Inguinal hernia surgery
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Inguinal hernia Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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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
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)
- Classification of current repair techniques for inguinal hernias include:[1][2][3]
- 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
- Total extraperitoneal
- 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 | ||||||||||||||||||||||||
Related Chapter
References
- ↑ 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.