidence of light to moderate pain following inguinal hernia repair is as high as 10% and 2% for severe disabling chronic pain. Postoperative chronic pain not only affects...... the individual patient, but may also have a great impact on relatives and society, and may be a cause of concern for the responsible surgeon. This paper provides an overview of the anatomy, surgical procedures, and disposing factors (age, gender, ethnicity, genotype, previous hernia repair, pain prior to surgery...

  2. Sports Hernia: Diagnosis, Management and Operative Treatment

    Science.gov (United States)

    Emblom, Benton A.

    2017-01-01

    Objectives: Athletic Pubalgia, also known as sports hernia or core muscle injury, causes significant dysfunction in athletes. Increased recognition of this specific injury distinct from inguinal hernia pathology has led to better management of this debilitating condition. We hypothesize that patients who undergo our technique of athletic pubalgia repair will recover and return to high-level athletics. Methods: Using our billing and clinical database, patients who underwent sports hernia repair by single surgeon at a single institution were contacted for Harris hip score, functional outcome, and return to play data. Results: Of 101 patients who met criteria, 43 were contacted. 93% of patients were able to return to play at an average of 4.38 mo. Normal activities were rated at 95.5% and athletic function was rated at 88.9%. Negative predictors were female sex, multiple operations, and prior inguinal hernia repair. Overall complication rate was 4.6%, and reoperation rate was 4.6%. Conclusion: Our method of adductor to rectus abdominis turn up flap is a safe procedure with high return to play success. Patients who had previously undergone inguinal hernia repair or other hip/pelvic related surgery had a worse outcome.

  3. Amyand’s Hernia: Rare Presentation of a Common Ailment

    Directory of Open Access Journals (Sweden)

    Sanjeev Singhal

    2015-01-01

    Full Text Available Inguinal hernia with vermiform appendix as content is known as Amyand’s hernia. It is a rare entity but we encountered four cases within six months. A 52-year-old female had high grade fever and evidence of inflammatory pathology involving the ileocaecal region. She was initially managed conservatively and subsequently underwent exploratory laparatomy. The appendix was perforated and herniating in the inguinal canal. Appendectomy was done with herniorrhaphy without mesh placement. A 74-year-old male with bilateral inguinal hernia, of which, the right side was more symptomatic, underwent open exploration. Operative findings revealed a lipoma of the sac and a normal appearing appendix as content. Contents were reduced without appendectomy and mesh hernioplasty was performed. A 63-year-old male with an obstructed right sided hernia underwent emergency inguinal exploration which revealed edematous caecum and appendix as content without any inflammation. Contents were reduced without any resection. Herniorrhaphy was performed without mesh placement. A 66-year-old male with an uncomplicated right inguinal hernia underwent elective surgery. The sac revealed an appendix with adhesions at the neck. Contents were reduced after adhesiolysis and hernioplasty was performed with mesh placement. Emphasis is made to the rarity of disease, variation in presentation, and difference in treatment modalities depending upon the state of appendix.

  4. Spontaneous Enterocutaneous Fistula Resulting from Richter's Hernia.

    Science.gov (United States)

    Hajong, Ranendra; Khongwar, Donkupar; Komut, Ojing; Naku, Narang; Baru, Kappa

    2017-08-01

    Richter's hernia is due to the entrapment of a part of circumference of the bowel wall. As the bowel continuity is maintained, the patients usually do not have intestinal obstruction. Some patients with Richter's hernia may present with enterocutaneous fistula either spontaneous or due to surgical intervention mistaking the obstructed hernia to be inguinal abscess. This is more so in developing countries due to lack of awareness among the masses or due to the delay in seeking medical attention. Presenting here is a case of a 53-year-old male patient with enterocutaneous fistula which occurred spontaneously and sought medical attention only after about three years of repeated discharge of yellowish fluid from the left inguinal region. Magnetic resonance fistulogram confirmed the diagnosis of enterocutaneous fistula. Laparotomy with resection and primary anastomosis of the fistulous bowel was done. Patient recovered uneventfully without any complications or recurrence.

  5. Cesarean section and hernia repair: simultaneous approach.

    Science.gov (United States)

    Gabriele, Raimondo; Conte, Marco; Izzo, Luciano; Basso, Luigi

    2010-10-01

    Hernias of the abdominal wall occurring during pregnancy are usually treated a few weeks after delivery. The aim of this study was to retrospectively evaluate the clinical outcome of inguinal or umbilical hernioplasty performed at the time of the cesarean section, and to compare the outcome of this group with a control population, who received a cesarean section alone. We reviewed 28 women who developed an inguinal or umbilical hernia during pregnancy from January 1, 2000 to December 31, 2007 and who received a combined cesarean section and hernia repair, and we compared this group with 100 women (controls) who only received a cesarean section. In the group of women who received a combined cesarean section and inguinal or umbilical hernia repair, median age was 23.8 years and hospital stay ranged from 3 to 5 days (versus 3-4 days for cesarean sections alone). The time employed for the combined surgical procedure was of 50 ± 7 min and 70 ± 4 min, respectively, for umbilical and inguinal hernia (versus 37.4 ± 12.6 min for cesarean sections alone). No complication was recorded during the perinatal and follow-up periods, and no recurrences were observed. Our analysis suggests that cesarean section and hernia repair, performed in one session, avoids need for readmission to hospital, is safe, effective, and well accepted. It neither increases the complication rate nor prolongs the hospital stay, with clear advantages for both the patients and the hospital budget. © 2010 The Authors. Journal of Obstetrics and Gynaecology Research © 2010 Japan Society of Obstetrics and Gynecology.

  6. Ultrasonic diagnosis of strangulated Richter's hernia. Ultralydundersoekelse av strangulert Richters hernie

    Energy Technology Data Exchange (ETDEWEB)

    Aakhus, S.; Roeysland, P.; Husby, O.S. (University and Regional Hospital, Trondheim (Norway))

    1990-10-01

    Ultrasonography may show early pathological changes in an obstructed intestine and also identify abnormal structures in the abdominal wall and inguinal region. A patient with intestinal obstruction due to a femoral hernia of Richter's type, is described. The hernia was well shown by ultrasonography. Ultrasonic examination of the abdomen, including the inguinal regions, may facilitate earlier diagnosis in patients with acute abdominal disease. 9 refs., 2 figs.

  7. Dysejaculation after laparoscopic inguinal herniorrhaphy: a nationwide questionnaire study

    DEFF Research Database (Denmark)

    Bischoff, Joakim Mutahi; Linderoth, Gitte; Aasvang, Eske Kvanner

    2012-01-01

    BACKGROUND: Dysejaculation and pain from the groin and genitals during sexual activity represent a clinically significant problem in up to 4% of younger males after open inguinal herniorrhaphy. The aim of this questionnaire study is to assess the prevalence of dysejaculation and pain during sexual...... activity after laparoscopic inguinal herniorrhaphy on a nationwide basis. METHODS: The study population comprised all men aged 18-50 years registered in the Danish Hernia Database (n = 1,671) who underwent primary laparoscopic herniorrhaphy between January 1, 1998 and November 30, 2009. Questionnaires...

  8. Intrathoracic Hernia after Total Gastrectomy

    Directory of Open Access Journals (Sweden)

    Yoshihiko Tashiro

    2016-05-01

    Full Text Available Intrathoracic hernias after total gastrectomy are rare. We report the case of a 78-year-old man who underwent total gastrectomy with antecolic Roux-Y reconstruction for residual gastric cancer. He had alcoholic liver cirrhosis and received radical laparoscopic proximal gastrectomy for gastric cancer 3 years ago. Early gastric cancer in the remnant stomach was found by routine upper gastrointestinal endoscopy. We initially performed endoscopic submucosal dissection, but the vertical margin was positive in a pathological result. We performed total gastrectomy with antecolic Roux-Y reconstruction by laparotomy. For adhesion of the esophageal hiatus, the left chest was connected with the abdominal cavity. A pleural defect was not repaired. Two days after the operation, the patient was suspected of having intrathoracic hernia by chest X-rays. Computed tomography showed that the transverse colon and Roux limb were incarcerated in the left thoracic cavity. He was diagnosed with intrathoracic hernia, and emergency reduction and repair were performed. Operative findings showed that the Roux limb and transverse colon were incarcerated in the thoracic cavity. After reduction, the orifice of the hernia was closed by suturing the crus of the diaphragm with the ligament of the jejunum and omentum. After the second operation, he experienced anastomotic leakage and left pyothorax. Anastomotic leakage was improved with conservative therapy and he was discharged 76 days after the second operation.

  9. Modern diagnosis and treatment of hiatal hernias.

    Science.gov (United States)

    Siegal, Steve R; Dolan, James P; Hunter, John G

    2017-12-01

    Hiatal hernias are a common finding on radiographic or endoscopic studies. Hiatal hernias may become symptomatic or, less frequently, can incarcerate or become a volvulus leading to organ ischemia. This review examines latest evidence on the diagnostic workup and management of hiatal hernias. A literature review of contemporary and latest studies with highest quality of evidence was completed. This information was examined and compiled in review format. Asymptomatic hiatal and paraesophageal hernias become symptomatic and necessitate repair at a rate of 1% per year. Watchful waiting is appropriate for asymptomatic hernias. Symptomatic hiatal hernias and those with confirmed reflux disease require operative repair with an anti-reflux procedure. Key operative steps include the following: reduction and excision of hernia sac, 3 cm of intraabdominal esophageal length, crural closure with mesh reinforcement, and an anti-reflux procedure. Repairs not amenable to key steps may undergo gastropexy and gastrostomy placement as an alternative procedure. Hiatal hernias are commonly incidental findings. When hernias become symptomatic or have reflux disease, an operative repair is required. A minimally invasive approach is safe and has improved outcomes.

  10. Gross hematuria as the presentation of an inguinoscrotal hernia: a case report

    Directory of Open Access Journals (Sweden)

    Ansari Kayvan

    2011-12-01

    Full Text Available Abstract Introduction Several complications have been reported with inguinal hernias. Although hematuria and flank pain, either as the presentation or as a complication of inguinal hernia, are infrequent, this condition may lead to the development of obstructive uropathy, which can have diverse manifestations. Case presentation A 71-year-old Iranian man with Persian ethnicity presented with new onset episodes of gross hematuria and left-sided flank pain. A physical examination revealed a large and non-tender inguinal hernia on his left side. An initial workup included an abdominal ultrasound, an intravenous pyelogram and cystoscopy, which showed left hydronephrosis and a bulging on the left-side of his bladder wall. On further evaluation, computed tomography confirmed that his sigmoid colon was the source of the pressure effect on his bladder, resulting in hydroureteronephrosis and hematuria. No tumoral lesion was evident. Herniorrhaphy led to the resolution of his signs and symptoms. Conclusion Our case illustrates a rare presentation of inguinal hernia responsible for gross hematuria and unilateral hydronephrosis. Urologic signs and symptoms can be caused by the content of inguinal hernias. They can also present as complications of inguinal hernias.

  11. Strangulated Morgagni’s Hernia: A Rare Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Malav Modi

    2016-01-01

    Full Text Available Morgagni hernia is a rare type of congenital diaphragmatic hernia. It accounts for only 3% of all diaphragmatic hernias. The defect is small and hernia being asymptomatic in the majority presents late in adulthood. Obstruction or incarceration in Morgagni hernia is uncommon. We report a rare occurrence of strangulated Morgagni hernia. A 40-year-old gentleman presented to our emergency department with features of intestinal obstruction. Computed tomography of the chest and abdomen showed a strangulated right Morgagni hernia. An exploratory laparotomy was performed with resection of the ischemic bowel segment with anastomosis and a primary repair of the diaphragmatic defect. Postoperative recovery was uneventful and asymptomatic at follow-up.

  12. Inguinal herniation of the ascending colon in a 6-month-old Standardbred colt.

    Science.gov (United States)

    Robinson, Emily; Carmalt, James L

    2009-12-01

    To report inguinal herniation of the ascending colon in a Standardbred colt. Case report. A 6-month-old Standardbred colt. The colt underwent surgical exploration of the hernia with large colon resection and anastomosis. A successful large colon resection and anastomosis was completed, however, the colt was euthanatized at the end of surgery upon owner request. Although uncommon, indirect inguinal herniation of the ascending colon can occur in young horses.

  13. Reoperation Rates for Laparoscopic vs Open Repair of Femoral Hernias in Denmark

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Bisgaard, Thue; Kehlet, Henrik

    2014-01-01

    IMPORTANCE: In Denmark approximately 10 000 groin hernias are repaired annually, of which 2% to 4% are femoral hernias. Several methods for repair of femoral hernias are used including sutured repair and different types of mesh repair with either open or laparoscopic techniques. The use of many...... laparoscopic vs open femoral hernia repair, analyzing data from a nationwide database. DESIGN, SETTING, AND PARTICIPANTS: A prospective cohort study was conducted. Data on femoral hernia repairs registered in the Danish Hernia Database from January 1998 until February 2012 were extracted and analyzed. All...... repairs were followed in the database and analyzed for reports of reoperation, which were used as a proxy for recurrence. Femoral hernia recurrence and inguinal hernia occurrence after the index repair were analyzed. EXPOSURE: Repair of a femoral hernia. MAIN OUTCOMES AND MEASURES: Reoperation...

  14. Handlebar hernia: a case report and literature review on traumatic abdominal wall hernia in children.

    Science.gov (United States)

    van Bemmel, A J M; van Marle, A G J; Schlejen, P M; Schmitz, R F

    2011-08-01

    A rare case of abdominal trauma, a handlebar hernia, is described, as well as a review of the pertinent literature. A 7-year-old boy presented to our emergency room after sustaining blunt force to the abdomen; he fell on the handlebar of his bicycle. Immediately after the accident, a bulge was noticeable at the point of impact. Handlebar hernia is a diagnosis that is easily missed, which can lead to strangulation and incarceration of the bowel. With this case report, we hope to augment the knowledge on traumatic abdominal wall hernia, hopefully leading to early diagnosis and treatment.

  15. [Femoroacetabular impingement as a cause of inguinal pain].

    Science.gov (United States)

    Mardones R, Rodrigo; Barrientos C, Víctor; Nemtala U, Fernando; Tomic, Alexander; Salineros U, Matías

    2010-01-01

    Femoro-acetabular impingement is an anatomical disturbance of the hip, caused by a deformity of the acetabulum, femur or both that causes an abnormal contact between both structures during certain movements. Its prevalence is 10 to 15% and causes chronic inguinal pain. It can be confused with several other causes of inguinal pain such as hernias, facet syndromes, a renal colic, etc. Patients with this condition are usually young individuals with inguinal pain that may appear after a minor trauma. During examination, pain may be elicited by infernal rotation and abduction movements of hip, flexed in 90 degrees . Plain hip X ray is the most commonly used diagnostic method. Non-steroidal anti-inflammatory drugs and physical therapy can be used to alleviate pain, but the definitive treatment is surgical.

  16. Stomal Closure: Strategies to Prevent Incisional Hernia

    Directory of Open Access Journals (Sweden)

    Rhiannon L. Harries

    2018-04-01

    Full Text Available Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias.

  17. Stomal Closure: Strategies to Prevent Incisional Hernia

    Science.gov (United States)

    Harries, Rhiannon L.; Torkington, Jared

    2018-01-01

    Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias. PMID:29670882

  18. Use of a barbed suture for laparoscopic closure of the internal inguinal rings in a horse.

    Science.gov (United States)

    Ragle, Claude A; Yiannikouris, Stavros; Tibary, Ahmed A; Fransson, Boel A

    2013-01-15

    A 4-year-old castrated Arabian horse was evaluated for a history of a right-sided nonstrangulating inguinal hernia that was manually reducable. Physical examination revealed a right-sided hydrocele and bilateral enlargement of the inguinal rings detectable by both external digital and rectal palpation. Biportal laparoscopic internal inguinal ring closure was performed with a continuous suture line of unidirectional barbed suture applied with a mechanical suturing instrument. The barbed suture contributed to a secure closure with the added benefit of not requiring knots to be tied at either the beginning or end of the suture line. Follow-up physical examination and laparoscopy confirmed healing of the surgical sites and a reduction in size of the inguinal rings. The horse exercised for 20 months following surgery without recurrence of the inguinal hernia. In horses, laparoscopic application of unidirectional barbed sutures should be considered among the treatment options for recurrent inguinal herniation. This technique was accomplished with only 2 portals/side, in contrast to the additional 3 to 4 portals that are most commonly required. The use of a barbed suture with a mechanical suturing instrument offered added security to the closure. The difficulties of dual instrument suturing and intracorporeal knot tying were eliminated, dramatically reducing the challenges of performing suture reduction of the internal inguinal ring.

  19. Interposition of the omentum and/or the peritoneum in the emergency repair of large ventral hernias with polypropylene mesh.

    Science.gov (United States)

    Sorour, Magdy A

    2014-01-01

    Ventral and incisional hernias are common surgical problems and their repairs are among the common surgeries done by a general surgeon. Repair of a large ventral hernia is still associated with high postoperative morbidity and recurrence rates. No single approach to ventral hernia repair will be the best choice for all patients. Large ventral hernias are often better approached with open surgery but may still be problematic when the defect is too wide for primary fascial closure to be achieved, as this leaves mesh exposed, bridging the gap. Techniques for incisional hernia repair have evolved over many years, and the use of mesh has reduced recurrence rates dramatically. The use of polypropylene mesh is reported to be associated with long-term complications such as severe adhesions and enterocutaneous fistula, which occur more commonly if the mesh is applied intraperitoneally with direct contact of the serosal surface of the intestine. Composite meshes containing expanded polytetrafluoroethylene (ePTFE) have been used recently; their major drawbacks lie in their high cost, inferior handling characteristics, and poor incorporation into the tissues. Although several studies have clearly demonstrated the safety and efficacy of prosthetic mesh repair in the emergency management of the incarcerated and/or strangulated inguinal and ventral hernias, however, surgeons remained reluctant to use prosthetics in such settings. The aim of this work was to evaluate the effectiveness and safety of placing the omentum and/or the peritoneum of the hernia sac as a protective layer over the viscera in the emergency repair of large ventral hernias using on-lay polypropylene mesh whenever complete tension-free closure of the abdominal wall was impossible. This study was carried out on all patients with large ventral hernia presented to the Gastrointestinal Surgery Unit, Main Alexandria University Hospital in an emergency situation during the period from October 2005 till October 2012

  20. Colonic diverticulosis is associated with abdominal wall hernia.

    Science.gov (United States)

    Oma, E; Jorgensen, L N; Meisner, S; Henriksen, N A

    2017-08-01

    Colonic diverticulosis and abdominal wall hernia are common pathologies. Studies have suggested that connective tissue alterations play a role in the formation of both diverticulosis and abdominal wall hernia. The aim of this cohort study was to evaluate the association between diverticulosis and abdominal wall hernia in a large cohort of patients undergoing colonoscopy. All consecutive patients who underwent colonoscopy between 2001 and 2013 at Bispebjerg Hospital were eligible for inclusion. The endoscopists prospectively registered the findings of diverticulosis in a database. Data were merged with the Danish Hernia Database identifying patients who underwent groin and ventral hernia repair. Calculated odds ratios (ORs) were used to describe the extent of association and multivariable logistic regression models were utilized to adjust for age and gender. A total of 13,855 patients were included, 3685 (26.6%) of whom were diagnosed with diverticulosis. Diverticulosis was independently associated with direct inguinal, OR 1.33, 95% CI 1.00-1.76, P = 0.049, and umbilical/epigastric hernia repair, OR 1.74, 95% CI 1.16-2.63, P = 0.008. Colonic diverticulosis was associated with direct inguinal and umbilical/epigastric hernia repair suggesting that connective tissue alterations, herniosis, could be a common etiologic factor of colonic diverticulosis and these abdominal wall hernias.

  1. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    Directory of Open Access Journals (Sweden)

    Reza Firoozabadi

    2015-09-01

    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  2. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

    Directory of Open Access Journals (Sweden)

    Reza Firoozabadi

    2015-10-01

    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  3. Laparoscopic Diagnosis of Incarcerated “Spigelian Hernia”: Report of a Case and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sanoop Koshy Zachariah

    2011-01-01

    Full Text Available Spigelian hernias are rare hernias, representing only about 1-2% of all abdominal hernias. An accurate preoperative diagnosis of this condition is often difficult because the physical presence of these hernias is often not demonstrable owing to its peculiar anatomic location. Many patients with Spigelian hernias, therefore, may have no obvious findings on clinical examination. The diagnosis is even trickier in obese patients wherein the hernia sac may lie in an intraparietal plane, masked by the abdominal subcutaneous fat. Here we describe a case of incarcerated Spigelian hernia where clinical and radiological findings were inconsistent and the accurate diagnosis was made by laparoscopy and was followed by a laparoscopic-assisted repair using an open anterior approach with an onlay mesh. We therefore feel that laparoscopy can be a useful tool for confirming the diagnosis and also for performing a definitive repair in doubtful cases of Spigelian hernias.

  4. Open preperitoneal groin hernia repair with mesh

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    BACKGROUND: For the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique. DATA SOURCES......: A systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh......-analysis. Open preperitoneal techniques with placement of a mesh through an open approach seem promising compared with the standard anterior techniques. This systematic review provides an overview of these techniques together with a description of surgical methods and clinical outcomes....

  5. Open preperitoneal groin hernia repair with mesh

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Rosenberg, Jacob

    2017-01-01

    Background For the repair of inguinal hernias, several surgical methods have been presented where the purpose is to place a mesh in the preperitoneal plane through an open access. The aim of this systematic review was to describe preperitoneal repairs with emphasis on the technique. Data sources...... A systematic review was conducted and reported according to the PRISMA statement. PubMed, Cochrane library and Embase were searched systematically. Studies were included if they provided clinical data with more than 30 days follow up following repair of an inguinal hernia with an open preperitoneal mesh......-analysis. Open preperitoneal techniques with placement of a mesh through an open approach seem promising compared with the standard anterior techniques. This systematic review provides an overview of these techniques together with a description of surgical methods and clinical outcomes....

  6. Pain after groin hernia repair

    DEFF Research Database (Denmark)

    Callesen, T; Bech, K; Nielsen, R

    1998-01-01

    BACKGROUND: The purpose of the study was to provide a detailed description of postoperative pain after elective day-case open inguinal hernia repair under local anaesthesia. METHODS: This was a prospective consecutive case series study. After 500 hernia operations in 466 unselected patients aged 18......-90 years, pain was scored (none, light, moderate or severe) at rest, while coughing and during mobilization, daily for the first postoperative week and after 4 weeks. Pain scores were added together over the first postoperative week. RESULTS: On days 1, 6 and 28, 66, 33 and 11 per cent respectively had...... moderate or severe pain while coughing or mobilizing. Total pain scores were higher while coughing or mobilizing than at rest (P pain scores than older patients while coughing or mobilizing (P0

  7. Does nerve identification during open inguinal herniorrhaphy reduce the risk of nerve damage and persistent pain?

    DEFF Research Database (Denmark)

    Bischoff, J M; Aasvang, E K; Kehlet, H

    2012-01-01

    the risk of development of persistent postherniorrhaphy pain, sensory dysfunction in the groin and functional ability score after open hernia repair. METHODS: A total of 244 men with a primary inguinal hernia underwent open Lichtenstein repair in a high-volume hernia surgery centre, where information...... = 0.59), the genitofemoral nerve (P = 0.40) or all nerves (P = 0.52). There were no differences in regard to sensory loss in the groin area or in regard to improvement in functional outcome following surgery, between patients with and without nerve identification. CONCLUSIONS: Although intraoperative...

  8. ADULT ABDOMINAL WALL HERNIA IN IBADAN.

    Science.gov (United States)

    Ayandipo, O O; Afuwape, O O; Irabor, D O; Abdurrazzaaq, A I

    2015-12-01

    Abdominal wall hernias are very common diseases encountered in surgical practice. Groin hernia is the commonest type of abdominal wall hernias. There are several methods of hernia repair but tension-free repair (usually with mesh) offers the least recurrent rate. To describe the clinical profile of anterior abdominal wall hernias and our experience in the surgical management of identified hernias. The project was a retrospective study of all patients with abdominal wall hernia presenting into surgical divisions of University College Hospital Ibadan during a 6 year period (January 2008 to December 2013). Relevant information was retrieved from their case notes and analysed. The case records of 1215 (84.7%) patients out of 1435 were retrieved. Elective surgery was done in 981(80.7%) patients while 234 (19.3%) patients had emergency surgery. There were 922 (84.8%) groin hernias and post-operative incisional hernia accounted for 9.1% (111) of the patients. About half (49.1%) of those with incisional hernia were post obstetric and gynaecologic procedure followed by post laparotomy incisional hernias 16 (14%) and others (23.5%). The ratio of inguinal hernia to other types in this study is 3:1. Hollow viscus resection and emergency surgery were predictors of wound infection statistically significant in predicting wound infection (P < 0.001). Peri-operative morbidity/mortality at 28 days post operation was documented in 113 patients (12.1%). One year recurrence rate of groin hernia was 2.1%. The pattern of presentation and management of anterior wall hernias are still the same compared with the earlier study in this hospital. New modality of treatment should be adopted as the standard choice of care. Abdominal wall hernias are very common clinical presentation. Modified Bassini repair was the preferred method of repair due to its simplicity. Mesh repair is becoming more common in recent time but high cost and initial non-availability of the mesh limit its use in our centre.

  9. Smooth muscle cell differentiation in the processus vaginalis of children with hernia or hydrocele.

    Science.gov (United States)

    Mouravas, V K; Koletsa, T; Sfougaris, D K; Philippopoulos, A; Petropoulos, A S; Zavitsanakis, A; Kostopoulos, I

    2010-04-01

    Incomplete obliteration of the processus vaginalis (PV) in children with inguinal hernia or hydrocele has recently been proposed to relate to smooth muscle cell (SMC) persistence. The aim of this study was to evaluate the diversity and differentiation of smooth muscle phenotypes in sacs associated with inguinal hernia and hydrocele through the expression of alpha-smooth muscle actin (SMA), h-caldesmon, desmin, and vimentin. Sacs associated with male hernia (n = 22), female hernia (n = 8), and hydrocele (n = 10) were immunohistochemically evaluated using monoclonal antibodies against SMA, h-caldesmon, desmin, and vimentin. Peritoneal samples (male, 4; female, 3) and obliterated PV (male, 3) obtained from age-matched patients served as controls. Expressions according to the groups were compared through chi-squared test, and P values less than 0.05 were considered to be statistically significant. Immunohistochemistry did not shown the presence of SMCs in control samples. The expression of SMA, desmin, and h-caldesmon did not differ among sacs obtained from patients with inguinal hernia and hydrocele. However, strong expression of vimentin in SMCs within sacs obtained from patients with hydrocele in comparison with sacs from male patients with inguinal hernia were observed. Our results indicate that sacs from patients with inguinal hernias and especially from male inguinal hernias have fully differentiated SMCs. On the other hand SMCs in sacs obtained from boys with hydrocele are in an intermediate state of differentiation-dedifferentiation. This phenotypic modulation may represent attempted apoptosis of SMCs, since sacs more sensitive to apoptosis appeared to have more dedifferentiated SMCs. It also probably depicts the differing influence of sympathetic and parasympathetic tonuses during the descent of the testis and the obliteration of PV.

  10. Inguinal Herniation of a Transplant Ureter: Lessons Learned From a Case of "Water Over the Bridge".

    Science.gov (United States)

    Hakeem, Abdul R; Gopalakrishnan, Palanivel; Dooldeniya, Mohantha D; Irving, Henry C; Ahmad, Niaz

    2016-02-01

    Inguinal herniation of the transplant ureter is rare, and there is a paucity of reports in the literature. Herniation is usually secondary to implanting a long redundant ureter and may be precipitated by its course over the spermatic cord. Most often, there is loss of the allograft owing to delayed presentation and chronic ureteric obstruction. Here, we report a case of inguinal herniation of a transplant ureter with obstruction and graft dysfunction. A 72-year-old man presented 9 years after deceased-donor kidney transplant, with progressive graft dysfunction and a symptomatic right inguinal hernia. A nephrostogram and subsequent surgery confirmed herniation of a loop of transplant ureter into the inguinal canal with a proximal dilated ureter and hydronephrosis. A long and redundant ureter had been anastomosed "over" the spermatic cord to the bladder during the original operation. The ureter was shortened by excising the distal segment, and the proximal dilated ureter was anastomosed to the bladder passing it "underneath" the spermatic cord. We used a Vicryl (polyglactin 910) mesh to repair the hernia. The graft function improved to baseline levels after the nephrostomy and remained stable after the surgery. This case emphasizes the need to keep the ureter short, and the importance of passing it underneath the spermatic cord before anastomosing to the bladder. Transplant and general surgeons should be aware of such presentations of graft dysfunction with inguinal hernia to avoid delayed diagnosis and graft loss.

  11. Pulsed Radiofrequency in the Treatment of Persistent Pain After Inguinal Herniotomy

    DEFF Research Database (Denmark)

    Werner, Mads U; Bischoff, Joakim Mutahi; Rathmell, James P

    2012-01-01

    ABSTRACT: In the United States, it is estimated that between 6000 and 18,000 individuals each year present with disabling pain after inguinal hernia repair. Although surgical treatment with mesh removal is one of few options available, effective alternatives to nonsurgical management are needed. ...

  12. Sutures for inguinal herniorrhaphy--a comparison of monofilaments with PTFE.

    Science.gov (United States)

    Cahill, J.; Northeast, A. D.; Jarret, P. E.; Leach, R. D.

    1989-01-01

    Polybutester (Novafil, Davis & Geck) and expanded polytetrafluoroethylene PTFE (Gore-tex, W L Gore) were compared with nylon (Ethilon, Ethicon UK) for elective inguinal herniorrhaphy. PTFE had the best handling characteristics, but is expensive, and increased wound sepsis attended its use. Polybutester had significantly better handling characteristics, and is an attractive alternative to nylon for hernia repair. PMID:2705719

  13. [Celioscopic treatment of recurrence of inguinal hernia after insertion of a prosthesis. Value of the intraperitoneal technique with ePTFE patch? Group CHIC (Cure des Hernies Inguino-Crurales sous Coelioscopie)].

    Science.gov (United States)

    Gillion, J F; Balique, J G; Begin, G F; Elhadad, A; Fourtanier, G

    1996-01-01

    From April 1993 to December 1994, 14 failures of classic prosthetic herniorraphies in 13 patients (13 men) were treated by a laparoscopic intraperitoneal onlay mesh technique (IPOM) using an ePTFE patch. The mean age of these patients was 55.69 +/- 13.11 years (28 to 70). The mean operating time was 72.5 +/- 24 mn (40 to 120). The technique could not be performed in one case. The mean postoperative pain at D1, evaluated by a visual analog scale graduated from 0 to 10 was 2.36 (2 to 3). The mean hospital stay was 1.64 days (1 to 3). One inguinal hematoma occurred and resolved after a short incision. The mean time to return to work or normal activity was 12.14 +/- 7.25 days (3 to 30). All patients were reviewed. The mean follow-up was 13.37 +/- 2.87 months (6 to 25). No testicular atrophy was observed. One recurrence occurred at M6 treated at M9 by an open procedure. Our study suggests that this technique, avoiding extensive preperitoneal dissection, thus decreasing vascular and genital risks, would be useful in the treatment of failures of prosthetic herniorraphies.

  14. Intestinal perforation secondary to blunt inguinal trauma in a soccer player: a case report.

    Science.gov (United States)

    Vucetich, Nevenka; Andresen, Max; Hasbún, Pablo; Regueira, Tomás; Ibáñez, Luis; González, Alejandro

    2012-05-01

    Intestinal perforation caused by blunt trauma to an inguinal hernia is a very uncommon event. We present the case of a 55-year old man who suffered trauma to the inguinal area while playing soccer and later developed intense abdominal pain with no categorical signs of peritoneal irritation. Computed tomography scan at arrival showed a right inguinal hernia, with partial protrusion of the ileum, inflammatory changes of the mesenteric fat tissue inside the hernial sac, and free intraperitoneal fluid. Several hours later he developed hypotension and fever. An emergency laparotomy was performed, revealing ileum perforation with peritonitis. Intestinal perforation was repaired without intestinal resection. After surgery, the patient developed severe septic shock with multiple organ failure. He recovered without sequelae and was discharged 3 weeks later. This case emphasizes the potential clinical complications associated with this condition. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Hernia Surgery in Nyeri Provincial General Hospital, Kenya: Our 6 ...

    African Journals Online (AJOL)

    The average length of hospital stay was 3 days. Of the inguinal ... on hernia disease with reference to prevalence, pattern and management at a provincial general hospital in Kenya. Methods. After obtaining permission from the hospital administration, we .... financial constraint on hospitals, length of hospital stay and enable ...

  16. Open inguinal herniotomy: Analysis of variations

    Directory of Open Access Journals (Sweden)

    Musa Ibrahim

    2015-01-01

    Full Text Available Background: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of open herniotomy by comparing external ring incision, hernial sac twisting and whether or not double ligation has benefit over a single suture application. Materials and Methods: A multi-centre prospective randomised clinical trial was conducted with a total of 428 patients having congenital inguinal hernia and/or hydrocele. Patients were randomly assigned into four groups: RO (had external ring opened, hernial sac twisted and doubly ligated, ST (had hernial sac twisted and doubly ligated without opening the ring, DL (had double ligation of hernial sac without ring opening nor twisted while SL (had single ligation of hernial sac with neither ring opening nor sac twisting. Results: A total of 458 repairs were done. Patients′ age ranged from 0.25 years (3 months to 21 years in group RO with mean of 4.87 × 4.07 (median, 4, 0.069 years (24 days to 17 years in group ST with mean of 4.23 × 4.03 (median, 3, 0.5 years (6 months to 16 years in group DL with mean of 4.59 × 3.87 (median, 4 and 1 year to 19 years in group SL with mean of 5.00 × 4.19 (median, 4. Operation time per repair was 26.50 × 5.46 min, range 16-40 min (median, 27 min in group RO, 22.18 × 5.34 min, range 12-39 min (median, 21 min in group ST while 17.98 × 3.40 min with range of 12-39 min (median, 17 min in group DL and 15.27 × 4.18 min, range 7-40 min (median, 15 min in group SL P < 0.0001. The mean paracetamol dose/patient was 3.96 × 1.43, 2.94 × 0.81, 2.18 × 0.69, 1.87 × 0.78 in group RO, ST, DL and SL, respectively, P < 0.0001. Conclusion: Congenital inguinal hernia repair with opening of the external ring, hernia sac twisting and double ligation of the processus vaginalis

  17. Open inguinal herniotomy: Analysis of variations

    Science.gov (United States)

    Ibrahim, Musa; Ladan, Mu’azu Adamu; Abdussalam, Umar Sharif; Getso, Kabiru Ibrahim; Mohammad, Mohammad Aminu; Chukwuemeka, Anyanwu Lofty-John; Owolabi, Femi Luqman; Akhparov, Nurlan Nurkenovich; Aipov, Rassulbek Rakhmanberdievich

    2015-01-01

    Background: Repair of congenital groin hernia/hydrocele is the most common surgical procedure performed by paediatric surgeons. There is dearth of literature comparing the outcomes of open herniotomy in children using various surgical approaches. This study was aimed at evaluating the efficacy of open herniotomy by comparing external ring incision, hernial sac twisting and whether or not double ligation has benefit over a single suture application. Materials and Methods: A multi-centre prospective randomised clinical trial was conducted with a total of 428 patients having congenital inguinal hernia and/or hydrocele. Patients were randomly assigned into four groups: RO (had external ring opened, hernial sac twisted and doubly ligated), ST (had hernial sac twisted and doubly ligated without opening the ring), DL (had double ligation of hernial sac without ring opening nor twisted) while SL (had single ligation of hernial sac with neither ring opening nor sac twisting). Results: A total of 458 repairs were done. Patients’ age ranged from 0.25 years (3 months) to 21 years in group RO with mean of 4.87 ± 4.07 (median, 4), 0.069 years (24 days) to 17 years in group ST with mean of 4.23 ± 4.03 (median, 3), 0.5 years (6 months) to 16 years in group DL with mean of 4.59 ± 3.87 (median, 4) and 1 year to 19 years in group SL with mean of 5.00 ± 4.19 (median, 4). Operation time per repair was 26.50 ± 5.46 min, range 16-40 min (median, 27 min) in group RO, 22.18 ± 5.34 min, range 12-39 min (median, 21 min) in group ST while 17.98 ± 3.40 min with range of 12-39 min (median, 17 min) in group DL and 15.27 ± 4.18 min, range 7-40 min (median, 15 min) in group SL P < 0.0001. The mean paracetamol dose/patient was 3.96 ± 1.43, 2.94 ± 0.81, 2.18 ± 0.69, 1.87 ± 0.78 in group RO, ST, DL and SL, respectively, P < 0.0001. Conclusion: Congenital inguinal hernia repair with opening of the external ring, hernia sac twisting and double ligation of the processus vaginalis confers

  18. Abdominal wall hernia and pregnancy: a systematic review.

    Science.gov (United States)

    Jensen, K K; Henriksen, N A; Jorgensen, L N

    2015-10-01

    There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy. A literature search was undertaken in PubMed and Embase in combination with a cross-reference search of eligible papers. We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported in 102 patients without major complications. The literature on abdominal wall hernia and pregnancy is sparse. Abdominal wall hernia repair with suture or mesh may cause pain in the last trimester of a subsequent pregnancy. Hernia repair in conjunction with cesarean section appear as the optimal treatment of a pregnant patient with a symptomatic abdominal wall hernia.

  19. Umbilical Hernia

    Science.gov (United States)

    ... 15, 2015. Umbilical hernia Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  20. Umbilical Hernia

    Science.gov (United States)

    ... creates a soft swelling or bulge near the navel (umbilicus). If your baby has an umbilical hernia, you ... doctor if you have a bulge near your navel. Seek emergency care if the bulge becomes painful ...

  1. Spontaneous Enterocutaneous Fistula Resulting from Richter’s Hernia

    Science.gov (United States)

    Khongwar, Donkupar; Komut, Ojing; Naku, Narang; Baru, Kappa

    2017-01-01

    Richter’s hernia is due to the entrapment of a part of circumference of the bowel wall. As the bowel continuity is maintained, the patients usually do not have intestinal obstruction. Some patients with Richter’s hernia may present with enterocutaneous fistula either spontaneous or due to surgical intervention mistaking the obstructed hernia to be inguinal abscess. This is more so in developing countries due to lack of awareness among the masses or due to the delay in seeking medical attention. Presenting here is a case of a 53-year-old male patient with enterocutaneous fistula which occurred spontaneously and sought medical attention only after about three years of repeated discharge of yellowish fluid from the left inguinal region. Magnetic resonance fistulogram confirmed the diagnosis of enterocutaneous fistula. Laparotomy with resection and primary anastomosis of the fistulous bowel was done. Patient recovered uneventfully without any complications or recurrence. PMID:28969198

  2. Inguinal hernioraphy under local anesthesia in the elderly patients

    Directory of Open Access Journals (Sweden)

    Nurettin Kahramansoy

    2012-12-01

    Full Text Available Objectives: The incidence of inguinal hernia and the frequencyof comorbidity increase in the elderly. Therefore,in operations of these patients, anesthesia methods areimportant. The aim of our study was to investigate the feasibilityof local anesthesia in the operation of the elderly.Materials and methods: The patients operated for inguinalhernia were analyzed retrospectively. They weredivided into two groups: the elderly (>60 years and theyounger. Anesthesia methods, additional anesthesia requirementand complications were compared.Results: Of totally 177 patients, 30.5% were elderly.Operation type, anesthesia method and score of operationalrisk differed between groups. The percentage of comorbidity (55.6% in the elderly was significantly high (p<0.001. Among elderly, the frequency of co morbidity wasslightly higher in patients who had local anesthesia comparedto spinal and general anesthesia. Patients in youngand middle ages preferred to be operated less under localanesthesia (34.1% compared to elderly (70.4%. Therewas one case (2.6% converted to general anesthesiaas an additional anesthesia in the elderly group. Postoperativecomplications were slight more frequent in elderly.These cases were five in number (31.3% and were operatedunder spinal or general anesthesia (p=0.002.Conclusions: The frequency of co morbidity and riskscore of operation (ASA category rise in the elderly.However, inguinal hernioraphy can be performed underlocal anesthesia without complication and conversion togeneral anesthesia.Key words: Inguinal hernia; aged; comorbidity; local anesthesia

  3. Local anaesthesia as a risk factor for recurrence after groin hernia repair

    DEFF Research Database (Denmark)

    Kehlet, H.; Bay-Nielsen, M.

    2008-01-01

    BACKGROUND: The literature is inconclusive regarding the effect of local infiltration anaesthesia on the risk of recurrence after groin hernia repair. METHODS: Based upon the Danish Hernia Database, reoperations after a primary Lichtenstein mesh repair were assessed in 43,123 patients between 1998...... and 2005. Data were analysed in relation to type of inguinal hernia and whether repaired in public hospitals or by private hernia surgeons. RESULTS: The nationwide data showed no overall difference in reoperation rate (about 3.5% after five years), whether performed in local or general/regional anaesthesia....... Reoperation rates were about 50% higher when performed for a direct hernia than for an indirect hernia. The use of local anaesthesia was followed by higher reoperation rates compared with general or regional anaesthesia after repair of a direct but not an indirect hernia in hospitals. However, reoperation...

  4. Ultrasound In Diagnosis Of Herniae In Pregnancy: A Case Report ...

    African Journals Online (AJOL)

    A 26-year old trader presented with abdominal pain with a four month old pregnancy and was diagnosed clinically, (wrongly of course) as a case of peptic ulcer in pregnancy, with co-existing uterine fibroid. Ultrasound scan (USS) revealed an incarcerated supra-umblical (anterior abdominal wall) hernia as the cause of her ...

  5. Hernia de Amyand: presentación de un caso y revisión de la literatura

    OpenAIRE

    NICOLA S,MARTÍN; MORA M,GUILLERMO; STOCK,RODNEY; VALLEJOS C,RODRIGO; ROBLES M,MATÍAS; TAPIA Z,CAROLINA; CID B,HÉCTOR; GUASTAVINO B,GONZALO

    2007-01-01

    La presencia de apendicitis aguda en una hernia inguinal es un hecho infrecuente, con un 0,13% de los casos. Esta rara condición se conoce como Hernia de Amyand. La forma de presentación habitual es la de una hernia inguinal complicada. Es por este motivo que el diagnóstico preoperatorio de apendicitis aguda requiere de una alta sospecha clínica, realizándose mayoritariamente durante la cirugía. El estudio de imágenes, en particular la Tomografía Axial Computada, ha sido utilizado para plante...

  6. Abdominal wall hernias: imaging with spiral CT

    International Nuclear Information System (INIS)

    Stabile Ianora, A.A.; Midiri, M.; Vinci, R.; Rotondo, A.; Angelelli, G.

    2000-01-01

    Computed tomography is an accurate method of identifying the various types of abdominal wall hernias, especially if they are clinically occult, and of distinguishing them from other diseases such as hematomas, abscesses and neoplasia. In this study we examined the CT images of 94 patients affected by abdominal wall hernias observed over a period of 6 years. Computed tomography clearly demonstrates the anatomical site of the hernial sac, the content and any occlusive bowel complications due to incarceration or strangulation. Clinical diagnosis of external hernias is particularly difficult in obese patients or in those with laparotic scars. In these cases abdominal imaging is essential for a correct preoperative diagnosis and to determine the most effective treatment. (orig.)

  7. Diagnosis of Groin Pain Associated With Sports Hernia Using Dynamic Ultrasound and Physical Examination: A Case Report.

    Science.gov (United States)

    Yang, Dong Chan; Nam, Ki Yeun; Kwon, Bum Sun; Park, Jin Woo; Ryu, Ki Hyung; Lee, Ho Jun; Sim, Gyu Jeong

    2015-12-01

    Groin pain in athletes is a complex diagnostic and therapeutic challenge. Sports hernia is one of the common causes of groin pain. We report a case of sports hernia, initially presented as groin pain and aggravated by sports activity. A 19-year-old soccer player visited the outpatient department of general surgery and was referred to the rehabilitation center due to no abnormalities detected in the abdomen and pelvis by computed tomography. An incipient direct bulge of the posterior inguinal wall was detected with dynamic ultrasound when abdominal tension was induced by raising both legs during a full inhalation. Surgery was performed and preoperatively both groins showed the presence of inguinal hernia. Diagnosing sports hernia is very challenging. Through careful history documentation and physical examination followed by dynamic ultrasonography, we identified his posterior inguinal wall deficiency for early management.

  8. Traumatic Abdominal Wall Hernia After a Blunt Trauma: A Case Report

    Directory of Open Access Journals (Sweden)

    Ersin Dumlu

    2014-06-01

    Full Text Available Traumatic abdominal wall hernia is a rare result of blunt abdominal traumas in adults. Altough the detection of the injuries of the abdominal organs is the priority in blunt traumas, abdominal wall defect may also occur in these patients. These hernias can go undetected due to preservation of the skin overlying the hernia defect. Traumatic abdominal wall hernias can have high morbidity and mortality rates due to incarceration and perforation of tubular hollow organs, especially if there is any delay. The possibility of traumatic hernia should always be considered in cases with serious blunt trauma. Computed Tomography (CT scan examinations should be performed routinely due to their high diagnostic value if trumatic hernia is suspected. In this report, a traumatic abdominal wall hernia patient who was treated by surgery has been presented with the review of the current literature.

  9. Canal of Nuck Hernia in a Female Infant Containing Uterus, Bilateral Adnexa and Bowel

    Directory of Open Access Journals (Sweden)

    Betül Emine Derinkuyu

    2016-10-01

    Full Text Available Background: The canal of Nuck is a fold of peritoneum that invaginates into the inguinal canal and closes at or just before birth. If the canal of Nuck remains open in female infants, herniation of the uterus, adnexa and/or bowel loops may arise through the inguinal canal into the labia majora. Case Report: The present case is a 12-week-old female infant with complaints of left groin swelling and discomfort. Ultrasonographic examination revealed a left inguinal hernia containing both adnexa (ovaries and fallopian tubes, uterus and small bowel loops with fluid. Conclusion: A hernia containing ovary and uterus should be considered as a possible cause in a female infant with a groin mass. Ultrasonography of the inguinal mass lesions should be performed routinely in a female infant for accurate diagnosis.

  10. Hepatitis C and Incarceration

    Science.gov (United States)

    HEPATITIS C & INCARCERATION What is hepatitis? “Hepatitis” means inflammation or swelling of the liver. The liver is an ... of viral hepatitis: Hepatitis A, Hepatitis B, and Hepatitis C. They are all different from each other and ...

  11. Hernia repair during endoscopic (laparoscopic) radical prostatectomy.

    Science.gov (United States)

    Stolzenburg, Jens-Uwe; Rabenalt, Robert; Dietel, Anja; Do, Minh; Pfeiffer, Heidemarie; Schwalbe, Steffen; Dorschner, Wolfgang

    2003-02-01

    We retrospectively reviewed our experience in performing endoscopic extraperitoneal radical prostatectomy (EERPE) and totally extraperitoneal (TEP) hernia repair in one procedure to evaluate its feasibility and safety. Based on our experience of 70 laparoscopic radical prostatectomies, a total of 60 patients underwent EERPE. Eight of these had 10 hernias repaired with Prolene mesh. The median total operating time for EERPE was 165 minutes. Mesh placement required an additional 15 minutes for a unilateral hernia and 25 minutes for bilateral hernias. The conversion rate and the reoperation rate were 0%. The median duration of vesical catheterization was 8.3 days. One patient required a blood transfusion. The most common minor complications, occurring in eight patients, were edema and hematoma of the penis. No wound infection occurred. The only major complication was a deep venous thrombosis in one patient. No additional complications developed in the hernioplasty group. We conclude that the extraperitoneal approach for radical prostatectomy allows concomitant inguinal hernia repair with a low morbidity rate and within an acceptable operating time.

  12. Laparoscopic appendicectomy for suspected mesh-induced appendicitis after laparoscopic transabdominal preperitoneal polypropylene mesh inguinal herniorraphy

    Directory of Open Access Journals (Sweden)

    Jennings Jason

    2010-01-01

    Full Text Available Laparoscopic inguinal herniorraphy via a transabdominal preperitoneal (TAPP approach using Polypropylene Mesh (Mesh and staples is an accepted technique. Mesh induces a localised inflammatory response that may extend to, and involve, adjacent abdominal and pelvic viscera such as the appendix. We present an interesting case of suspected Mesh-induced appendicitis treated successfully with laparoscopic appendicectomy, without Mesh removal, in an elderly gentleman who presented with symptoms and signs of acute appendicitis 18 months after laparoscopic inguinal hernia repair. Possible mechanisms for Mesh-induced appendicitis are briefly discussed.

  13. Endometriosis of the Vermiform Appendix within a Hernia Sac Infiltrating the Pubic Bone.

    Science.gov (United States)

    Ziaja, Damian; Bolkowski, Tomasz; Januszewski, Krzysztof; Skrzypulec-Plinta, Wioletta; Chudek, Jerzy; Ziaja, Krzysztof

    2015-01-01

    Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described. Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter) tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand's hernia). Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.

  14. Endometriosis of the Vermiform Appendix within a Hernia Sac Infiltrating the Pubic Bone

    Directory of Open Access Journals (Sweden)

    Damian Ziaja

    2015-01-01

    Full Text Available Purpose. Appendicular endometriosis mimicking appendicitis is a rare finding. Inguinal tumor in the course of appendicular endometriosis located within an inguinal hernia sac and infiltrating the periosteum of the pubic bone has not yet been described. Case Report. This paper describes a case of a rapidly enlarging, solid, unmovable, very painful upon palpation inguinal tumor, in a 36-year-old nulliparous woman. During surgery, a hard (approximately 4 cm in diameter tumor infiltrating the periosteum of the right pubic bone and continuous with the inguinal hernia sac was dissected. The distal segment of the vermiform appendix was an element of the dissected tumor. Histological examination revealed endometriosis of the distal vermiform appendix. After 6 months of hormone treatment, she was referred for reoperation due to tumor recurrence. Once again histological examination of the resected tissue revealed endometriosis. There was no further recurrence of the disease with goserelin therapy. In addition to the case report, we present a review of the literature about endometriosis involving the vermiform appendix and the inguinal canal (Amyand’s hernia. Conclusion. This case expands the list of differential diagnoses of nodules found in the inguinal region of women.

  15. Sports hernia repair with adductor tenotomy.

    Science.gov (United States)

    Harr, J N; Brody, F

    2017-02-01

    Sports hernias, or athletic pubalgia, is common in athletes, and primarily involves injury to the fascia, muscles, and tendons of the inguinal region near their insertion onto the pubic bone. However, management varies widely, and rectus and adductor tenotomies have not been adequately described. The purpose of this manuscript is to demonstrate a suture repair and a rectus and adductor longus tenotomy technique for sports hernias. After magnetic-resonance-imaging confirmation of sports hernias with rectus and adductor tendonitis, 22 patients underwent a suture herniorrhaphy with adductor tenotomy. The procedure is performed through a 4-cm incision, and a fascial release of the rectus abdominis and adductor tenotomy is performed to relieve the opposing vector forces on the pubic bone. All 22 patients returned to their respective sports and regained their ability to perform at a high level, including professional status. No further surgery was required. In athletes with MRI confirmation of rectus and adductor longus injuries, tenotomies along with a herniorraphy may improve outcomes. A suture repair to reinforce the inguinal floor prevents mesh-related complications, especially in young athletes.

  16. Hernias (For Parents)

    Science.gov (United States)

    ... umbilical hernia . It is most obvious when the baby cries, coughs, or strains. Umbilical hernias are more common in females, those of African heritage, and low birth weight babies. These hernias range in size from less than ...

  17. Colonic diverticulosis is associated with abdominal wall hernia

    DEFF Research Database (Denmark)

    Oma, E.; Jorgensen, L. N.; Meisner, S.

    2017-01-01

    Purpose: Colonic diverticulosis and abdominal wall hernia are common pathologies. Studies have suggested that connective tissue alterations play a role in the formation of both diverticulosis and abdominal wall hernia. The aim of this cohort study was to evaluate the association between...... diverticulosis and abdominal wall hernia in a large cohort of patients undergoing colonoscopy. Methods: All consecutive patients who underwent colonoscopy between 2001 and 2013 at Bispebjerg Hospital were eligible for inclusion. The endoscopists prospectively registered the findings of diverticulosis......: A total of 13,855 patients were included, 3685 (26.6%) of whom were diagnosed with diverticulosis. Diverticulosis was independently associated with direct inguinal, OR 1.33, 95% CI 1.00–1.76, P = 0.049, and umbilical/epigastric hernia repair, OR 1.74, 95% CI 1.16–2.63, P = 0.008. Conclusions: Colonic...

  18. Acquired umbilical hernias in four captive polar bears (Ursus maritimus).

    Science.gov (United States)

    Velguth, Karen E; Rochat, Mark C; Langan, Jennifer N; Backues, Kay

    2009-12-01

    Umbilical hernias are a common occurrence in domestic animals and humans but have not been well documented in polar bears. Surgical reduction and herniorrhaphies were performed to correct acquired hernias in the region of the umbilicus in four adult captive polar bears (Ursus maritimus) housed in North American zoos. Two of the four bears were clinically unaffected by their hernias prior to surgery. One bear showed signs of severe discomfort following acute enlargement of the hernia. In another bear, re-herniation led to acute abdominal pain due to gastric entrapment and strangulation. The hernias in three bears were surgically repaired by debridement of the hernia ring and direct apposition of the abdominal wall, while the large defect in the most severely affected bear was closed using polypropylene mesh to prevent excessive tension. The cases in this series demonstrate that while small hernias may remain clinically inconsequential for long periods of time, enlargement or recurrence of the defect can lead to incarceration and acute abdominal crisis. Umbilical herniation has not been reported in free-ranging polar bears, and it is suspected that factors such as body condition, limited exercise, or enclosure design potentially contribute to the development of umbilical hernias in captive polar bears.

  19. Post Incisional Hernia Meshplasty Vesicocutaneous Fistula – A Rare Complication

    Directory of Open Access Journals (Sweden)

    M. Raghavendran

    2017-07-01

    Full Text Available Laparoscopic meshplasty is gold standard in hernia surgery. Mesh migration into bowel/bladder has been documented after laparoscopic repair, though migration into bowel is more common than bladder. Only 12 cases of migration into bladder have been described post inguinal meshplasty. We report the 1st case of mesh migration into bladder post Incisional hernia meshplasty, presenting as vesicocutaneous fistula. The objectives of this report are highlighting important points enabling earlier diagnosis, treatment. We would also like to suggest important preventive measures during meshplasty which we believe will go a long way in avoiding this important complication, thus immensely benefiting patients.

  20. Sertoli cell tumor arising in a cryptorchid testis presenting as a content of inguinal hernial sac

    Directory of Open Access Journals (Sweden)

    Kusuma Venkatesh

    2016-01-01

    Full Text Available Sertoli cell tumors (SCTs are rare tumors accounting for <1% of all testicular tumors. Here, we report a rare case of SCT in a 60-year-old man presenting as a painless swelling in the right groin since childhood. Clinically, he presented with right-sided inguinal hernia with absence of the right testis. He had normal left testis and had no gynecomastia or infertility. The specimen of hernial sac showed testis with a 1.6 cm × 1.5 cm nodular mass having gray tan-cut surface. Histopathologically, the testis showed atrophy and the nodular portion showed tumor cells arranged in tubular and microcystic pattern, with no solid pattern or necrosis. The diagnosis of SCT was confirmed with immunohistochemical staining for inhibin which showed fine granular cytoplasmic positivity. Cryptorchid testis having SCT and presenting as a content of inguinal hernia is a rare occurrence.

  1. [The ultrasound semiotics of uncomplicated wound healing after inguinal mesh plastics].

    Science.gov (United States)

    Kharitonov, S V; Ziniakova, M V

    2012-01-01

    Dynamic ultrasound (US) investigation was performed in 89 patients operated on inguinal hernia with the use of meshes of various type. The US scanning proved to be a highly informative means of visualization, allowing the objective postoperative assessment of muscular and aponeurotic structures as well as the implant form and position. The study showed, that the mesh implantation was always accompanied by the exudative tissue reaction, which was determined by the physico-chemical characteristics of the implant.

  2. Bochdalek's diaphragmatic hernia

    International Nuclear Information System (INIS)

    Kuckein, D.

    1984-01-01

    Bochdalek's diaphragmatic hernia (hernia through trigonum lumbocostale of diaphragm) may be demonstrated unequivocally via computerised tomography. An additional scan in prone position is recommended. In this way, not only the relationship of the hernia to the diaphragm can be shown but also the diaphragmatic gap (trigonum lumbocostale). In some cases sagittal image reconstruction is helpful to identify the hernia. (orig.) [de

  3. Strangulated spigelian hernia

    International Nuclear Information System (INIS)

    Amin, F.M.; Sultan, T.

    2004-01-01

    Spigelian hernia is a rare ventral hernia. Strangulation is Spigelian hernia is common but still seen very rarely in clinical practice. We report a case of strangulated Spigelian hernia in an elderly women which was managed satisfactory and the patient discharged on ninth post operative day. (author)

  4. [Inguinal symptoms of acute abdomen].

    Science.gov (United States)

    Baeza-Herrera, Carlos; Jiménez-González, Newton; Atzin-Fuentes, José Luis; Sanjuan-Fabián, Héctor; Godoy-Esquivel, Arturo Hermilo

    2004-01-01

    We describe a syndrome in which empty hernial sac, in its role of peritoneal recess, becomes distended with pus during or after general peritonitis, usually caused by acute appendicitis. Until 1998, only 14 pediatric cases were described in the literature. We presented here eight cases of patients who experienced inguinal symptoms. In four, appendectomy was performed; in four, this was secondary to necrotizing enterocolitis. Inguinal complaints, pain, and flogosis were present in first group, while pneumoperitoneum and visible duct vaginalis were present in second group. These cases demonstrated that persistent patent processus vaginalis may predispose to inguinal pathology secondary to intraabdominal sepsis and represent a unique complication.

  5. Inguinal Herniation of the Urinary Bladder Presenting as Recurrent Urinary Retention

    Directory of Open Access Journals (Sweden)

    Amit Frenkel

    2015-01-01

    Full Text Available Herniation of the urinary bladder into the inguinal canal is an uncommon finding, observed in 0.5–4% of inguinal hernias (Curry (2000. It is usually associated with other conditions that increase intra-abdominal pressure such as bladder neck obstruction due to prostatic hypertrophy. Consequently, in men, it is usually associated with some degree of urinary retention. We present a 42-year-old man in whom herniation of the urinary bladder was the cause of urinary retention, and not vice versa. The patient was on tumor necrosis factor alpha antagonist (TNFA (Etanercept for severe Ankylosing spondylitis. Initially, the urinary retention was thought to be a side effect of the medication, but after the drug was discontinued, urinary retention persisted. CT and MRI demonstrated huge herniation of the urinary bladder into the inguinal canal. Immediately after the hernia was repaired, bladder function was restored. TNF treatment was restarted, and no further urinary symptoms were observed in the next two years of follow-up. In this case, the primary illness and its treatment were distracting barriers to early diagnosis and treatment. In younger patients with a large hernia who develop unexpected urinary retention, herniation of the urinary bladder should be highly considered in the differential diagnosis.

  6. Academy Engages Incarcerated Youths

    Science.gov (United States)

    Zehr, Mary Ann

    2010-01-01

    It's not easy to keep young people on task for learning in a youth prison, but David Domenici, the principal of the Maya Angelou Academy, a charter-like school serving incarcerated juveniles, is trying to do it while at the same time creating a model program for improving educational services for young offenders. Located at the New Beginnings…

  7. Sports hernias: a systematic literature review.

    Science.gov (United States)

    Caudill, P; Nyland, J; Smith, C; Yerasimides, J; Lach, J

    2008-12-01

    This review summarises the existing knowledge about pathogenesis, differential diagnosis, conservative treatment, surgery and post-surgical rehabilitation of sports hernias. Sports hernias occur more often in men, usually during athletic activities that involve cutting, pivoting, kicking and sharp turns, such as those that occur during soccer, ice hockey or football. Sports hernias generally present an insidious onset, but with focused questioning a specific inciting incident may be identified. The likely causative factor is posterior inguinal wall weakening from excessive or high repetition shear forces applied through the pelvic attachments of poorly balanced hip adductor and abdominal muscle activation. There is currently no consensus as to what specifically constitutes this diagnosis. As it can be difficult to make a definitive diagnosis based on conventional physical examination, other methods, such as MRI and diagnostic ultrasonography are often used, primarily to exclude other conditions. Surgery seems to be more effective than conservative treatment, and laparoscopic techniques generally enable a quicker recovery time than open repair. However, in addition to better descriptions of surgical anatomy and procedures and conservative and post-surgical rehabilitation, well-designed research studies are needed, which include more detailed serial patient outcome measurements in addition to basing success solely on return to sports activity timing. Only with this information will we better understand sports hernia pathogenesis, verify superior surgical approaches, develop evidence-based screening and prevention strategies, and more effectively direct both conservative and post-surgical rehabilitation.

  8. Recurrence mechanisms after inguinal hernia repair by the Onstep technique

    DEFF Research Database (Denmark)

    Öberg, S; Andresen, K; Hauge, D

    2016-01-01

    have been reduced or disappeared. CONCLUSIONS: The main reasons for recurrence may be broken sutures in the mesh laterally or a suboptimal size of the opening in fascia transversalis medially, enabling the mesh to displace. Furthermore, the results suggest a learning curve. These findings may guide...

  9. Open surgery in VR : Inguinal hernia repair according to Lichtenstein

    NARCIS (Netherlands)

    Sanders, A.J.B.; Warntjes, P.; Geelkerken, R.H.; Mastboom, W.J.B.; Klaase, J.M.; Rödel, S.G.J.; Luursema, J.M.; Kommers, P.A.M.; Verwey, W.B.; van Houten, F.J.A.M.; Kunst, E.E.; Westwood, James D.

    2006-01-01

    VREST (Virtual Reality Educational Surgical Tools) is developing a universal and autonomous simulation platform which can be used for training and assessment of medical students and for continuing education of physicians. A workstation consisting of two haptic devices and a 3D vision system is part

  10. Factors Influencing Choice of Inguinal Hernia Repair Technique ...

    African Journals Online (AJOL)

    Annals of African Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 14, No 1 (2017) >. Log in or Register to get access to full text downloads.

  11. Outcome of laparoscopic inguinal hernia repair in a South African ...

    African Journals Online (AJOL)

    In this practice, all patients' records are stored using electronic practice management ... codes and billing records) are entered contemporaneously into the database, ensuring complete retention of all consultation notes and operative records. Patients for the study were identified using ICD-10, procedural and billing codes ...

  12. Comparison of Desarda versus Modified Bassini inguinal Hernia ...

    African Journals Online (AJOL)

    jen

    technique in many developed countries, its use has remained low in the developing world due to the initial cost of the mesh. The most ... The operations were all done under local anesthesia via a regular ... medial leaf on both of its surfaces was done to facilitate its approximation to the lateral leaf. The first stitch was taken ...

  13. Recurrence and complications of pediatric inguinal hernia repair ...

    African Journals Online (AJOL)

    Annals of Pediatric Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 2 (2013) >. Log in or Register to get access to full text downloads.

  14. Letter to the Editor : Direct inguinal hernia containing a prolapsed ...

    African Journals Online (AJOL)

    Annals of Pediatric Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 9, No 4 (2013) >. Log in or Register to get access to full text downloads.

  15. Recurrence and complications of pediatric inguinal hernia repair ...

    African Journals Online (AJOL)

    wound infection, recurrence, and other complications. The v2-test was .... operative period. The follow-up period of our study was longer than that of the Kalantari et al.'s study [15]. In our study, bilateral involvement was observed in 12.2% of the male ... frequency of surgical site infection for outpatient (1%) cases is lower ...

  16. Pathogenetic substantiation of surgical treatment of recurrent inguinal hernia

    Directory of Open Access Journals (Sweden)

    Bilіanskyі L.S.

    2014-06-01

    Full Text Available Research purpose was to investigate tissue reactions on implantation of polypropylene mesh, processed with collagen, after plastic surgery of experimental defect in rats in preperitoneal prosthesis localization. Research was performed in two experimental groups. Group 1 – in 17 rats an experimental defect of anterior abdominal wall with 3 cm of size with further preperitoneal fixation of the polypropylene mesh of 0,5×1,0 cm size was performed. Group 2 – in 20 rats under analogous conditions preperitoneal fixation of polypropylene mesh, processed with collagen was performed. Morphological analysis of stages of scar tissue formation in the implantation region in the preperitoneal cavity of rats by stereological characteristics of cellular and fiber structures of connective tissue considering hemodynamic characteristics shows substantial benefits of polypropylene mesh, processed with collagen, during 2 montha after experimental hernioplasty.

  17. Hernia uterine inguinale with transverse testicular ectopia and mixed germ cell tumor

    Directory of Open Access Journals (Sweden)

    Rajshekhar C Jaka

    2007-01-01

    Full Text Available Persistent mullerian duct syndrome is a rare disorder characterized by the presence of uterus and fallopian tube in 46XY phenotypic males and is ascribed to defects in the synthesis or action of anti-mullerian hormone. We report a rare case of hernia uterine inguinale, transverse testicular ectopia associated with mixed germ cell tumor of the testis with metastasis. Transverse testicular ectopia should be suspected preoperatively in patients who have unilateral inguinal hernia associated with contralateral nonpalpable testis. In such cases ultrasonography should be done prior to repair of hernia to evaluate the possible presence of mullerian structures and testicular malignancy, for better management.

  18. Umbilical Hernia Repair and Pregnancy: Before, during, after…

    Science.gov (United States)

    Kulacoglu, Hakan

    2018-01-01

    Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable. If the hernia is not complicated, but symptomatic an elective repair should be proposed. When the patient has a small and asymptomatic hernia it may be better to postpone the repair until she gives birth. If the hernia is repaired by suture alone, a high risk of recurrence exists during pregnancy. Umbilical hernia repair during pregnancy can be performed with minimal morbidity to the mother and baby. Second trimester is a proper timing for surgery. Asymptomatic hernias can be repaired, following childbirth or at the time of cesarean section (C-section). Elective repair after childbirth is possible as early as postpartum of eighth week. A 1-year interval can give the patient a very smooth convalescence, including hormonal stabilization and return to normal body weight. Moreover, surgery can be postponed for a longer time even after another pregnancy, if the patients would like to have more children. Diastasis recti are very frequent in pregnancy. It may persist in postpartum period. A high recurrence risk is expected in patients with rectus diastasis. This risk is especially high after suture repairs. Mesh repairs should be considered in this situation. PMID:29435451

  19. [Progressive preoperative pneumoperitoneum in patients with giant hernias of the abdominal wall].

    Science.gov (United States)

    López Sanclemente, María Clara; Robres, Joaquim; López Cano, Manuel; Barri, Joan; Lozoya, Roberto; López, Sergio; Vasco, M Angeles; Buqueras, M Carmen; Subirana, Helena; Jorba, Rosa

    2013-01-01

    Patients with giant hernias with loss of domain require proper planning of surgical repair, because of the high associated comorbidity. The progressive preoperative pneumoperitoneum technique described by Goñi Moreno allows a more physiological adaptation of the patient and the abdominal cavity to the reinstatement of the viscera to the abdomen, enabling adequate surgical repair. The objective of this study was to analyze our experience in the treatment of this type of hernia. We carried out a retrospective study that included 11 patients with major abdominal wall defects and loss of domain who were treated with this technique in 2 centers between 2005 and 2010. Eight patients had abdominal hernias and 3 had inguinal hernias. The average insufflation time was 2 weeks and the total amount of air was between 6.6 and 18 l. In 2 patients who showed pulmonary disease decompensation, insufflation had to be temporarily postponed. A further 2 patients had subcutaneous emphysema during the last few days of insufflation, which resolved spontaneously without sequelae. The open mesh repair technique was used in ventral hernias and the preperitoneal technique in all inguinal hernias. There was one recurrence during the 1-year follow-up. Goñi Moreno's technique remains safe to prepare patients with giant hernias with loss of domain. This procedure can reduce the morbidity caused by the increase in abdominal pressure after abdominal wall repair. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

  20. Massive hiatus hernia: evaluation and surgical management.

    Science.gov (United States)

    Maziak, D E; Todd, T R; Pearson, F G

    1998-01-01

    Paraesophageal hernias represent advanced degrees of sliding hiatus hernia with intrathoracic displacement of the intraesophageal junction. Gastroesophageal reflux disease occurs in most cases, resulting in acquired short esophagus, which should influence the type of repair selected. Between 1960 and 1996, 94 patients with massive, incarcerated paraesophageal hiatus hernia were operated on at the Toronto General Hospital. The mean age was 64 years (39 to 85 years), with a female to male ratio of 1.8:1. Organoaxial volvulus was present in 50% of cases. Clinical presentation in these patients included postprandial pain in 56%, dysphagia in 48%, chronic iron deficiency anemia in 38%, and aspiration in 29%. Symptomatic reflux, either present or remote, was recorded in 83% of cases. All patients underwent endoscopy by the operating surgeon. In 91 of 94 patients, the esophagogastric junction was found to be above the diaphragmatic hiatus, denoting a sliding type of hiatus hernia. Gross, endoscopic peptic esophagitis was observed in 36% of patients: ulcerative esophagitis in 22% and peptic esophagitis with stricture in 14%. A complete preoperative esophageal motility study was obtained for 41 patients. The lower sphincter was hypotensive in 21 patients (51%), and the amplitude of peristalsis in the distal esophagus was diminished in 24 patients (59%). These abnormalities are both features of significant gastroesophageal reflux disease. In 13 recent, consecutive patients with paraesophageal hernia, the distance between the upper and lower esophageal sphincters was measured during manometry. The average distance was 15.4 +/- 2.33 cm (11 to 20 cm), which is consistent with acquired short esophagus. The normal distance is 20.4 cm +/- 1.9 (p incidence of endoscopic reflux esophagitis and of acquired short esophagus. True paraesophageal hernia, with the esophagogastric junction in a normal abdominal location, appears rare. Our observations were supported by measurements

  1. Clinical Implantation with the novel D-13 prosthesis for inguinal hernioplasty: A retrospective cohort study.

    Science.gov (United States)

    Gao, Peng-Zhi; Li, Ming; Yu, Ying-Jian; Hao, Xiang-Dong; Li, Wu-Zi; Rong, Ya-Jun; Zheng, Zhi-Gang; Meng, Ning

    2015-05-01

    Using a mesh to repair inguinal hernias is now a standard procedure that is widely accepted as superior to primary suture repair. Although a variety of meshes are available, individual meshes may have their own unattractive features. This retrospective study examines the efficacy of our originally designed D-13 prosthesis, which is used in patients with inguinal hernias. A total of 305 patients who underwent a herniorrhaphy between January 2009 and March 2011 were included in this study. The recurrent rate, chronic pain and feeling of a foreign body were examined at a 3-year follow-up. The D-13 prosthesis, made from clear polypropylene monofilament mesh, was originally designed by the first author of this study and constructed with the upper and lower pieces of polypropylene mesh having different shapes and sizes. Both pieces are linked together by a connector. The mesh is well tolerated. At a 3-year follow-up, only two patients had a foreign body sensation at the operative site, and three patients had recurrent hernias. The unique design of the D-13 prosthesis with two pieces of mesh provided encouraging long-term outcome for hernia recurrence, chronic pain and the feeling of a foreign body. Copyright © 2015 IJS Publishing Group Limited. All rights reserved.

  2. Resident postgraduate year does not influence rate of complications following inguinal herniorrhaphy.

    Science.gov (United States)

    Renteria, Oswaldo; Mokdad, Ali A; Imran, Jonathan; Huerta, Sergio

    2017-11-01

    Previous data indicate that patients who undergo surgery with a postgraduate year 3 (PGY-3) resident as the junior surgeon have a lower rate of recurrence compared with PGY-1 and PGY-2 after an open inguinal herniorrhaphy. Lower PGY level was also associated with increased operative time. We hypothesize that when controlling for surgeon, technique, and hernia type, the outcomes for inguinal herniorrhaphy are the same independent of PGY level. A retrospective review of all open unilateral inguinal hernia repairs done by residents who assisted the same senior surgeon at the Veterans Affairs North Texas Health Care System was performed. Seven hundred fifty-two open unilateral inguinal hernia were identified: mean patient age = 60.6 ± 12.7 y; mean body mass index = 27.0 ± 10.8 kg/m 2 ; American Society of Anesthesia III-IV = 51%; and Nyhus type 2 = 44.7%, 3a = 41.6%, and 3b = 13.7%. Residents involved were PGY-1 (17.2%), PGY-2/3 (71.1%), and PGY-4/5 (11.7%). Postoperative complications for intern, junior (PGY-2 and PGY-3), and senior residents (PGY-4 and PGY-5) were 4%, 9%, and 6%, respectively (P = 0.14). Compared to interns, junior residents finished the operation 3.9 min faster (95% confidence interval = -7.5, -0.3). There was no time difference between interns and senior residents completing the operations after controlling for hernia type. Logistic regression did not identify PGY level as an independent predictor of complications or recurrence. There was a slight decrease in operative time when the repair was done with junior-level residents. PGY level did not influence outcomes for open, unilateral inguinal herniorrhaphy when controlled for hernia type and technique. Published by Elsevier Inc.

  3. The vermiform appendix presenting in a laparoscopic port site hernia.

    Science.gov (United States)

    Latyf, Rafiq; Slater, Richard; Garner, Jeffrey P

    2011-07-01

    Laparoscopic port site hernias (PSHs) are uncommon but present a potential source of morbidity due to incarceration of the hernial contents which is usually omental fat or small bowel. We report only the third case of the vermiform appendix presenting in a symptomatic PSH; we discuss the appropriate management of this condition as well as ways in which the incidence of PSHs may be reduced.

  4. The vermiform appendix presenting in a laparoscopic port site hernia

    Directory of Open Access Journals (Sweden)

    Rafiq Latyf

    2011-01-01

    Full Text Available Laparoscopic port site hernias (PSHs are uncommon but present a potential source of morbidity due to incarceration of the hernial contents which is usually omental fat or small bowel. We report only the third case of the vermiform appendix presenting in a symptomatic PSH; we discuss the appropriate management of this condition as well as ways in which the incidence of PSHs may be reduced.

  5. The effect of chronic constipation on the development of inguinal herniation.

    Science.gov (United States)

    Kartal, A; Yalcın, M; Citgez, B; Uzunkoy, A

    2017-08-01

    To investigate the effect of constipation on the development of inguinal herniation and type of herniation using the Constipation severity scale. A total of 100 patients who underwent surgical inguinal hernia repair (study group) and 100 healthy volunteers without inguinal herniation (control group) were included in this study. The constipation severity scale was administered to all patients. The type of the herniation was classified using Nyhus scale during surgery and the side of the herniation was recorded on completed questionnaires. The obstructive defecation sub-scale score, colonic inertia sub-scale score, pain sub-scale score, and the total score were recorded for each patient and the association between constipation and the development of inguinal herniation was investigated. The mean age of patients in Group 1 and 2 was 40.92 ± 17.80 and 33.71 ± 9.13, respectively. There was a significant difference between the two groups in terms of obstructive defecation and colonic inertia sub-scale scores (p constipation severity scale in patients in Group 1 (p constipation may represent an important etiological factor for the development of inguinal herniation.

  6. Comparison of the inguinal and scrotal approaches for the treatment of communicating hydrocele in children.

    Science.gov (United States)

    Alp, Bilal Firat; Irkilata, Hasan Cem; Kibar, Yusuf; Zorba, Unal; Sancaktutar, Ahmet Ali; Kaya, Engin; Dayanc, Murat

    2014-04-01

    The inguinal approach is used for the treatment of hydrocele in the pediatric population. Although studies on scrotal orchiopexy have mentioned hernia or hydrocele repair through the same scrotal incision as a part of an orchiopexy procedure, there are a few studies reporting the treatment of isolated communicating hydrocele through a scrotal incision. We retrospectively evaluated and compared the outcomes of inguinal and scrotal approaches for the treatment of communicating hydrocele in boys. The classical inguinal and scrotal approaches to the treatment of communicating hydrocele were performed on 46 and 30 testicular units (in 43 boys and 27 boys, respectively). The patients' charts were reviewed to assess the operative times as well as the immediate and long-term complications during follow-up periods. The patients' ages ranged from 1 year to 8 years (3.6 ± 2.0 years) in the inguinal group and from 1 year to 10 years (mean 4.6 ± 2.8 years) in the scrotal group. Operative time was significantly lower in the scrotal group (p hydrocele recurrence after a mean follow-up of 6 months. The advantages of the scrotal approach for the treatment of communicating hydrocele are as follows: it is well tolerated, simple, and cosmetically appealing, and it has a short operative time in comparison with the standard inguinal approach. The scrotal incision technique is an effective alternative in communicating hydrocele treatment. Copyright © 2013. Published by Elsevier B.V.

  7. [Prospects of hernia and abdominal wall surgery in China].

    Science.gov (United States)

    Tang, J X; Huang, L; Li, S J; Hu, X C

    2017-01-01

    In recent 20 years, hernia and abdominal wall surgery has made great progress in China. However, what we've done still leaves much to be desired. Related guidelines of hernia disease had been conducted, but China is short of multi-center, prospective, and large-sample research evidence. These guidelines are still with low evidence level, and contents need additional modified to well meet Chinese real situation. In terms of treatment of inguinal and abdominal wall incisional hernia, some consensus has been reached from certain key issues globally, but further exploration are still needed. To stand at top of the world, we are a long distance. We should not only strengthen training and quality control but also establish patient registration system and overall management process.

  8. Intense FDG Uptake around the Inguinal Surgical Mesh 5 Years after Operation: Case Report and Review of the Literature

    OpenAIRE

    Bah?eci, Tatiana; Nursal, G?l Nihal; Ayd?n, Mehmet

    2012-01-01

    We present the case of a 40-year-old man who underwent a FDG PET/CT study for restaging of renal cell carcinoma treated with left nephrectomy, for suspected metastasis in lung and retroperitoneal lymph nodes. The patient had a history of left inguinal hernia repair with implantation of mesh prosthesis 5 years ago. PET/CT image revealed linear intense FDG uptake in left inguinal region most likely corresponding to a persistent foreign body reaction. In this article, a case with an intense FDG ...

  9. Our Experience with the Use of Low Cost Mesh in Tension-Free Inguinal Hernioplasty in Northern Ghana.

    Science.gov (United States)

    Yenli, Edwin M T; Abanga, John; Tabiri, Stephen; Kpangkpari, Steve; Tigwii, Aubrey; Nsor, Azare; Amesiya, Robert; Ekremet, Kwame; Abantanga, Francis A

    2017-06-01

    To describe our experience and success in the use of low cost mesh for the repair of inguinal hernias in consenting adult patients. A prospective study was carried out from August 2010 to December 2013 in ten district hospitals across Northern Ghana. The patients were divided into four groups according to Kingsnorth's classification of hernias. Low cost mesh was used to repair uncomplicated groin hernia. Those hernias associated with complications were excluded. We assessed the patients for wound infection, long term incisional pain and recurrence of hernia. The data collected was entered, cleaned, validated and analyzed. One hundred and eighty-four patients had tension-free repair of their inguinal hernias using non-insecticide impregnated mosquito net mesh. The median age of the patients was 51 years. The male to female ratio was 7:1. Using Kingsnorth's classification, H3 hernias were (62, 33.7%), followed by the H1 group (56, 30.4%). Local anaesthesia was used in 70% and less than 5% had general anaesthesia. The cost of low cost mesh to each patient was calculated to be $ 1.8(GH¢7.2) vs $ 45(GH¢ 180) for commercial mesh of same size. The benefit to the patient and the facility was enormous. Wound hematoma was noticed in 7% while superficial surgical site infection was 3%. No patient reported of long term wound pain. There was no recurrence of hernia. Low cost mesh such as sterilized mosquito net mesh for use in hernioplasty in resource-limited settings is reasonable, acceptable and cost-effective, it should be widely propagated. None declared.

  10. Stratification of surgical site infection by operative factors and comparison of infection rates after hernia repair.

    Science.gov (United States)

    Olsen, Margaret A; Nickel, Katelin B; Wallace, Anna E; Mines, Daniel; Fraser, Victoria J; Warren, David K

    2015-03-01

    To investigate whether operative factors are associated with risk of surgical site infection (SSI) after hernia repair. Retrospective cohort study. Patients Commercially insured enrollees aged 6 months-64 years with International Classification of Diseases, Ninth Revision, Clinical Modification procedure or Current Procedural Terminology, fourth edition, codes for inguinal/femoral, umbilical, and incisional/ventral hernia repair procedures from January 1, 2004, through December 31, 2010. SSIs within 90 days after hernia repair were identified by diagnosis codes. The χ2 and Fisher exact tests were used to compare SSI incidence by operative factors. A total of 119,973 hernia repair procedures were analyzed. The incidence of SSI differed significantly by anatomic site, with rates of 0.45% (352/77,666) for inguinal/femoral, 1.16% (288/24,917) for umbilical, and 4.11% (715/17,390) for incisional/ventral hernia repair. Within anatomic sites, the incidence of SSI was significantly higher for open versus laparoscopic inguinal/femoral (0.48% [295/61,142] vs 0.34% [57/16,524], P=.020) and incisional/ventral (4.20% [701/16,699] vs 2.03% [14/691], P=.005) hernia repairs. The rate of SSI was higher following procedures with bowel obstruction/necrosis than procedures without obstruction/necrosis for open inguinal/femoral (0.89% [48/5,422] vs 0.44% [247/55,720], Poperative factors may facilitate accurate comparison of SSI rates between facilities.

  11. Left paraduodenal hernias; Hernias paraduodenales izquierdas

    Energy Technology Data Exchange (ETDEWEB)

    Lopez-Negrete, L.; Garcia-Lozano, J.; Sanchez, J. L.; Tejeiro, A.; Sala, J. [Hospital Valle del Nalon. Riano-Sama. Asturias (Spain)

    2002-07-01

    We report two cases of left paraduodenal internal hernias located in the fossa of Landzert that were diagnosed by CT. Internal hernias are an infrequent cause of acute abdomen, due to the intestinal sub occlusion they produce. Left paraduodenal hernias are responsible for about 50% of internal hernias. CT makes it possible to demonstrate the group of herniated loops between the stomach, fourth segment of the duodenum, descending colon, and tail of the pancreas. The identification of the loops in an atypical position together with displaced blood vessels (mesenteric vessels) and colon gives concerns on them a typical radiological semiology that makes them easily identifiable. (Author) 9 refs.

  12. Tumor borderline do ovário localizado no canal inguinal: relato de caso A borderline ovarian tumor in inguinal canal: case report

    Directory of Open Access Journals (Sweden)

    Vinícius Basso Preti

    2010-06-01

    Full Text Available Os sintomas do tumor ovariano são inespecíficos e uma forma rara de apresentação é como conteúdo de uma hérnia inguinal. Relatamos o caso de uma paciente de 82 anos, com diagnóstico de câncer de mama e lesão anexial hipoecoica à ecografia. A mesma foi submetida à cirurgia conservadora da mama e à laparotomia, com achado de lesão ovariana sólido-cística no interior do canal inguinal à direita. A análise por congelação foi negativa para malignidade, e o exame anatomopatológico mostrou tratar-se de tumor ovariano borderline.The symptoms of ovarian tumor are not specific and a rare presentation of the tumor is as the content of an inguinal hernia. We reported a case of an 82-year-old woman, diagnosed with breast cancer and with a concomitant hypoecoic adnexal mass at the ecographic exam. The patient was treated with conservative breast surgery and laparotomy. A cystic-solid ovarian lesion was found inside the right inguinal canal. Frozen-section examination was negative for malignancy, and the anatomopathological analysis revealed a borderline ovarian tumor.

  13. Posterolateral diaphragmatic hernia with small-bowel incarceration ...

    African Journals Online (AJOL)

    cm defect in the posterior diaphragm repaired with interrupted polydiaxonone sutures, and the abdomen closed. The patient required organ support postoperatively and was transferred to the intensive care unit (ICU). Postoperatively, gut function was slow to return and a small empyema resolved with sustained drainage ...

  14. Incarcerated fallopian tube presenting in an incisional hernia : a ...

    African Journals Online (AJOL)

    a tender thickening along the right lateral aspect of the Pfannenstiel scar. There was no cough impulse. Because of these findings and her symptoms, she underwent surgical exploration of this area. At surgery an ovoid cystic structure was noted. On inadvertent disruption of this, a tubular structure was encountered (Fig 1).

  15. De Garengeot's Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia.

    Science.gov (United States)

    Jin, Zhaosheng; Imtiaz, Muhammad Rafiz; Nnajiuba, Henry; Samlalsingh, Suzette; Ojo, Akinyede

    2016-01-01

    We present two cases of incarcerated de Garengeot's hernia. This anatomical phenomenon is thought to occur in as few as 0.5% of femoral hernia cases and is a rare cause of acute appendicitis. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. In earlier reports operative treatment invariably involves simultaneous appendicectomy and femoral hernia repair. Both patients were correctly diagnosed preoperatively with computed tomography (CT). Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. Both patients recovered without complications. Routine diagnostic imaging modalities such as ultrasonography and standard CT have previously shown little success in identifying de Garengeot's hernia preoperatively. We believe this to be the first documented case of CT with concurrent oral and intravenous contrast being used to confidently and correctly diagnose de Garengeot's hernia prior to surgery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.

  16. De Garengeot’s Hernia: Two Case Reports with Correct Preoperative Identification of the Vermiform Appendix in the Hernia

    Directory of Open Access Journals (Sweden)

    Zhaosheng Jin

    2016-01-01

    Full Text Available We present two cases of incarcerated de Garengeot’s hernia. This anatomical phenomenon is thought to occur in as few as 0.5% of femoral hernia cases and is a rare cause of acute appendicitis. Risk factors include a long pelvic appendix, abnormal embryological bowel rotation, and a large mobile caecum. In earlier reports operative treatment invariably involves simultaneous appendicectomy and femoral hernia repair. Both patients were correctly diagnosed preoperatively with computed tomography (CT. Both had open femoral hernia repair, one with appendectomy and one with the appendix left in situ. Both patients recovered without complications. Routine diagnostic imaging modalities such as ultrasonography and standard CT have previously shown little success in identifying de Garengeot’s hernia preoperatively. We believe this to be the first documented case of CT with concurrent oral and intravenous contrast being used to confidently and correctly diagnose de Garengeot’s hernia prior to surgery. We hope that this case report adds to the growing literature on this condition, which will ultimately allow for more detailed case-control studies and systematic reviews in order to establish gold-standard diagnostic studies and optimal surgical management in future.

  17. Role of Sonography in Clinically Occult Femoral Hernias.

    Science.gov (United States)

    Brandel, David W; Girish, Gandikota; Brandon, Catherine J; Dong, Qian; Yablon, Corrie; Jamadar, David A

    2016-01-01

    The purpose of this article is to evaluate the diagnostic accuracy of sonography in clinically occult femoral hernias and to describe our sonographic technique. The clinical and imaging data for 93 outpatients referred by general surgeons, all of whom underwent sonographic evaluation and surgery, were reviewed retrospectively. Of these, 55 patients who underwent surgical exploration for groin hernias within 3 months of sonography and met all inclusion criteria were included in the study. The sonographic technique involves using the pubic tubercle as an osseous landmark to identify and appropriately visualize the femoral canal. The Valsalva maneuver is then used to differentiate the movement of normal fat (a potential pitfall) from true herniation in the femoral canal. Surgical findings were used as the reference standard by which sonographic results were judged. Two-by-two contingency tables were used to calculate the sensitivity, specificity, positive predictive value, and negative predictive value. In these 55 patients, surgery revealed 15 femoral hernias. Eight femoral hernias occurred in women, and 7 occurred in men. For diagnosing femoral hernias, sonography demonstrated sensitivity of 80%, specificity of 88%, a positive predictive value of 71%, and a negative predictive value of 92%. True-positive cases of femoral hernias have a sonographic appearance of a hypoechoic sac with speckled internal echoes. When examining during the Valsalva maneuver, a femoral hernia passes deep to the inguinal ligament, expands the femoral canal, displacing the normal canal fat, and effaces the femoral vein. Sonography can exclude femoral hernias with high confidence in light of its exceptional negative predictive value. With attention to technique and imaging criteria, the diagnostic accuracy of sonography can be enhanced.

  18. [Monster hernia programme in Hernia Centre Liberec].

    Science.gov (United States)

    Škach, J; Harcubová, R; Petráková, V; Brzulová, L; Krejbichová, M; Kocmanová, K

    The authors introduce a unique programme in the Czech Republic focused on extreme herniology. Patients with giant complex ventral hernias (monster hernias) have been concentrated in a high-volume hernia center with the most advanced perioperative intensive care since 2012. The authors present their single centre experience with the support of literature. Between 20122015 we operated on 36 patients with a giant complex hernia. Minimal inclusion criteria for enrolment in the very heterogeneous group included: a defect over 15 cm wide, loss of domain of 20% and higher, and the mean surface area of at least 225 cm².We consider not only advanced abdominal wall reconstruction techniques to be essential in the treatment of giant complex ventral hernias. Open component separation, endoscopic component separation technique, bariatric procedures, panniculectomy, abdominoplasty, advancement flaps, skin grafting, preoperative progressive pneumoperitoneum, CT volumetry, individual binders tailoring, crane pulley and many others (see the text) should all be included in the armamentarium of such specialized, high-volume hernia centres. The anatomy, function and aesthetics should be inseparable parts of preoperative planning. Apart from the operation there are three major aspects in the treatment of the so called monster hernias: tailoring, preconditioning and complex postoperative care. NPWT (negative pressure wound therapy) should be easily accessible in case of extensive skin necrosis with mesh infection after major abdominal hernia repairs. Using negative pressure we have saved 100% of infected prostheses from explantation (including MRSA, ESBL..). Monster hernia programme is challenging for both the patient and the surgeon. It is costly, time consuming, associated with a high complication ratio (high morbidity and recurrence) and is designed for patients with a significant health, social, work, sexual and sports handicap, and with the risk of further severe or irreversible

  19. Does pregnancy increase the risk of abdominal hernia recurrence after prepregnancy surgical repair?

    Science.gov (United States)

    Lappen, Justin R; Sheyn, David; Hackney, David N

    2016-09-01

    associated with an increased risk of abdominal hernia recurrence after adjusting for confounding factors. The magnitude of this association is likely underestimated, given that the risk of recurrence was defined as reoperation, which captures only the most clinically significant group of recurrences. This information will facilitate counseling for reproductive-aged women planning elective ventral or incisional hernia repair. The risk of recurrence and subsequent reoperation should be balanced against the risk of incarceration and emergent surgery during pregnancy. As such, the desire for future pregnancy and/or contraception should be considered when planning asymptomatic hernia repair for women of reproductive age. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Usage of a self-adhesive mesh in TAPP hernia repair: A prospective study based on Herniamed Register

    Directory of Open Access Journals (Sweden)

    Pavol Klobusicky

    2016-01-01

    Full Text Available Introduction: Inguinal hernia repair is one of the most frequently performed surgical procedures worldwide in general surgery. The transabdominal laparoscopic (TAPP approach in the therapy of inguinal hernia seems to be a suitable alternative to classical open inguinal hernia repair mainly in the hands of an experienced surgeon. TAPP repair offers the possibility of gentle dissection with implantation of the mesh and the possibility of non-invasive fixation of the implanted mesh. Materials and Methods: Data analysis encompassed all patients who underwent inguinal hernia surgery at our Surgical Department within the period from July 1, 2012 to September 30, 2014 and who fulfilled the inclusion criteria. The standard surgical technique was used. Data were entered and subsequently analysed on the Herniamed platform. Herniamed is an Internet-based register in German and English, and includes all data of outpatient and hospitalised patients who underwent surgery for some type of hernia. All relevant patient data are collected via Internet. Results: There were 241 patients enrolled in the group and there were 396 inguinal hernias repaired in total. Standard long-term follow-up after 12 months was evaluated in 205 patients (85.06%, and in the rest of the patients during the closing of the study, but at least 6 months after operation. The mean follow-up was at 19.69 months. At the 1-year assessment, mild discomfort was reported in the groin in 10 patients (4.88% [1-3 on the visual analogue scale (VAS]. Post-operative pain lasting over 12 months in the groin of moderate degree (4-6 VAS was reported in two cases (0.97%. There was no recurrence and no chronic post-operative pain of severe degree reported. Conclusion: Our study demonstrates that laparoscopic inguinal hernia repair using the TAPP technique with the implantation of a self-fixation mesh is fast, effective, reliable and economically advantageous method in experienced hands and, according to our