Inguinal hernia surgery
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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 | ||||||||||||||||||||||||
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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.