Femoral hernia surgery: Difference between revisions
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**Excision of the sac | **Excision of the sac | ||
**Closure of the femoral ring to prevent recurrence | **Closure of the femoral ring to prevent recurrence | ||
*Surgical techniques used are either femoral or inguinal based approaches, used individually or in combination:<ref name="pmid10954820">{{cite journal |vauthors=Hernandez-Richter T, Schardey HM, Rau HG, Schildberg FW, Meyer G |title=The femoral hernia: an ideal approach for the transabdominal preperitoneal technique (TAPP) |journal=Surg Endosc |volume=14 |issue=8 |pages=736–40 |year=2000 |pmid=10954820 |doi= |url=}}</ref><ref name="pmid12885618">{{cite journal |vauthors=Swarnkar K, Hopper N, Nelson M, Feroz A, Stephenson BM |title=Sutureless mesh-plug femoral hernioplasty |journal=Am. J. Surg. |volume=186 |issue=2 |pages=201–2 |year=2003 |pmid=12885618 |doi= |url=}}</ref><ref name="pmid14663407">{{cite journal |vauthors=Zandi G, Vasquez G, Buonanno A, Mazza P |title=[PHS Repair in femoral hernia surgery] |language=Italian |journal=Minerva Chir |volume=58 |issue=6 |pages=797–9 |year=2003 |pmid=14663407 |doi= |url=}}</ref><ref name="pmid12885618">{{cite journal |vauthors=Swarnkar K, Hopper N, Nelson M, Feroz A, Stephenson BM |title=Sutureless mesh-plug femoral hernioplasty |journal=Am. J. Surg. |volume=186 |issue=2 |pages=201–2 |year=2003 |pmid=12885618 |doi= |url=}}</ref> | *Surgical techniques used are either femoral or inguinal based approaches, used individually or in combination:<ref name="pmid10954820">{{cite journal |vauthors=Hernandez-Richter T, Schardey HM, Rau HG, Schildberg FW, Meyer G |title=The femoral hernia: an ideal approach for the transabdominal preperitoneal technique (TAPP) |journal=Surg Endosc |volume=14 |issue=8 |pages=736–40 |year=2000 |pmid=10954820 |doi= |url=}}</ref><ref name="pmid12885618">{{cite journal |vauthors=Swarnkar K, Hopper N, Nelson M, Feroz A, Stephenson BM |title=Sutureless mesh-plug femoral hernioplasty |journal=Am. J. Surg. |volume=186 |issue=2 |pages=201–2 |year=2003 |pmid=12885618 |doi= |url=}}</ref><ref name="pmid14663407">{{cite journal |vauthors=Zandi G, Vasquez G, Buonanno A, Mazza P |title=[PHS Repair in femoral hernia surgery] |language=Italian |journal=Minerva Chir |volume=58 |issue=6 |pages=797–9 |year=2003 |pmid=14663407 |doi= |url=}}</ref><ref name="pmid12885618">{{cite journal |vauthors=Swarnkar K, Hopper N, Nelson M, Feroz A, Stephenson BM |title=Sutureless mesh-plug femoral hernioplasty |journal=Am. J. Surg. |volume=186 |issue=2 |pages=201–2 |year=2003 |pmid=12885618 |doi= |url=}}</ref><ref name="pmid14533910">{{cite journal |vauthors=Hachisuka T |title=Femoral hernia repair |journal=Surg. Clin. North Am. |volume=83 |issue=5 |pages=1189–205 |year=2003 |pmid=14533910 |doi=10.1016/S0039-6109(03)00120-8 |url=}}</ref> | ||
**McVay operation (basic hernioplasty operation) | **McVay operation (basic hernioplasty operation) | ||
**Hernioplasties with prosthetic materials (polypropylene mesh, sutureless mesh-plug repair) | **Hernioplasties with prosthetic materials (polypropylene mesh, sutureless mesh-plug repair) | ||
**Laparoscopic approach | **Laparoscopic approach | ||
*McVay operation: | *McVay operation:<ref name="pmid14533910">{{cite journal |vauthors=Hachisuka T |title=Femoral hernia repair |journal=Surg. Clin. North Am. |volume=83 |issue=5 |pages=1189–205 |year=2003 |pmid=14533910 |doi=10.1016/S0039-6109(03)00120-8 |url=}}</ref> | ||
**Inguinal aproach | **Inguinal aproach | ||
**Insertion of the transversus abdominis muscle and transversalis fascia to the cooper's ligament | **Insertion of the transversus abdominis muscle and transversalis fascia to the cooper's ligament | ||
*Lichtenstein repair: | *Lichtenstein repair:<ref name="pmid14533910">{{cite journal |vauthors=Hachisuka T |title=Femoral hernia repair |journal=Surg. Clin. North Am. |volume=83 |issue=5 |pages=1189–205 |year=2003 |pmid=14533910 |doi=10.1016/S0039-6109(03)00120-8 |url=}}</ref> | ||
**PerFix mesh plug technique | **PerFix mesh plug technique | ||
**Used for elective femoral hernia repair | **Used for elective femoral hernia repair | ||
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==Contraindications== | ==Contraindications== | ||
*When incarceration or strangulation is present surgical intervention does increase morbidity and mortality, but it still needs to be performed.<ref name="pmid7225757">{{cite journal |vauthors=Andrews NJ |title=Presentation and outcome of strangulated external hernia in a district general hospital |journal=Br J Surg |volume=68 |issue=5 |pages=329–32 |year=1981 |pmid=7225757 |doi= |url=}}</ref> | *When incarceration or strangulation is present surgical intervention does increase morbidity and mortality, but it still needs to be performed.<ref name="pmid7225757">{{cite journal |vauthors=Andrews NJ |title=Presentation and outcome of strangulated external hernia in a district general hospital |journal=Br J Surg |volume=68 |issue=5 |pages=329–32 |year=1981 |pmid=7225757 |doi= |url=}}</ref> | ||
*In cases of incarceration or strangulation the mesh plug technique is avoided due to the risk of infection, and the McVay repair is preferred. | *In cases of incarceration or strangulation the mesh plug technique is avoided due to the risk of infection, and the McVay repair is preferred.<ref name="pmid14533910">{{cite journal |vauthors=Hachisuka T |title=Femoral hernia repair |journal=Surg. Clin. North Am. |volume=83 |issue=5 |pages=1189–205 |year=2003 |pmid=14533910 |doi=10.1016/S0039-6109(03)00120-8 |url=}}</ref> | ||
==References== | ==References== | ||
Revision as of 20:45, 6 February 2018
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Femoral hernia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Femoral hernia surgery On the Web |
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American Roentgen Ray Society Images of Femoral hernia surgery |
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Risk calculators and risk factors for Femoral hernia surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [2]
Overview
Surgery is the mainstay of treatment for femoral hernia.
Indications
- The mainstay of treatment for femoral hernia is surgery. Immediate surgical intervention is indicated in cases of:[1][2]
- Strangulation
- Incaceration
Surgery
- Surgery is the mainstay of treatment for femoral hernia.[2]
- Surgery should not be delayed because of the high incidence of strangulation or incarceration.[2]
- In case of incarceration or strangulation immediate surgical intervention is required regardless of age of the patient.[1]
- Objectives of hernia surgery are:[3][4][5]
- Reduction of the hernia
- Excision of the sac
- Closure of the femoral ring to prevent recurrence
- Surgical techniques used are either femoral or inguinal based approaches, used individually or in combination:[3][4][5][4][6]
- McVay operation (basic hernioplasty operation)
- Hernioplasties with prosthetic materials (polypropylene mesh, sutureless mesh-plug repair)
- Laparoscopic approach
- McVay operation:[6]
- Inguinal aproach
- Insertion of the transversus abdominis muscle and transversalis fascia to the cooper's ligament
- Lichtenstein repair:[6]
- PerFix mesh plug technique
- Used for elective femoral hernia repair
Contraindications
- When incarceration or strangulation is present surgical intervention does increase morbidity and mortality, but it still needs to be performed.[1]
- In cases of incarceration or strangulation the mesh plug technique is avoided due to the risk of infection, and the McVay repair is preferred.[6]
References
- ↑ 1.0 1.1 1.2 Andrews NJ (1981). "Presentation and outcome of strangulated external hernia in a district general hospital". Br J Surg. 68 (5): 329–32. PMID 7225757.
- ↑ 2.0 2.1 2.2 Gallegos NC, Dawson J, Jarvis M, Hobsley M (1991). "Risk of strangulation in groin hernias". Br J Surg. 78 (10): 1171–3. PMID 1958976.
- ↑ 3.0 3.1 Hernandez-Richter T, Schardey HM, Rau HG, Schildberg FW, Meyer G (2000). "The femoral hernia: an ideal approach for the transabdominal preperitoneal technique (TAPP)". Surg Endosc. 14 (8): 736–40. PMID 10954820.
- ↑ 4.0 4.1 4.2 Swarnkar K, Hopper N, Nelson M, Feroz A, Stephenson BM (2003). "Sutureless mesh-plug femoral hernioplasty". Am. J. Surg. 186 (2): 201–2. PMID 12885618.
- ↑ 5.0 5.1 Zandi G, Vasquez G, Buonanno A, Mazza P (2003). "[PHS Repair in femoral hernia surgery]". Minerva Chir (in Italian). 58 (6): 797–9. PMID 14663407.
- ↑ 6.0 6.1 6.2 6.3 Hachisuka T (2003). "Femoral hernia repair". Surg. Clin. North Am. 83 (5): 1189–205. doi:10.1016/S0039-6109(03)00120-8. PMID 14533910.