scholarly journals Sportsmen’s Groin—Diagnostic Approach and Treatment With the Minimal Repair Technique: A Single-Center Uncontrolled Clinical Review

2010 ◽  
Vol 2 (3) ◽  
pp. 216-221 ◽  
Author(s):  
Ulrike Muschaweck ◽  
Luise Masami Berger
Keyword(s):  
Groin Pain ◽  
Sports Injuries ◽  
Inguinal Canal ◽  
Posterior Wall ◽  
Professional Athletes ◽  
Chronic Groin Pain ◽  
Suture Repair ◽  
Minimal Repair ◽  
Repair Technique ◽  
Sportsmen’S Groin

Context: Sportsmen’s groin, also called sports hernia and Gilmore groin, is one of the most frequent sports injuries in athletes and may place an athletic career at risk. It presents with acute or chronic groin pain exacerbated with physical activity. So far, there is little consensus regarding pathogenesis, diagnostic criteria, or treatment. There have been various attempts to explain the cause of the groin pain. The assumption is that a circumscribed weakness in the posterior wall of the inguinal canal, which leads to a localized bulge, induces a compression of the genital branch of the genitofemoral nerve, considered responsible for the symptoms. Methods: The authors developed an innovative open suture repair—the Minimal Repair technique—to fit the needs of professional athletes. With this technique, the circumscribed weakness of the posterior wall of the inguinal canal is repaired by an elastic suture; the compression on the nerve is abolished, and the cause of the pain is removed. In contrast with that of common open suture repairs, the defect of the posterior wall is not enlarged, the suture is nearly tension free, and the patient can return to full training and athletic activity within a shorter time. The outcome of patients undergoing operations with the Minimal Repair technique was compared with that of commonly used surgical procedures. Results: The following advantages of the Minimal Repair technique were found: no insertion of prosthetic mesh, no general anesthesia required, less traumatization, and lower risk of severe complications with equal or even faster convalescence. In 2009, a prospective cohort of 129 patients resumed training in 7 days and experienced complete pain relief in an average of 14 days. Professional athletes (67%) returned to full activity in 14 days (median). Conclusion: The Minimal Repair technique is an effective and safe way to treat sportsmen’s groin.

scholarly journals THE FEATURES OF THE DIAGNOSIS AND TREATMENT OF A SPORTS HERNIA: A LITERATURE REVIEW

2020 ◽  
Vol 116 (2) ◽  
pp. 58-66
Author(s):  
Anastasiia Omelchenko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Comparative Analysis ◽  
Groin Pain ◽  
Inguinal Canal ◽  
Family Physicians ◽  
Posterior Wall ◽  
Football Players ◽  
Resonance Imaging ◽  
Sports Hernia ◽  
General Surgeons

Sports hernia is an important problem in professional and amateur sports. The article systematizes the literature and approaches to solving the groin pain during exercises, which is the main manifestation of sports hernia in football players. The presented research results show that a characteristic feature of a sports hernia is the presence of weakness of the posterior wall of the inguinal canal without anatomical signs of a typical hernia. For verification, the diagnosis is ultrasound and magnetic resonance imaging of the groin. The study conducted a comparative analysis of the results of surgical treatment of sports hernia. This research can be useful for general surgeons, sports physicians, family physicians, orthopedists and traumatologists.

scholarly journals MRI AND ULTRASOUND CRITERIA FOR THE DIAGNOSIS OF A SPORTS HERNIA IN FOOTBALL PLAYERS

2020 ◽  
Vol 73 (4) ◽  
pp. 755-760
Author(s):  
Oleksandr Yu. Ioffe ◽  
Natalia M. Negria ◽  
Anastasiia V. Omelchenko ◽  
Oleksandr P. Stetsenko ◽  
Yuri A. Dibrova ◽  
...  
Keyword(s):  
Signal Intensity ◽  
Groin Pain ◽  
Inguinal Canal ◽  
Posterior Wall ◽  
Football Player ◽  
Pubic Bone ◽  
Football Players ◽  
Sports Hernia ◽  
Two Factors ◽  
Sports Activities

The aim of the study is to specify diagnostic MRI and ultrasound criteria for a sports hernia in order to verify its diagnosis in football players. Materials and methods: The study included 50 professional and amateur football players aged 15 to 34 from 2016 to 2019. The criteria for inclusion in the study were: the presence of groin pain in football players, which prevented them from continuing to actively participate in sports activities. Results: The findings of the study revealed that during MRI the two factors, which had the strongest influence, were “increased MR signal intensity on PDfs observed from the structures of the inguinal canal” and “increased MR signal intensity on PDfs observed from bone marrow of superior ramus of the pubic bone”. During ultrasound of the inguinal area, the main criterion for a sports hernia diagnosis was “increased size of the inguinal canal”. The verification of the diagnosis was carried out on the basis of the presence of a protrusion in the posterior wall of the inguinal canal. For a sports hernia diagnosis the MRI sensitivity is 91.67% (95% CI 77.5 – 98.2), specificity –78.57% (95% CI 49.2 – 95.3) and the sensitivity of ultrasound is 88.89% (95% CI 73.9 – 96.9), the specificity – 50% (95% CI 23.0 – 77). Conclusions: The combination of MRI and ultrasound makes it possible to accurately detect the presence of a sports hernia in the football player. Based on the findings of our study, we formulated MRI and ultrasound criteria for a sports hernia diagnosis.

scholarly journals 950 Experience of Inguinal Mesh Hernioplasty Under Local Anaesthesia: A 3-Year Experience in A Teaching Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
Z Hashmi ◽  
R Ahmed ◽  
T Zafar ◽  
M Ahmed ◽  
N Yousaf ◽  
...  
Keyword(s):  
Local Anaesthesia ◽  
Groin Pain ◽  
Clinical Judgement ◽  
Chronic Groin Pain ◽  
Day Case ◽  
Post Operative Pain ◽  
The Mean ◽  
Mesh Hernioplasty ◽  
Operating Surgeon

Abstract Objective To prove Inguinal mesh hernioplasty under L/A is safe and acceptable. Helps with post-operative pain and enables rapid recovery as a day case. Method All patients who underwent inguinal hernia repair under local anaesthesia were retrospectively analysed in our hospital between July 2014- July 2017. Clinical judgement was used for inclusion and exclusion parameters. Results From July 2014- July 2017, 260 patients were included in study who underwent Inguinal mesh hernioplasty under L/A. ASA grade for all patients ranged between I-III. The mean age was 37 (20-65). Intraoperatively (9.1) 3.5% patients had problems such as pain, hypotension or sweating. About (86.3%) 224 patients were discharged home the same day and remaining stayed overnight for less than 24 hours. Hematoma was seen in 5 (1.92%) patients, Urinary retention in 2 (0.7%) patients, Wound infection seen in 24(9.2%) patients, Readmission in 10 (3.8%) patients. Chronic groin pain was seen in 10 (3.9%) patients and no recurrence on 6 months follow up. Conclusions Our results showed that this procedure is feasible under L/A and can be performed safely. It showed satisfactory acceptance by the operating surgeon and patient, without significant perioperative issues. It is reliable and showed shorter hospital stay.

scholarly journals Case report: direct suture repair of inferior vena cava to rescue a stab patient with hepatic and caval injury through left hepatectomy and total vascular exclusion

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Reina Hirooka ◽  
Kyoji Ito ◽  
Nobuyuki Takemura ◽  
Fuminori Mihara ◽  
Norihiro Kokudo
Keyword(s):  
Inferior Vena Cava ◽  
Hepatic Resection ◽  
Inferior Vena ◽  
Vena Cava ◽  
Damage Control Surgery ◽  
Posterior Wall ◽  
Emergency Laparotomy ◽  
Suture Repair ◽  
Vascular Exclusion ◽  
Total Vascular Exclusion

Abstract Background The mortality of abdominal vena caval injuries is as high as 50–80%. Yet, there were few reports on how to repair injured inferior vena cava (IVC). This report presents a method of vena caval repair in a case of penetrating retrohepatic IVC injury, requiring hepatic resection and total vascular exclusion (TVE). Case presentation The patient was a 20-year-old man with a stab wound in the epigastrium. An emergency laparotomy was performed in the emergency room, and a stab incision on the left liver was detected. As the Pringle’s maneuver did not reduce bleeding, hepatic vein injury was suspected, and left hemihepatectomy was performed to confirm the bleeding point. After the hepatectomy, laceration was still evident deeper into the resection, and IVC injury was suspected. The bleeding was temporarily controlled by tentative hepatorrhaphy and gauze packing, and the initial damage control surgery was terminated. Definitive surgery was performed on the third postoperative day. The lacerated point was observed under TVE, and the laceration penetrated the retrohepatic IVC through its posterior wall. The slit of the posterior wall was sutured first, followed by suturing of the anterior wall of the IVC. Finally, the lacerated liver was closed with hepatorrhaphy. TVE was removed, and the massive bleeding was successfully controlled. Conclusion In severe liver injuries involving the retrohepatic IVC, hepatic resection and TVE may be useful for ensuring an optimized surgical field for repairing the injured IVC.

scholarly journals Umbilical hernia: Factors indicative of recurrence

Medicina ◽  
2008 ◽  
Vol 44 (11) ◽  
pp. 855 ◽  
Author(s):  
Linas Venclauskas ◽  
Jolita Šilanskaitė ◽  
Mindaugas Kiudelis
Keyword(s):  
Risk Factors ◽  
Recurrence Rate ◽  
Umbilical Hernia ◽  
Hernia Recurrence ◽  
Suture Repair ◽  
Repair Technique ◽  
Umbilical Hernia Repair ◽  
Open Mesh Repair ◽  
Onlay Technique ◽  
Hernia Size

Umbilical hernia has gained little attention from surgeons in comparison with other types of abdominal wall hernias (inguinal, postoperative); however, the primary suture for umbilical hernia is associated with a recurrence rate of 19–54%. The aim of this study was to analyze the results of the umbilical hernia repair and to assess the independent risk factors influencing umbilical hernia recurrence. Materials and methods. A retrospective analysis of patients who underwent surgery for umbilical hernia in the Hospital of Kaunas University of Medicine in 2001–2006 was performed. Age, sex, hospital stay, hernia size, patient’s body mass index, and postoperative complications were analyzed. Postoperative evaluation included pain and discomfort in the abdomen and hernia recurrence rate. The questionnaire, which involved all these previously mentioned topics, was sent to all patients by mail. Hernia recurrence was diagnosed during the patients’ visit to a surgeon. Two surgical methods were used to repair umbilical hernia: open suture repair technique (keel technique) and open mesh repair technique (onlay technique). Every operation was chosen individually by a surgeon. Results. Ninety-seven patients (31 males and 66 females) with umbilical hernia were examined. The mean age of the patients was 57.1±15.4 years, hernia anamnesis – 7.6±8.6 years, hospital stay – 5.38±3.8 days. Ninety-two patients (94.8%) were operated on using open suture repair technique and 5 (5.2%) patients – open mesh repair technique. Only 7% of patients whose BMI was >30 kg/m2 and hernia size >2 cm and 4.3% of patients whose BMI was <30 kg/m2 and hernia size <2 cm were operated on using onlay technique (P>0.05). The rate of postoperative complications was 5.2%. Sixty-seven patients (69%) answered the questionnaire. The complete patient’s recovery time after surgery was 2.4±3.4 months. Fourteen patients (20.9%) complained of pain or discomfort in the abdomen, and 7 patients (10.4%) had ligature fistula after the surgery. Forty-five patients (67.2%) did not have any complaints after surgery. The recurrence rate after umbilical hernia repair was 8.9%. The recurrence rate was higher when hernia size was >2 cm (9% for <2 cm vs 10.5% for >2 cm) and patient’s BMI was >30 kg/m2 (8.6% for < 30 vs 10.7% for >30). There were 5 recurrence cases after open suture repair and one case after onlay technique. Fifty-six patients (83.6%) assessed their general condition after surgery as good, 9 patients (13.4%) as satisfactory, and only 2 patients (3%) as poor. Conclusions. We did not find any significant independent risk factors for umbilical hernia recurrence. However, based on reviewed literature, higher patient’s body mass index and hernia size of >2 cm could be the risk factors for umbilical hernia recurrence.

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