Anatomical variations of the inguinal morphometric features in  patients with inguinal hernia and its association with the type of inguinal hernia: a prospective clinical study

Background: Variations of inguinal canal and inguinal nerves are not uncommon. Knowledge about those variations is important to avoid inadvertent injury to the vital structures and to prevent recurrence.Methods: This prospective clinical study included all patients undergoing open inguinal hernia repair. Laparoscopic hernia repair, emergency surgery for complication and recurrent inguinal hernia were excluded. Parameters studied include interspinous distance, length and obliquity of inguinal ligament, attachment of conjoint tendon, condition of transversalis fascia and position and variations of ilioinguinal nerve.Results: The study included 192 patients. The mean interspinous distance (ISD) was 22±3.45 cm (CI: 30-32). ISD was not significant different among the two types of hernia. The mean length of internal oblique on inguinal ligament from anterior superior iliac spine was significantly longer in patients with indirect inguinal hernia (4±0.791 vs. 4.27±1.34; p=0.000). Significant patients in the direct hernia had weak transversalis fascia ((95% vs. 43%). 80% of the patients with direct hernia had defect in the transversalis fascia compared to only 8.8% in the indirect hernia. The difference is statistically significant. The nerve variation was present in only 1.3% in direct hernia group compared to 3.5% in the indirect hernia group.Conclusions: It was observed that the type of hernia did not significantly influenced by the length of inguinal ligament, the mean distance of midinguinal point, obliquity of the inguinal ligament. The nerve variation was present in only 1.3% in direct hernia group compared to 3.5% in the indirect hernia group.

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Laparoscopic treatment of inguinal hernia in female children – national experience

Lietuvos chirurgija ◽

10.15388/lietchirur.2021.20.37 ◽

2021 ◽

Vol 20 (1) ◽

pp. 20-26

Author(s):

Toni Risteski

Keyword(s):

Inguinal Hernia ◽

Open Repair ◽

Average Length ◽

Prospective Clinical Study ◽

Indirect Inguinal Hernia ◽

Group 4 ◽

Repair Materials ◽

Female Children ◽

The Mean

Background. Although, laparoscopic inguinal hernia repair in children is gaining ground as a safe, feasible, and popular method, still many pediatric surgeons continue to debate its safety, efficacy, and cosmesis in comparison with conventional open repair. Materials and methods. This was a prospective clinical study, that elaborated 98 female children aged 1–14 with clinically diagnosed indirect inguinal hernia. Equal proportions of 49 children were treated via laparoscopic (PIRS) either conventional open repair (OR). Outpatient clinic follow up was performed regardless of the type of the intervention, on the 7th day and 6 weeks after discharge. Results. The mean age of children in PIRS vs. OR group was 5.3±2.7 vs. 5.9±3.3 years. There was no significant differences between the groups related to age (p = 0.4221), weight (p = 0.5482), family history (p = 0.5377), and residency rural/urban (p = 0.3161). The average length of unilateral vs. bilateral PIRS repair (29.5±6.8 vs. 43.6±7.2 min) was significantly shorter than OR (44±4.2 vs. 97±8.1 min) for consequently p = 0.0023 vs. p = 0.00001. The post-operative hospitalization after PIRS repair was 14.1±3.1 hours and was significantly shorter compared to OR – 44±4.2 hours (p = 0.00001). In OR group, 4 (8.2%) children had postoperative nausea compared to none in PIRS group. Significantly bigger cosmetic satisfaction was found in PIRS compared to OM group (p = 0.0001). Conclusion. With due respect to OR as a gold standard, the proven advantages of PIRS are motivation for further improvement of this technique for the purpose of treatment of inguinal hernia of female children.

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A Prospective Clinical Study on the Impact of Occupation on Inguinodynia after Inguinal Hernia Repair

Surgery Current Research ◽

10.4172/2161-1076.1000313 ◽

2018 ◽

Vol 08 (02) ◽

Author(s):

Ojas Vijayanand Potdar ◽

Nitin Borle ◽

Sanjay Nagral ◽

Shraddha Bhone ◽

Amrita Patkar

Keyword(s):

Inguinal Hernia ◽

Clinical Study ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Prospective Clinical Study ◽

The Impact

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STUDY OF PATTERNS OF PRESENTATION AND MANAGEMENT OF COMPLICATED INGUINAL HERNIAS

10.36106/ijsr/4029417 ◽

2020 ◽

pp. 1-2

Author(s):

Sarita Durge ◽

Mayur Bandawar

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Surgical Intervention ◽

Age Distribution ◽

Emergency Setting ◽

Indirect Inguinal Hernia ◽

Hernia Surgery ◽

Inguinal Hernia Surgery ◽

The Mean

Background There are a lot of advancement in techniques of elective inguinal hernia surgery, but progress for management of complicated inguinal hernia repair in emergency, fall behind. The aim of study was to know age distribution, pattern of presentation, to evaluate the outcome of various types of surgical procedure done for complicated inguinal hernia and their post-operative complications. Methods and Materials This retrospective study included 62 patients suffering from complicated inguinal hernia,and who underwent emergency surgery, from Jan-2016to Dec-2019. Results The mean of age of sampled patients was 53.88 + 14.23 years, with increased incidence in males.Right sided, indirect inguinal hernia was frequently involved.Commonest postoperative complication was wound infection.Tension free repair Lichenstein’s technique (Hernioplasty) was done in maximum cases. Conclusion Mesh repair (hernioplasty) is acceptable and safe option for inguinal hernia repair in emergency setting. Early hospitalization and timely surgical intervention are associated with better outcome.

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Conversion of Total Extraperitoneal (TEP) to Transabdominal Preperitoneal (TAPP) for repair of inguinal hernia; Frequency and causes.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.02.3157 ◽

2020 ◽

Vol 27 (02) ◽

pp. 242-245

Author(s):

Muhammad Ghayasuddin ◽

Fareya Usmani ◽

Imran Munir ◽

Mahwash Anjum Shafiq ◽

Syed Muhammad Sheraz Raza Naqvi

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

P Value ◽

Indirect Hernia ◽

Transabdominal Preperitoneal ◽

Total Extraperitoneal ◽

Direct Hernia ◽

Study Population ◽

Transabdominal Preperitoneal Inguinal Hernia

Objectives: Our study aims to determine the incidence of and reasons for the conversion of hernia operations from laparoscopic guided total extraperitoneal (TEP) to transabdominal preperitoneal inguinal hernia repair (TEPP). Study Design: Cross-sectional study. Setting: A large tertiary care hospital in Karachi Pakistan. Period: From August 2016 to November 2018. Material & Methods: The sampling technique utilized was consecutive non-probability sampling. The study population consisted of patients between the ages of 22 and 50 years, males, having unilateral inguinal hernia, both direct and indirect presentation. A complete history and physical examination was performed and recorded in a pre-designed proforma for all the patients. Laboratory investigations were performed per routine. The patients underwent laparoscopic total extraperitoneal hernia repair and were noted for complications and conversion to transabdominal preperitoneal inguinal hernia repair. Data was analyzed using IBM SPSS statistics version 20. Chi-square test was used to analyze categorical variables, while mean and percentages were used for numerical data. A p value of less than 0.05 is considered to be statistically significant. Results: The study population was n= 150, mean age of the patients was 36.25 +/- 7.08 with a minimum of 22 and a maximum of 50 years. The direct hernia was present in 47.33% (71 patients) while an indirect hernia was present in 52.67% (79 patients). Out of the total patient population, 21 (14%) of the patients (having a p-value of 0.013) were converted to the TAPP procedure of which 10 (14.08%) has a direct hernia and 11 (13.92%) had an indirect hernia respectively (having a p-value of 0.953). The most common reason for conversion was peritoneal tear, hemorrhage and instrument failure. Conclusion: According to the results of our study, 14% of cases of direct and indirect hernia had to convert from TEP to TAPP procedure, and the main reasons for this conversion were found to be hemorrhage, peritoneal tear and instrument failure.

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Single port laparoscopic transabdomional preperitoneal inguinal hernia repair: prospective cohort study

International Surgery Journal ◽

10.18203/2349-2902.isj20192143 ◽

2019 ◽

Vol 6 (6) ◽

pp. 1972

Author(s):

Tejinder Pal Singh Sodhi ◽

Kirti Savyasacchi Goyal ◽

Utkarsh Garg ◽

Kritesh Goel ◽

Hemangi Gandhi

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Single Incision ◽

Single Port ◽

Single Incision Laparoscopic Surgery ◽

Indirect Inguinal Hernia ◽

Medical Sciences ◽

The Mean ◽

One Year

Background: Laparoscopic inguinal hernia repair offers variety of advantages than the conventional repair. Therefore, laparoscopic transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques are frequently preferred. Single-incision laparoscopic surgery (SILS) was developed with the aim of reducing the invasiveness of conventional laparoscopy and has been successfully performed by many surgeons.Methods: This study was conducted on 25 patients over a period of one year from November 2011 to October 2012 in Department of General Surgery, Acharya Sri Chander College of Medical Sciences and Hospital, Sidhra, Jammu (ASCOMS), India with uncomplicated inguinal hernia which underwent single port laparoscopic TAPP (SPL-TAPP).Results: In this study, all the patients (100%) had unilateral inguinal hernia, among them 16 (64%) had direct and 9 (36%) had indirect inguinal hernia. Pediatric patients were excluded from study. The mean age, weight and height were 44.4, 59.46 and 157.2 cm respectively. Intraoperative data for SPL-TAPP had complications in 1 case (seroma formation) and need for conversion to conventional surgery was also seen in 1 case.Conclusions: Single port TAPP offers to be safe and efficacious with minimum re-occurrences and shorter hospital stay.

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Outcome of tension free open mesh repair of inguinal hernia

Journal of Surgical Sciences ◽

10.3329/jss.v22i1.44010 ◽

2020 ◽

Vol 22 (1) ◽

pp. 21-24

Author(s):

Mohammad Masum ◽

Md Aminul Islam ◽

Masflque Ahmed Bhuiyan ◽

Kazi Mazharul Lslam ◽

Md Selim Morshed ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Inguinal Hernia Repair ◽

Mesh Repair ◽

Groin Hernia ◽

Synthetic Mesh ◽

Indirect Inguinal Hernia ◽

Prolene Mesh ◽

Tension Free ◽

Open Mesh Repair

Background: In the practice of General Surgery, hernia repair is the second most common procedure after appendectomy. Several methods have been developed over the years to try to improve hernia repair. Good result can be expected using Bassini's, McVay's, Shouldice's techniques provided the exact nature of hernia is recognized and the repair is done without tension using healthy tissue. The introduction of synthetic mesh started a new era in hernia surgery. The use of synthetic mesh repair of primary and recurrent hernias has gradually gained acceptance among surgeons. Objective: To find out the outcome and complications of open inguinal hernia repair with prolene mesh. Methods: This is a prospective cross sectional study conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December, 2011 to May, 2012. One hundred patients of inguinal hernia admitted in different surgical units of BSMMU, Dhaka for elective surgery were studied. We have given 1 gm ijv Cephradine per operatively and then 500 gm cephradine ijv 6 hourly for 24 hours followed by oral form of Cephradine for next 5 days. Polypropylene mesh of 11 cm x 7 cm size was used in all cases. All the operations were done by open tension free prolene mesh repair technique. Patients were followed for one year to see the outcome. Results: Out of 100 cases of inguinal hernia, 71 patients (71%) had indirect inguinal hernia and 29 cases (29%) had direct inguinal hernia; 90 cases (90%) were primary hernia and only 10 cases (10%) were recurrent hernia; 58 cases were right sided, 34 cases (34%) were left sided and 8 cases (8%) were bilateral. Complications of mesh repair of groin hernia in this study included wound infection (5%), scrotal oedema (2%), mesh infection (0%), scrotal hematoma (2%), echymoces of peri-incisional skin (5%), early wound and groin pain (7%), chronic inguinodynia (2%), hernia recurrence (1%). Conclusion: In the present study an attempt is made to evaluate the outcome of patients undergoing inguinal hernia repair by prolene mesh. The results confirm that Lichtenstein tension free mesh repair of inguinal hernia is safe and reliable for both primary and recurrent groin hernia, with less recurrence rate. Patient's compliance was good with minimum morbidity. Journal of Surgical Sciences (2018) Vol. 22 (1): 21-24

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INGUINAL HERNIA REPAIR BY THE “MESH PLUG” TECHNIQUE

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2013.6.7 ◽

2014 ◽

pp. 40-46

Author(s):

Doan Van Phu Nguyen ◽

Loc Le ◽

Van Lieu Nguyen

Keyword(s):

Inguinal Hernia ◽

Postoperative Pain ◽

Operating Time ◽

Life Assessment ◽

Medium Size ◽

Mesh Plug ◽

Indirect Hernia ◽

Postoperative Rehabilitation ◽

Early Return ◽

Direct Hernia

Background:In 1989, Lichtenstein I. L., Shulman A. G., Amid P. K., and Montlor M. M. presented an idea of using Mesh Plug to repair the defect inguinal canal. The new technique quickly became accepted by surgeons all over the world for several reasons: faster overall rehabilitation, less postoperative pain, less complication, shorter stay in the hospital and early return to normal activities and work. Materials and method:From December 2011 to October 2012, 97 patients with inguinal hernia were surgically treated with 110 Mesh Plugs applied at the Surgery Unit of Hue University of Medicine and Pharmacy. Result:The patients’ mean age was 48.96±23.19. There were 60 patients over 40 years old, accounting for 61.9%, and 93 of the group were males, accounting for 95.8%. 24 cases were direct hernia, accounting for 21.8%, 86 cases were indirect hernia accounting for 78.2% and 11cases were direct hernia associated with indirect hernia. Based on Nyhus’s classification, there were 76 cases of IIIA and IIIB (69.1%). Based on the position of protrusion, there were 66 cases of right inguinal hernia (60.0%), 44 cases of left inguinal hernia (40.0%), and 13 cases of hernia on both sides. The average size of the deep ring is 2.19±1.54cm. 65 cases used Mesh Plug of medium size (59.1%). The mean operating time was 37.26 minutes. The time of staying in the hospital was 3.58±1.17 days. Quality of life assessment after the surgery showed 93 very good and good cases 95.8% and 4 cases (4.2%) with satisfactory result. No case of bad outcome was recorded. Conclusion: Surgical treatment of inguinal hernia by the Mesh Plug technique is really effective, safe with faster postoperative rehabilitation, less postoperative pain, less complications, shorter hospital stay and early return to normal activities and work. Key words: Inguinal hernia, Mesh Plug.

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Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v24i5.1358 ◽

2020 ◽

Vol 24 (5) ◽

Author(s):

Carla Hipólito ◽

Vicente Vieira ◽

Virginia Antunes ◽

Petra Alves ◽

Adriana Rodrigues ◽

...

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Airway Management ◽

Inguinal Hernia Repair ◽

Neuromuscular Blockade ◽

Retrospective Review ◽

Laparoscopic Inguinal Hernia Repair ◽

Laparoscopic Inguinal Hernia ◽

Increased Risk ◽

The Mean

Background: Inguinal hernia is one of the most common conditions presented for surgical repair in children and laparoscopic approaches are increasingly performed. Previous studies have shown safety and efficacy in the use of supraglottic devices (SGD) as an alternative to tracheal intubation, which fits particularly well with outpatient anesthesia. Methodology: we conduct a retrospective observational study, collecting data from the electronic anesthetic form, from all patients aged 0 to 17 y who underwent ambulatory laparoscopic percutaneous internal ring suturing between February 2015 and August 2019, if I-gelTM was used to airway management. Results: We found 230 patients meeting the inclusion criteria. The mean age was 5.2 y old, mean weight 20.1 kg. All patients were ASA I (n=203) or ASA II (n=27). The mean surgery duration was 38 minutes. We found 4 respiratory adverse events, three bronchospasms, and one laryngospasm, managed in the operating room. Ninety percent of the surgeries were performed without neuromuscular blockade. Conclusion: I-gelTM was a safe, effective, and convenient alternative to airway management to laparoscopic inguinal hernia repair in the ambulatory setting. According to available literature, our practice did not represent an increased risk for the studied respiratory events. SGD obviates the need for neuromuscular blockade. Key words: I-gel; Supraglottic devices; Laparoscopy; Inguinal hernia repair; Pediatrics; Anesthesia, ambulatory Citation: Hipólito C, Vieira V, Antunes V, Alves P, Rodrigues A, Santos MJ. Airway management with I-gelTM for ambulatory laparoscopic inguinal hernia repair in children; a retrospective review of 230 cases. Anaesth. pain intensive care 2020;24(5): Received: 18 February 2020, Reviewed: 5 August, 6 September 2020, Accepted: 11 September 2020

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