scholarly journals Clinical and anatomical rationale for the use of simple methods of inguinal hernia repair

2021 ◽  
Vol 43 (6) ◽  
pp. 25-26
Author(s):  
A. I. Baryshnikov

Despite significant advances in the field of surgical treatment of inguinal hernias, its results cannot be considered completely satisfactory. This is evidenced by the damage to the intestines, bladder, testicular atrophy and relapses arising from hernia repair.

2021 ◽  
Vol 6 (2) ◽  
pp. 104-115
Author(s):  
Hosni Mubarak Khan ◽  
◽  
Tirumal Rao Patwari

Objective. This is a prospective study of 50 cases of inguinal hernias which were treated through open inguinal hernia repair techniques. The study was conducted with the objective of comparing the effectiveness of these procedures and complications. Materials and Methods. A number of 50 cases of inguinal hernias admitted to Dr. BR Ambedkar Medical College and Hospital were selected on the basis of the non-probability (purposive) sampling method. All the patients with direct and indirect uncomplicated hernias treated by means of an open approach were included. After the preoperative preparation, they were randomly chosen either for Desarda’s or Modified Bassini’s repair techniques. Results. In the postoperative period, moderate pain was experienced by 19 patients included in the Desarda group and 17 patients included in the Modified Bassini’s repair group on day 1. The postoperative wound infection developed in 2 cases of Desarda and 3 cases of Modified Bassini’s, erythema was observed in 2 cases of Desarda and 3 cases of Modified Bassini’s, 3 cases reported the occurrence of seroma in the Desarda group and 4 cases of seroma were recorded in the Modified Bassini’s group. Conclusions. The patients who underwent Desarda repair complained of a higher intensity of pain, which could probably be attributed to the extensive dissection involved. The duration of Desarda repair was longer due to the learning curve of the surgeons in our hospital. The return to normal gait and normal activities was significantly lower in the Desarda group. The duration of hospital stays and the postoperative complications was not significantly different in the two groups. There were no recurrences in either of the groups until the current study.


BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
N H Dhanani ◽  
O A Olavarria ◽  
S Wootton ◽  
M Petsalis ◽  
N B Lyons ◽  
...  

Abstract Background Contralateral clinically occult hernias are frequently noted at the time of laparoscopic unilateral inguinal hernia repair. There is no consensus on the role of contralateral exploration and repair. This systematic review assessed the safety and efficacy of operative repair of occult contralateral inguinal hernias found during unilateral repair. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to February 2020. Adults diagnosed with a unilateral inguinal hernia undergoing laparoscopic repair were included. The primary outcome was the incidence of occult contralateral hernias. Summative outcomes of operative and expectant management were reported along with development of a Markov decision process. Results Thirteen studies (1 randomized trial, 12 observational cohorts) with 5000 patients were included. The incidence of occult contralateral inguinal hernias was 14.6 (range 7.3–50.1) per cent. Among patients who underwent repair, 10.5 (4.3–17.0) per cent experienced a postoperative complication. Of patients managed expectantly, 29 per cent later required elective repair for symptoms. Mean follow-up was 36 (range 2–218) months. Using a Markov decision process, it was calculated that, for every 1000 patients undergoing unilateral inguinal hernia repair, contralateral exploration would identify 150 patients with an occult hernia. Repair would result in 15 patients developing a postoperative complication and 105 undergoing unnecessary repair. Alternatively, expectant management would result in 45 patients requiring subsequent repair. Conclusion Contralateral repair is not warranted in patients with occult hernias diagnosed at the time of elective hernia repair. The evidence is largely based on observational studies at high risk of bias.


Author(s):  
Sabriye Dayı

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.


2016 ◽  
pp. 26-28
Author(s):  
Serkan Ketenciler ◽  
Kamil Boyacioglu ◽  
Ilknur Akdemir ◽  
Vedat Erentug ◽  
Nihan Kayalar

2019 ◽  
Vol 6 (3) ◽  
pp. 65-73
Author(s):  
N. G. Kulchenko

Inguinal hernia is a common disease affecting about 5-10% of the population. About 370 000 inguinal hernia repair per year is registered in Russia. Surgeons have reduced recurrence of hernias to a minimum after the widespread introduction of non-tension hernia repair. However, today other complications of inguinal hernias have become prevalent: infection, pain and paresthesia in the scrotum, pathospermia. Opinion about the negative impact on spermatogenesis of both herniation and surgery for hernia is still controversial. This article provides an overview of modern foreign and Russian literature on the аssociation of different types of inguinal hernia repair with pathospermia.


2018 ◽  
Vol 5 (11) ◽  
pp. 3719
Author(s):  
Komal B. Gurung ◽  
Niroj Banepali ◽  
Rakesh R. Sthapit ◽  
Baikuntha Adhikari

Background: Laparoscopic inguinal hernia repair has been proven to be a safe and effective procedure for groin hernias. In recent years, many of the tertiary centers in Nepal have started performing laparoscopic hernia repair. With the availability of resources and the facilities, the laparoscopic repairs for inguinal hernias are going to be more accessible in near future in Nepal. The aim of this study was to compare the intraoperative events and postoperative complications of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques of laparoscopic inguinal hernia repairs.Methods: Out of 56 patients, 30 underwent TAPP and 26 TEP repairs for primary unilateral inguinal hernias and were prospectively analyzed. Patient demographics, past medical and surgical history, intraoperative, and postoperative events were recorded. Patients were followed-up for two years.Results: Demographic parameters were comparable in both the groups. The difference in mean operating time was statistically significant (longer in the TAPP group). Intraoperative events such as port-site bleeding and peritoneal tear were comparable in both groups. The immediate postoperative complications like skin ecchymosis, cord hematoma, and scrotal edema were comparable in both repairs.  Immediate postoperative pain was significantly lesser in TEP repair whereas the hospital stays and time to return to the normal physical activity were comparable in both groups.Conclusions: Both TAPP and TEP laparoscopic techniques are safe and effective for inguinal hernia repair. However, there are few advantages of TEP repair such as shorter duration of surgery and less postoperative pain.


2002 ◽  
Vol 21 (7) ◽  
pp. 39-44 ◽  
Author(s):  
Angela Burd ◽  
Randall Burd

Inguinal hernia repair is one of the most common surgical procedures performed on premature infants. Improved survival rates in the NICU have led to an increase in the incidence of premature infants with inguinal hernias. The NICU nurse, often the first to notice an inguinal hernia in a premature infant, should understand the etiology, basic pathophysiology, and nursing care for this condition.


2011 ◽  
Vol 27 (2) ◽  
pp. 86 ◽  
Author(s):  
Adnan Haslak ◽  
Ibrahim Taskin Rakici ◽  
Beyza Ozcinar ◽  
Ali Tardu ◽  
Yavuz Selim Sari ◽  
...  

2015 ◽  
Vol 100 (11-12) ◽  
pp. 1403-1407 ◽  
Author(s):  
Fatih Ciftci

The trans-abdominal preperitoneal (TAPP) approach provides access to the contralateral groin for exploration and repair of occult hernias. Previous studies have shown that the total extraperitoneal (TEP) approach also provides access to the contralateral groin for inguinal hernia repair. The aim of the current study was to document the rate of contralateral occult inguinal hernias diagnosed during the TAPP procedure. Data from all cases of TAPP inguinal hernia repair in our hospital were recorded prospectively for 3 years. Follow-up appointments included physical examinations. A total of 302 patients underwent TAPP inguinal hernia repair. We excluded 3 patients from the study and 299 were included. A total of 204 (68%) patients were scheduled for unilateral hernia repair and contralateral occult hernias were detected in 44 (21%) patients in this group. Of the 74 patients scheduled for bilateral repair, 60 (81%) underwent bilateral repair. In the remaining 29 patients, the diagnosis was changed to unilateral hernia. In this group, unilateral hernia repair was planned along with the possibility of contralateral hernia in 18 (6%) patients. Of these patients, 5 (27%) were subsequently found to have contralateral defects, 1 of whom underwent femoral repair. Our clinical diagnoses were 78% accurate. Identifying the actual incidence of contralateral occult inguinal hernia will enhance the planning of the treatment preoperatively and favor resource allotment planning for utilization of the operating room. TAPP allows preoperative diagnosis and treatment of contralateral occult hernias, saving the patient from additional symptoms and reoperations.


2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Takeshi Matsutani ◽  
Tsutomu Nomura ◽  
Nobutoshi Hagiwara ◽  
Akihisa Matsuda ◽  
Yoshimune Takao ◽  
...  

Purpose.To evaluate the feasibility, safety, and effectiveness of laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair using a memory-ring patch (Polysoft™mesh).Patients and Methods.Between April 2010 and March 2013, a total of 76 inguinal hernias underwent TAPP repair using Polysoft mesh in 67 adults under general anesthesia. Three different senior resident surgeons performed TAPP repair under the instruction of a specialist surgeon. Nine patients had bilateral hernias. The 76 hernias included 37 indirect inguinal hernias, 29 direct hernias, 1 femoral hernia, 1 pantaloon hernia (combined direct/indirect inguinal hernia), and 8 recurrent hernias after open anterior hernia repair. The immediate postoperative outcomes as well as the short-term outcomes (mainly recurrence and incidence of chronic pain) were studied.Results.There was no conversion from TAPP repair to anterior open repair. The mean operation time was 109 minutes (range, 40–132) for unilateral hernia repair. Scrotal seroma was diagnosed at the operation site in 5 patients. No patient had operation-related orchitis, testicle edema, trocar site infection, or chronic pain during follow-up.Conclusions.The use of Polysoft mesh for TAPP inguinal hernia repair does not seem to adversely affect the quality of repair. The use of this mesh is therefore feasible and safe and may reduce postoperative pain.


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