Inguinal hernia surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The inability to "reduce" the bulge back into the abdomen usually means the hernia is "incarcerated," often necessitating emergency surgery. Recent data questions the routine elective repair of all inguinal hernias. Some studies indicate that inguinal hernias can be left alone with no greater risk than prompt elective treatment. Nevertheless, the bias remains toward surgical repair. Provided there are no serious co-existing medical problems, patients are advised to get the hernia repaired surgically at the earliest convenience after a diagnosis is made. Emergency surgery for complications such as incarceration and strangulation carry much higher risk than planned, "elective" procedures.

Surgery

• Surgery is the mainstay of treatment for inguinal hernia. There are 3 general types for inguinal hernia repair:
  • 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)
• Tension-free prosthetic repairs
  • 1. Anterior repairs
    • lichenstein repair and its modification
    • Plug repairs
    • Patch and plug repairs
    • Double-layer devices
  • 2. Posterior (prepritoneal) repairs
    • Open techniques via inguinal incision
    • Stoppa repair
    • Laparoscopic/endoscopic repairs
      • Transabdominal preperitoneal
      • Total extraperitoneal
• Tissue-suture repairs
  • 1. Bassini-Shouldice technique and its modifications
  • 2. Marcy repair

Related Chapter

Inguinal hernia repair

References

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