This study evaluates whether an extra incision is needed in addition to the standard inguinal incision for the surgery of incarcerated groin hernias. Patients with groin hernias present to an emergency unit when their hernia incarcerates or strangulates. The classical approach to such presentations is open surgery, and a second incision is sometimes needed to resect the strangulated organ. This is a retrospective study enrolling 218 patients treated for incarcerated groin hernias at a state hospital between 2006 and 2010. Data collected were demographic data, type and location of hernia, type of surgery and anesthesia, type of incision, need for resection, and preoperative complications. A total of 37.9% of female and 13.2% of male patients had resection of an abdominal organ. Of patients with incarcerated groin hernias, 20% (n = 43) had resection. Omentum was the most commonly resected organ (n = 19; 8.8%), followed by small intestine (n = 11; 5.1%), bladder, appendix, lymphadenopathy, and preperitoneal fat (each n = 3 and 1.4%). Of 218 patients, 10 (4.58%) needed a secondary incision for hernia reduction. All of these patients had their surgery with one of the anterior approach techniques. There was no statistically significant difference (P = 0.4) in need for secondary incision between the anterior and posterior approach techniques. In recent years, posterior approach for incarcerated groin hernias was deemed advantageous because it did not necessitate an additional incision for definitive surgery. Our study showed that in the treatment of incarcerated inguinal hernia, Lichtenstein repair is also a safe and easy alternative, without the need for a second incision.
Local anesthesia as an alternative option in repair of recurrent groin hernias: An outcome study from the American College of Surgeons NSQIP® database
