scholarly journals OV16 MASSIVE COMPLEX INGUINAL HERNIA

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Sharbel Elhage ◽  
Javier Otero ◽  
Michael Watson ◽  
Bradley Davis ◽  
B Todd Heniford
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Diagnostic Laparoscopy ◽  
Botulinum Toxin A ◽  
Perforated Diverticulitis ◽  
Wound Complications ◽  
Peritoneal Catheter ◽  
Scrotal Pain ◽  
Loss Of Domain ◽  
Preperitoneal Approach

Abstract Aim Massive complex inguinal hernias can be exceptionally difficult to repair, especially when they are associated with loss of domain (LOD). We aim to demonstrate an open preperitoneal approach to a complex massive inguinal hernia extending into the scrotum with severe LOD. Material and Methods Footage from clinic, diagnostic imaging, and all operative procedures was included. This included botulinum toxin A (BTA) injection, diagnostic laparoscopy and placement of a peritoneal catheter, outpatient pre-operative progressive pneumoperitoneum (PPP), and the preperitoneal hernia repair. Results A 53-year-old male construction worker with a known inguinal hernia presented with worsening groin and scrotal pain, associated with fever. CT imaging showed an abscess secondary to perforated diverticulitis within his massive inguinal hernia, as well as massive loss of domain with almost all small and large intestine within the hernia. He was treated with antibiotics and percutaneous drainage in preparation for surgery. He received pre-operative bilateral BTA injection in the oblique abdominal musculature. Subsequently, he underwent diagnostic laparoscopy and peritoneal catheter placement. He received 2 weeks of outpatient PPP. He then underwent open inguinal hernia repair with left orchiectomy and total abdominal colectomy. The hernia was repaired with a biologic mesh placed in the pre-peritoneal plane. The patient recovered very well and had no wound complications post-operatively. He has since followed up in clinic multiple times with no recurrence and excellent cosmetic results. Conclusions In this patient with a complex massive inguinal hernia and loss of domain, we demonstrate a successful open preperitoneal repair following pre-operative BTA injection and PPP.

scholarly journals Laparoscopic total extraperioneal mesh hernioplasty is a novel approach for inguinal hernia: our experience over 7 years

2019 ◽  
Vol 6 (11) ◽  
pp. 3982
Author(s):  
Dheer Singh Kalwaniya ◽  
Ranjith Mahadevan ◽  
Satya V. Arya ◽  
Jaspreet Singh Bajwa ◽  
Gowtham K. Gowda ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Mesh Repair ◽  
Wound Complications ◽  
Indirect Inguinal Hernia ◽  
Bilateral Inguinal Hernia ◽  
Hernia Surgery ◽  
Early Recovery ◽  
Inguinal Hernia Surgery ◽  
Laparoscopic Tep

Background: Inguinal hernia surgery is the most common performed surgery all over the world. Among them laparoscopic totally extra-peritoneal (TEP) mesh repair fulfils all the requirements with better clinical outcomes than other procedures.Methods: Data was collected from the inpatient and out-patient records of 60 patients who underwent laparoscopic TEP for unilateral or bilateral inguinal hernia in a single unit in the Department of General Surgery during May 2012-June 2019 including the two years of follow-up. 3D mesh was used for application and was fixed with tackers. Then patients were followed up in outpatient department after 1 week, 2 week, and 3 months, 6 months and yearly up to two years. In every visit post-operative pain (assessed by visual analogue scale), local wound complication (hematoma, seroma, wound infection) and recurrence were noted. The data was collected and evaluated and the results shown.Results: All patients were men, with average age of 36.5 years (range 32-58). On categorization 53 (88.3%) of them had unilateral inguinal hernia and 7 (11.6%) of them had bilateral inguinal hernia. Intra operatively 12 (20%) of them had direct inguinal hernia and 48 (80%) of them had indirect inguinal hernia. Haematoma was seen in 1 patients, surgical emphysema in 3, seroma in 5 and recurrence in 2 patients.Conclusions: Laparoscopic TEP mesh repair was effective and safe tool for hernia repair, in terms of lesser postoperative painless number of hospital days, early recovery and lesser wound complications. However recurrence rates are comparable with other methods of hernia repair.

Eikenella Corrodens Causing Necrotizing Fasciitis after an Elective Inguinal Hernia Repair in an Adult: A Case Report and Literature Review

2007 ◽  
Vol 73 (9) ◽  
pp. 876-879 ◽  
Author(s):  
Aaron T. Miller ◽  
John C. Byrn ◽  
Celia M. Divino ◽  
Kaare J. Weber
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Necrotizing Fasciitis ◽  
Inguinal Hernia Repair ◽  
Diagnostic Laparoscopy ◽  
Unusual Case ◽  
Cost Effective ◽  
Tissue Cultures ◽  
Necrotic Tissue ◽  
Eikenella Corrodens

We report an unusual case of necrotizing fasciitis in a 43-year-old man after elective inguinal hernia repair. The patient presented to the emergency department 9 days postoperatively with high fevers, tachycardia, and crepitus along his abdominal wall. He was treated with broad-spectrum antibiotics and underwent a diagnostic laparoscopy as well as a wide debridement of all necrotic tissue. Cultures grew out Eikenella corrodens, which, to our knowledge, has only been reported in one other case as a cause of necrotizing fasciitis. Patients can develop necrotizing fasciitis after elective, clean procedures and should be adequately resuscitated, undergo immediate surgical debridement, and receive antibiotics. Laparoscopy can be useful in determining if intraabdominal pathology is the cause of the infection and a wound vacuum-assisted device is a cost-effective way to decrease healing times.

Laparoscopic transabdominal preperitoneal approach for inguinal hernia repair: A five-year experience at a single center

Surgery Today ◽  
2011 ◽  
Vol 41 (2) ◽  
pp. 216-221 ◽  
Author(s):  
Zdravko Perko ◽  
Mislav Rakić ◽  
Zenon Pogorelić ◽  
Nikica Družijanić ◽  
Jasenka Kraljević
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Single Center ◽  
Transabdominal Preperitoneal ◽  
Preperitoneal Approach

scholarly journals 668 Inguinal Hernia Repair: Are We Compliant with The Recommended Consent Process?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M Barghash ◽  
T ElGhobashy ◽  
N Cheema ◽  
M Mansour
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Testicular Atrophy ◽  
Consent Process ◽  
Wound Complications ◽  
Local Policy ◽  
Patient Demographics ◽  
Retrospective Audit ◽  
The Uk

Abstract Aim Inguinal hernia repairs are one of the most commonly performed operative procedures in the UK. An adequate consent process gives the patient the autonomy in making decisions related to their care and treatment. In this project, we were auditing whether hernia patients have gone through a standardised consent process from time clinic presentation up to the day of surgery. Method This was a retrospective audit based on the Royal College of Surgeons’ (Good Surgical Practice) guidelines and trust local policy. We assessed 50 case notes for patients who had inguinal hernia repair between November 2019 and November 2020 in two of the busy district general hospitals in the UK. Results We found that our practice was fully compliant with documenting patient demographics, signatures, and the name of the procedure in the consent forms. Documented discussion prior to surgery was found only on79% of clinic letters. Poor compliance was noted in documenting some of the possible risks in the consent form including testicular atrophy (59%), injury to vas, vessels, and nerves (56%), wound complications (49%), chest infection (24%). Zero compliance was noted in documentation missed hernia and mortality as potential risks to the procedure. Conclusions A detailed documented discussion with the patient in relation to benefits, risks, and alternatives of surgery should take place on clinic presentation as well as on the day of surgery to ensure compliance with the consent process.

scholarly journals OV02 COMPLEX PARASTOMAL HERNIA REPAIR WITH MESH FISTULA AND MESH INFECTION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Sharbel Elhage ◽  
Eva Deerenberg ◽  
Sullivan Ayuso ◽  
Vedra Augenstein ◽  
Kevin Kasten ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hernia Repair ◽  
Parastomal Hernia ◽  
Botulinum Toxin A ◽  
Operative Procedure ◽  
Mesh Infection ◽  
Loss Of Domain ◽  
Parastomal Hernia Repair ◽  
Mesh Excision

Abstract Aim Parastomal hernias of any size can be difficult to manage and greatly affect a patient’s quality of life, however, they can be even more problematic when associated with loss of domain and infection. The aim of our video was to demonstrate open repair of a massive parastomal hernia complicated by loss of domain, mesh fistula, and mesh infection. Material and Methods Images and footage from clinic and the operative procedure were included. Results A 51-year-old female with a history of prior APR followed by failed ventral and parastomal hernia repairs presented with a massive parastomal hernia that was significantly impacting her and her family’s quality of life. Due to her hernia, she had become immobile and was bed bound. Furthermore, the hernia had caused significant chronic constipation secondary to colonic dysmotility. The patient also had loss of domain, and her hernia appeared to be complicated by a chronic mesh infection with a draining sinus. She underwent pre-operative bilateral botulinum toxin A injection in the oblique abdominal musculature. She then underwent open preperitoneal parastomal hernia repair with biologic mesh, excision of prior mesh, primary fistula repair, total abdominal colectomy, and end ileostomy. The patient tolerated the procedure well without complications and has continued to do well in follow-up. She has had great improvement in her quality of life. Conclusions In this patient with a massive parastomal hernia complicated by loss of domain, mesh fistula, and mesh infection, we demonstrate a successful open preperitoneal repair following pre-operative BTA injection.

scholarly journals P117 INFLUENCE OF THE MESH FIXATION METHOD ON THE RESULTS OF OPEN INGUINAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Maria Navid ◽  
Andrey Protasov ◽  
Ilgar Guseinov ◽  
Dmitriy Titarov ◽  
Mikhail Podolskiy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Polypropylene Mesh ◽  
Mesh Fixation ◽  
Fixation Method ◽  
Wound Complications ◽  
Sf 36

Abstract Aim Study of postoperative outcomes after Liechtenstein inguinal hernia repair using self-gripping mesh and polypropylene mesh with suture fixation. Material and Methods Medical records of 289 open inguinal hernia repairs were analyzed: 176 – with sutured polypropylene mesh and 113 – using self-gripping mesh. To assess the quality of life we have used EuraHS Qol and SF-36. Statistical analysis was performed using SPSS. Results There were no significant differences in wound complications (such as swelling, seroma, hematoma, orchitis) between these groups (p > 0,05). The duration of operation was significantly shorter with self-gripping mesh compared to sutured mesh (42,2 min. sd = 23,42 vs 58,5 min. sd = 16,70; p < 0.001). Pain on the first and 6th days after implantation self-gripping mesh was present significantly less frequently in comparison with sutured mesh (χ2 (1, N = 289) =7.925, p = 0.005 and χ2 (1, N = 289) =24.740, p < 0.001). NSAIDs intake time was less in self-gripping mesh group (3.01±1,07 vs 4.43±1,75 days; U = 11723, p < 0.001). We have found no significant differences in both groups for all quality-of-life indicators EuraHS (p = 0.234) and SF-36 (p = 0.190). Conclusions Self-gripping mesh has comparable outcomes with sutured polypropylene mesh regarding the frequency of wound complications and quality of life on long-term follow-up. However, self-gripping mesh is associated with reduced operation time, pain in the short-term postoperative period, and taking NSAIDs compared to sutured mesh.

Migrating Mesh Mimicking Colonic Malignancy

2006 ◽  
Vol 72 (12) ◽  
pp. 1210-1211 ◽  
Author(s):  
Peter Ojo ◽  
Alissa Abenthroth ◽  
Paul Fiedler ◽  
George Yavorek
Keyword(s):  
Case Report ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Diagnostic Laparoscopy ◽  
Right Hemicolectomy ◽  
Mesh Plug ◽  
Lower Quadrant ◽  
Colonic Malignancy ◽  
Right Lower Quadrant

The use of prosthetic mesh is the current acceptable standard for the repair of hernias. Recurrence rate has been greatly reduced since Lichtensen in 1986 first described mesh repair of inguinal hernias. The most common complication arising from inguinal hernia repair even with mesh is recurrence. There are isolated reports of migrated mesh in the three decades of mesh use in hernia repair. We present a case report of a migrated mesh plug presenting with features highly suggestive of an intra-abdominal neoplasm in a 63-year-old man who presented with weight loss, anorexia, fatigue, and a palpable right lower quadrant mass. Work up had revealed a large inflammatory mass involving the cecum and not amenable to percutaneous or colonoscopic biopsy, thus requiring diagnostic laparoscopy. He had a right inguinal hernia repair with mesh 8 years earlier. At diagnostic laparoscopy, an extensive right lower quadrant mass involving the cecum, bladder, and transverse colon and extending to the midline was found, necessitating conversion to open laparotomy and a right hemicolectomy. A mesh plug was found intimately involved with the specimen. Plugs used in inguinal hernia repair rarely migrate. It is rarer still for them to present as a possible colonic mass. This is the first known case report of mesh plug migration presenting as a suspected colonic malignancy.

scholarly journals Transabdominal Pre-Peritoneal (TAPP) Laparoscopic Inguinal Hernia Repair: Our Experience with 40 Cases

2020 ◽  
Vol 24 (1) ◽  
pp. 11-14
Author(s):  
Md Mamunur Rahman ◽  
Nelema Jahan ◽  
Md Mozammel Hoque ◽  
Md Saiful Islam ◽  
Mohammad Shahidul Alam ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Study Data ◽  
Long Term Results ◽  
Wound Complications ◽  
College Hospital ◽  
Medical College ◽  
Male Patients ◽  
Surgical Conditions

Background: Groin hernias are the most common surgical conditions all over the world. Laparoscopic (TAPP) approach has been achieved as the best technique of inguinal hernia repair due to less postoperative pain, earlier return to activity and fewer wound complications. Objectives: To share our experience with Transabdominal preperitoneal (TAPP) hernia repair and its outcome. Methods: This prospective study was performed in Shaheed Suhrawardy Medical College Hospital between January 2016 to December 2017. Forty male patients with inguinal hernia were included in this study. Data was collected in a proforma regarding demographic and baseline characteristics, operative time, outcome of patients and were analyzed in tabulated form. Results: Total 40 patients were included in our study. Age ranged from 20-60 years (mean age ± SD 38.88±10.92 years). The maximum duration of TAPP hernia repair ranged from 100-120 minutes s(mean ± SD 109±16.3 minutes). Post-operative complications were severe pain (10%), infection (5%), scrotal oedema (5%). Conclusion: Laparoscopic TAPP hernia repair is associated with satisfactory short- and long-term results. Journal of Surgical Sciences (2020) Vol. 24 (1) : 11-14

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