Inguinal hernia surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Inguinal hernia}} | {{Inguinal hernia}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{F.K}} | ||
==Overview== | ==Overview== | ||
Surgery is the mainstay of treatment for inguinal hernia and there are many types of surgical techniques. | |||
==Indications== | |||
*Surgery is the first-line treatment option for patients with inguinal hernia. Surgery is usually reserved for patients with either:<ref name="pmid18065912">{{cite journal |vauthors=Mathonnet M, Mehinto D |title=[Indications for inguinal hernia repair] |language=French |journal=J Chir (Paris) |volume=144 Spec No 4 |issue= |pages=5S11–4 |year=2007 |pmid=18065912 |doi= |url=}}</ref> | |||
**Large bulges through a small hole | |||
**Painful hernia | |||
**High risk for complication such as [[strangulation]], incarceration | |||
==Surgery== | ==Surgery== | ||
*Surgery is the mainstay of treatment for inguinal hernia. There are 3 general types for inguinal hernia repair: | *Surgery is the mainstay of treatment for inguinal hernia. There are 3 general types for inguinal hernia repair:<ref name="pmid16858177">{{cite journal |vauthors=O'Dwyer PJ, Norrie J, Alani A, Walker A, Duffy F, Horgan P |title=Observation or operation for patients with an asymptomatic inguinal hernia: a randomized clinical trial |journal=Ann. Surg. |volume=244 |issue=2 |pages=167–73 |year=2006 |pmid=16858177 |pmc=1602168 |doi=10.1097/01.sla.0000217637.69699.ef |url=}}</ref><ref name="pmid18244999">{{cite journal |vauthors=Jenkins JT, O'Dwyer PJ |title=Inguinal hernias |journal=BMJ |volume=336 |issue=7638 |pages=269–72 |year=2008 |pmid=18244999 |pmc=2223000 |doi=10.1136/bmj.39450.428275.AD |url=}}</ref> | ||
**Herniotomy (removal of the hernial sac only) | **Herniotomy (removal of the hernial sac only) | ||
**Herniorrhaphy (herniotomy plus repair of the posterior wall of the inguinal canal) | **[[Herniorrhaphy]] (herniotomy plus repair of the posterior wall of the inguinal canal) | ||
**Hernioplasty (herniotomy plus reinforcement of the posterior wall of the inguinal canal with a synthetic mesh) | **Hernioplasty (herniotomy plus reinforcement of the posterior wall of the inguinal canal with a synthetic mesh) | ||
*Classification of current repair techniques for inguinal hernias include:<ref name="pmid14533909">{{cite journal |vauthors=Shouldice EB |title=The Shouldice repair for groin hernias |journal=Surg. Clin. North Am. |volume=83 |issue=5 |pages=1163–87, vii |year=2003 |pmid=14533909 |doi=10.1016/S0039-6109(03)00121-X |url=}}</ref><ref name="pmid19636493">{{cite journal |vauthors=Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M |title=European Hernia Society guidelines on the treatment of inguinal hernia in adult patients |journal=Hernia |volume=13 |issue=4 |pages=343–403 |year=2009 |pmid=19636493 |pmc=2719730 |doi=10.1007/s10029-009-0529-7 |url=}}</ref><ref name="pmid15674961">{{cite journal |vauthors=Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant AM |title=Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD004703 |year=2005 |pmid=15674961 |doi=10.1002/14651858.CD004703.pub2 |url=}}</ref><ref name="pmid18573702">{{cite journal |vauthors=Elsebae MM, Nasr M, Said M |title=Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study |journal=Int J Surg |volume=6 |issue=4 |pages=302–5 |year=2008 |pmid=18573702 |doi=10.1016/j.ijsu.2008.04.006 |url=}}</ref> | |||
**Tension-free prosthetic repairs | |||
*** Anterior repairs | |||
****lichenstein repair and its modification | |||
****Plug repairs | |||
****Patch and plug repairs | |||
****Double-layer devices | |||
*** Posterior (prepritoneal) repairs | |||
****Open techniques via inguinal incision | |||
****Stoppa repair | |||
****[[Laparoscopic surgery|Laparoscopic]]/[[Endoscopy|endoscopic]] repairs | |||
*****Transabdominal preperitoneal (TAPP) repair | |||
*****Total extraperitoneal (TEP) repair | |||
*****Intraperitoneal onlay mesh (IPOM) repair | |||
**Tissue-suture repairs | |||
*** Bassini-Shouldice technique and its modifications | |||
*** Marcy repair | |||
{{Family tree/start}} | |||
{{Family tree | | | | | | A01 | | | |A01=Inguinal hernia}} | |||
{{Family tree | | |,|-|-|-|+|-|-|-|.|}} | |||
{{Family tree | | B01 | | B02 | | B03 | |B01=Strangulated| B02=Symptomatic| B03=Asymptomatic or minimally symptomatic}} | |||
{{Family tree | | |!| | | |!| | | |!|}} | |||
{{Family tree | | C01 | | C02 | | C03 | |C01=Emergency surgery(consider non-mesh when risk of infection| C02=Elective surgery| C03=Consider watchful waiting}} | |||
{{Family tree | | |,|-|-|-|+|-|-|-|.|}} | |||
{{Family tree | | D01 | | D02 | | D03 | |D01=Primary unilateral| D02=Primary bilateral |D03=Recurrent }} | |||
{{Family tree | | |!| | | |!| | | |!|}} | |||
{{Family tree | | E01 | | E02 | | |!| |E01=Mesh<br>Lichtenstin or endoscopic| E02=Mesh<br>endoscopic or Lichtenstin }} | |||
{{Family tree | | | | | | | | | | |!|}} | |||
{{Family tree | | |,|-|-|-|-|-|-|v|'|}} | |||
{{Family tree | | F01 | | | | | F02 | |F01=After anterior technique| F02=After posterior technique}} | |||
{{Family tree | | |!| | | | | | |!|}} | |||
{{Family tree | | G01 | | | | | G02 |G01=Mesh technique<br>endoscopic or open posterior approach|G02=Mesh technique<br>Lichenstein}} | |||
{{Family tree/end}} | |||
{{#ev:youtube|YwEuZ8wVVNI|500}} | |||
{{#ev:youtube|_3ulqbizQvA|500}} | |||
==Related Chapter== | ==Related Chapter== | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[Category:Needs content]] | [[Category:Needs content]] | ||
[[Category:Surgery]] | [[Category:Surgery]] | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||
Latest revision as of 22:25, 29 July 2020
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Inguinal hernia Microchapters |
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Inguinal hernia surgery On the Web |
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American Roentgen Ray Society Images of Inguinal hernia surgery |
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Risk calculators and risk factors for Inguinal hernia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]
Overview
Surgery is the mainstay of treatment for inguinal hernia and there are many types of surgical techniques.
Indications
- Surgery is the first-line treatment option for patients with inguinal hernia. Surgery is usually reserved for patients with either:[1]
- Large bulges through a small hole
- Painful hernia
- High risk for complication such as strangulation, incarceration
Surgery
- Surgery is the mainstay of treatment for inguinal hernia. There are 3 general types for inguinal hernia repair:[2][3]
- Herniotomy (removal of the hernial sac only)
- Herniorrhaphy (herniotomy plus repair of the posterior wall of the inguinal canal)
- Hernioplasty (herniotomy plus reinforcement of the posterior wall of the inguinal canal with a synthetic mesh)
- Classification of current repair techniques for inguinal hernias include:[4][5][6][7]
- Tension-free prosthetic repairs
- Anterior repairs
- lichenstein repair and its modification
- Plug repairs
- Patch and plug repairs
- Double-layer devices
- Posterior (prepritoneal) repairs
- Open techniques via inguinal incision
- Stoppa repair
- Laparoscopic/endoscopic repairs
- Transabdominal preperitoneal (TAPP) repair
- Total extraperitoneal (TEP) repair
- Intraperitoneal onlay mesh (IPOM) repair
- Anterior repairs
- Tissue-suture repairs
- Bassini-Shouldice technique and its modifications
- Marcy repair
- Tension-free prosthetic repairs
| Inguinal hernia | |||||||||||||||||||||||||
| Strangulated | Symptomatic | Asymptomatic or minimally symptomatic | |||||||||||||||||||||||
| Emergency surgery(consider non-mesh when risk of infection | Elective surgery | Consider watchful waiting | |||||||||||||||||||||||
| Primary unilateral | Primary bilateral | Recurrent | |||||||||||||||||||||||
| Mesh Lichtenstin or endoscopic | Mesh endoscopic or Lichtenstin | ||||||||||||||||||||||||
| After anterior technique | After posterior technique | ||||||||||||||||||||||||
| Mesh technique endoscopic or open posterior approach | Mesh technique Lichenstein | ||||||||||||||||||||||||
{{#ev:youtube|YwEuZ8wVVNI|500}}
{{#ev:youtube|_3ulqbizQvA|500}}
Related Chapter
References
- ↑ Mathonnet M, Mehinto D (2007). "[Indications for inguinal hernia repair]". J Chir (Paris) (in French). 144 Spec No 4: 5S11–4. PMID 18065912.
- ↑ O'Dwyer PJ, Norrie J, Alani A, Walker A, Duffy F, Horgan P (2006). "Observation or operation for patients with an asymptomatic inguinal hernia: a randomized clinical trial". Ann. Surg. 244 (2): 167–73. doi:10.1097/01.sla.0000217637.69699.ef. PMC 1602168. PMID 16858177.
- ↑ Jenkins JT, O'Dwyer PJ (2008). "Inguinal hernias". BMJ. 336 (7638): 269–72. doi:10.1136/bmj.39450.428275.AD. PMC 2223000. PMID 18244999.
- ↑ Shouldice EB (2003). "The Shouldice repair for groin hernias". Surg. Clin. North Am. 83 (5): 1163–87, vii. doi:10.1016/S0039-6109(03)00121-X. PMID 14533909.
- ↑ Simons MP, Aufenacker T, Bay-Nielsen M, Bouillot JL, Campanelli G, Conze J, de Lange D, Fortelny R, Heikkinen T, Kingsnorth A, Kukleta J, Morales-Conde S, Nordin P, Schumpelick V, Smedberg S, Smietanski M, Weber G, Miserez M (2009). "European Hernia Society guidelines on the treatment of inguinal hernia in adult patients". Hernia. 13 (4): 343–403. doi:10.1007/s10029-009-0529-7. PMC 2719730. PMID 19636493.
- ↑ Wake BL, McCormack K, Fraser C, Vale L, Perez J, Grant AM (2005). "Transabdominal pre-peritoneal (TAPP) vs totally extraperitoneal (TEP) laparoscopic techniques for inguinal hernia repair". Cochrane Database Syst Rev (1): CD004703. doi:10.1002/14651858.CD004703.pub2. PMID 15674961.
- ↑ Elsebae MM, Nasr M, Said M (2008). "Tension-free repair versus Bassini technique for strangulated inguinal hernia: A controlled randomized study". Int J Surg. 6 (4): 302–5. doi:10.1016/j.ijsu.2008.04.006. PMID 18573702.