scholarly journals The results of preperitoneal inguinal hernioplasty without fixation of the mesh endoprosthesis in the experiment.

2019 ◽  
Vol 12 (2) ◽  
pp. 97-101
Author(s):  
Anna Viktorovna Mokrova ◽  
Oleg Vladimirovich Zaitsev ◽  
Dmitry Anatolyevich Khubezov ◽  
Vladimir Alexandrovich Yudin ◽  
Sergey Vasilevich Tarasenko ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Inguinal Canal ◽  
Abdominal Cavity ◽  
Preperitoneal Space ◽  
Indirect Inguinal Hernia ◽  
Inguinal Hernioplasty ◽  
Experimental Development ◽  
Direct Inguinal Hernia ◽  
Significant Difference ◽  
Mesh Endoprosthesis

The purpose of the study is experimental development of preperitoneal inguinal hernioplasty with synthetic mesh, according assessment of the need of its fixation to the tissues. Materials and methods. An inguinal hernia was simulated on human cadaveric material. The study used 27 male corpses. Two inguinal hernias were modeled on one corpse: on one side - indirect, on the other - direct. A polypropylene mesh (standard density, 15 x 15 cm) was placed in the preperitoneal space. The endoprosthesis was impacted from the side of the abdominal cavity by a special designed device. The effect of a peak intra-abdominal pressure of 200 mm Hg was simulated. The degree of displacement of the reticular endoprosthesis into the inguinal canal was estimated at the moment of peak pressure on it from inside the abdominal cavity. For a simulated indirect inguinal hernia, two variants of the technique were considered: with fixation of the endoprosthesis to the underlying tissues and without fixation. For the modulated direct inguinal hernia, the following options were considered: non-fixative, with fixation at one point to the pubis and with plasty of the transverse fascia. Results. When modeling preperitoneal plasty of a direct inguinal hernia, there is a pronounced displacement of the endoprosthesis into the inguinal canal with a non-fixing plasty, unlike the method with transverse fascia plasty or fixation to the pubis. In indirect inguinal hernia, there was no significant displacement of the endoprosthesis in both considered variants. Conclusions. According to the obtained results, conclusions were drawn on the need for additional plasty of the transverse fascia or fixation of the endoprosthesis at a single point in a direct inguinal hernia. With indirect inguinal hernia in the experiment, no significant difference in the displacement of the mesh endoprosthesis into the inguinal canal was obtained with and without fixation.

scholarly journals Non-Descended Testicle Presenting as an Inguinal Hernia

2020 ◽  
pp. 1-2
Author(s):  
Wouter J Bakker ◽  
C. V. van Hessen ◽  
J. P. J. Burgmans ◽  
W. D. Rinkel ◽  
Wouter J Bakker
Keyword(s):  
Inguinal Hernia ◽  
Groin Pain ◽  
Undescended Testis ◽  
Inguinal Canal ◽  
Preperitoneal Space ◽  
Indirect Inguinal Hernia ◽  
Left Testis ◽  
Left Groin ◽  
Case Presentation ◽  
Adult Men

Background: An inguinal hernia is one of the most common surgical diagnosis worldwide and the most frequent anomaly of the groin area. Cryptorchidism, the failure of the testes to descend into the scrotum, is also a prevalent congenital abnormality, with a reported incidence of 1% to 2% at 12 months of age. However, it is rarely diagnosed in adult men. Case Presentation: We present the case of a 63-year-old male who presented to the Emergency Department with severe left-sided groin pain since a couple of days. A bulge in the left groin was visibly obvious and was painful but reducible. An inguinal hernia was diagnosed, and since the patient had no previous (abdominal) surgery, he was scheduled for a totally extraperitoneal (TEP) endoscopic inguinal hernia repair. Per-operatively, an indirect inguinal hernia was initially seen; however, after further dissection and displacement of the peritoneal fold cranially, it became clear that the alleged hernia was the left testis situated in the preperitoneal space. The testis was surgically brought out through the inguinal canal. A preperitoneal mesh was placed. Conclusion: In case of a painful and reducible inguinal swelling that occurs in a patient with an empty hemiscrotum, surgeons must consider the possibility of an undescended testis.

scholarly journals Strangulated direct inguinal hernia with intraperitoneal perforation

2017 ◽  
Vol 4 (12) ◽  
pp. 4093 ◽  
Author(s):  
Md Asjad Karim Bakhteyar ◽  
Binod Kumar ◽  
Sushil Kumar
Keyword(s):  
Small Intestine ◽  
Inguinal Hernia ◽  
Posterior Wall ◽  
Indirect Inguinal Hernia ◽  
Direct Inguinal Hernia ◽  
Peritoneal Perforation ◽  
Direct Hernia

Usually direct inguinal hernia doesn’t present as strangulation or incarceration as compared to indirect inguinal hernia because of earlier has wider neck. A patient of recurrent direct inguinal hernia presents as intra-scrotal gangrene and intra-peritoneal perforation. We reported a case of 65 years old male presented with septicemia and right sided strangulated direct hernia. On exploration through inguino scrotal incision and mid line laparotomy, gangrenous loop was found in scrotum and perforation was found in intra-peritoneal part of small intestine. Resection-anastomosis was done for both the parts of intestine. Inguinal Incision was closed by posterior wall closure and modified Bassini’s herniorraphy. Abdomen was closed in layers with brain. Long standing direct hernia may present as strangulation or incarceration specially in elderly but perforation and gangrene of intra-peritoneal part of small intestine is very rare.

scholarly journals Prospective comparison of post-operative quality of life (QOL) after laparoscopic total extra-peritoneal (TEP) and trans-abdominal pre-peritoneal (TAPP) repair of indirect inguinal hernia

2018 ◽  
Vol 5 (8) ◽  
pp. 2882
Author(s):  
Nikita Wadhwani ◽  
Ishwar Chand Mehar ◽  
Arun Singh ◽  
R. K. Soni
Keyword(s):  
Quality Of Life ◽  
Inguinal Hernia ◽  
P Value ◽  
Indirect Inguinal Hernia ◽  
Statistical Significant Difference ◽  
Tapp Repair ◽  
Significant Difference ◽  
Operative Quality

Background: As the laparoscopic method is becoming a popular choice of repair, the need to evaluate its impact on the patient’s quality of life (QOL) is also warranted. This study was undertaken to compare post operative QOL in patients undergoing Totally Extraperitoneal (TEP) and Transabdominal preperitoneal (TAPP) repair for indirect inguinal hernia.Methods: This prospective observational study was conducted in the Department of General Surgery at VMMC and Safdarjung Hospital, from June 2016 to March 2018. Patients with uncomplicated indirect inguinal hernia were included in the study after obtaining their informed consent. Post-operative QOL was evaluated using EuraHS-QOL scale at 24 hours and 1, 3 and 6 months after the surgery.Results: A total of sixty patients were enrolled-30 in TEP group and 30 in TAPP group. There was no statistical significant difference in scores at 24 hours follow-up except cosmetic discomfort domain, with higher scores in TAPP (p-value=0.014). Statistical significant difference was present at 1 month follow up with higher scores in TAPP (p-value=0.011). At 3 and 6 months, no statistical difference was found in the scores.Conclusions: Present study demonstrates a significant advantage of TEP over TAPP up to 1-month follow-up, in terms of post-operative QOL. Choosing a superior laparoscopic method between TEP and TAPP requires high powered RCTs with long term follow up to assess the technical advantages and post-operative complications along with post-operative quality of life in patients.

scholarly journals Radical direct inguinal hernia surgery

2021 ◽  
Vol 25 (11) ◽  
pp. 1235-1235
Author(s):  
I. Tsimkhes
Keyword(s):  
Inguinal Hernia ◽  
Inguinal Canal ◽  
Fatty Tissue ◽  
Purse String Suture ◽  
Hernia Surgery ◽  
Purse String ◽  
Direct Inguinal Hernia ◽  
Inguinal Hernia Surgery

E. Balogh (Zentrbl. F. Chir. No. 44/1929) suggests, when opening the inguinal canal, to dissect longitudinally the fascia transversa and separate it from all sides as far as possible from the underlying preperitoneal fatty tissue. Then, on the inside of the transverse fascia, apply a purse-string suture, removing the peritoneum with the instrument inward. Further, the operation ends, typically according to Basini.

scholarly journals Direct inguinal hernias in children

2021 ◽  
Vol 11 (2) ◽  
pp. 161-167
Author(s):  
Vyacheslav G. Svarich ◽  
Ilya M. Kagantsov ◽  
Violetta A. Svarich
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Ultrasound Examination ◽  
Laparoscopic Hernia Repair ◽  
Abdominal Cavity ◽  
Treatment Method ◽  
Long Term Results ◽  
Direct Inguinal Hernia ◽  
Surgical Department ◽  
Inguinal Hernias

AIM: Based on the accumulated clinical material, this study aims to show the possibilities of diagnosing and treating direct inguinal hernias in children. MATERIALS AND METHODS: During the period from 2000 to 2020, 3221 children with inguinal hernias were treated in the surgical department of the Republican Childrens Clinical Hospital in Syktyvkar. Of the above group of children with inguinal hernias, seven patients (0.22%) had direct inguinal hernias. The above was confirmed by ultrasound examination. In laparoscopic imaging, a rectal hernia was defined as a recess of the peritoneum of a stellate or rounded shape in the projection of the medial umbilical fossa. Two patients underwent the Bassini herniation procedure. Two children underwent laparoscopic hernia repair with intracorporeal suture insertion. In three patients, hernia repair was performed using the PRMS method. RESULTS: Long-term results were followed up from six months to 15 years. Immediate and postoperative complications were noted. No recurrence of hernia was reported. CONCLUSIONS: When establishing direct inguinal hernia diagnosis in children is clinically determined in the form of a rounded, soft-elastic formation localized medially and above the Pupart ligament next to the projection of the external (superficial) inguinal ring of the inguinal canal. It is easily set into the abdominal cavity with rumbling and confirmed by ultrasound examination results. The most preferred treatment method for direct inguinal hernia in children, in our opinion, is hernia repair using the percutaneous internal ring suturing (PIRS) method.

Comparison of post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker

2021 ◽  
Vol 15 (10) ◽  
pp. 2733-2735
Author(s):  
Shahid Hussain ◽  
Asiya Shabbir ◽  
Muhammad Asif
Keyword(s):  
Inguinal Hernia ◽  
Mesh Repair ◽  
Indirect Inguinal Hernia ◽  
Satisfactory Outcome ◽  
Post Operative Pain ◽  
Total Extraperitoneal ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Laparoscopic Tep

Objectives: To compare the post-operative pain after laparoscopic total extraperitoneal mesh repair of indirect inguinal hernia with tacker and without tacker fixation. Materials & Methods: This comparative study was done at Surgical Department of Bahawal Victoria Hospital, Bahawalpur from May 2020 to November 2020 over the period of 6 months. Total 182 patients with indirect inguinal hernia, having age range from 20 to 60 either male or female were selected. In group A patients, laparoscopic TEP mesh repair of inguinal hernia without tacker fixation was done while in group B patients, laparoscopic TEP mesh repair of inguinal hernia with tacker fixation was done. Patients were assessed for post-operative pain and outcome (satisfactory/unsatisfactory) at 1 month follow up. Results: Average of patients was 41.33 ± 12.37 years and 40.83 ± 12.04 years in group A and group B. Out of 182 patients, 170 (93.41%) were males and 12 (6.59%) were females. Mean post-operative pain in Group A was 1.46 ± 1.50 while in Group B was 1.77 ± 2.08 (p-value=0.2505). Satisfactory outcome was noted in 84 (92.31%) patients and 67 (73.63%) patients of group A and B and the difference was significant (P = 0.001). Conclusion: Results of this study showed that there is a significant difference of satisfactory outcome (less post-operative pain) between the non-fixation and fixation group. Difference of satisfactory outcome was also significant between male patients, diabetics and obese patients of both groups. Keywords: Inguinal hernia, laparoscopic, mesh, tacker fixation

scholarly journals A randomised controlled trial of excision versus invagination in the management of indirect inguinal hernial sac

2019 ◽  
Vol 101 (2) ◽  
pp. 119-122
Author(s):  
M Sharma ◽  
OP Pathania ◽  
A Kapur ◽  
S Thomas ◽  
A Kumar
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Testicular Atrophy ◽  
High Ligation ◽  
Indirect Inguinal Hernia ◽  
Tension Free ◽  
Hernial Sac ◽  
Significant Difference ◽  
Group A ◽  
Group B

Introduction Lichtenstein tension-free mesh hernioplasty of primary inguinal hernia is currently considered as the preferred method for the plastic reconstruction of inguinal hernia by the majority of surgeons. Several studies have examined the best way to manage the hernial sac in this surgery, but no consensus has been reached. This study was designed to compare the effects of excision of sac and invagination of sac on post-operative outcomes. Methods and methods This prospective randomised study included a total of 70 patients with primary unilateral uncomplicated indirect inguinal hernia. Group A (35 patients) underwent high dissection and invagination of the hernial sac and group B (35 patients) underwent high ligation and excision of the hernial sac. The repair of the posterior wall of the inguinal canal was done according to Lichtenstein tension-free technique. The primary outcome of this study was postoperative pain and secondary outcomes were wound infection, chronic sepsis, sinus formation, persistent pain, testicular atrophy and recurrence during the one-year follow-up period. Results There was a significant difference (P < 0.01) in pain experienced by the patients in the immediate post-operative period between the two groups; group A experienced less postoperative pain than group B. There was no significant difference in incidence of infection between the groups. Conclusions Invagination of the sac results in less postoperative pain compared with excision, with no significant difference in other postoperative outcomes.

scholarly journals 1598 Local Anaesthetic or General Anaesthetic: The Optimal Choice for Inguinal Hernia Repair

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
K Mushonga
Keyword(s):  
Inguinal Hernia ◽  
Local Anaesthetic ◽  
Inguinal Canal ◽  
Operating Time ◽  
Optimal Choice ◽  
General Anaesthetic ◽  
Significant Difference ◽  
Surgeon Experience ◽  
Randomised Control Trials ◽  
Post Operative Nausea

Abstract Aim Inguinal hernias occur when visceral tissue protrudes through the inguinal canal [1]. Around 20 million inguinal hernia repairs (IHR) are done annually worldwide and involve re-enforcement of the compromised wall of the inguinal canal using polypropylene mesh via open anterior approach or minimally invasive laparoscopy [2,3]. Despite gold standards in surgical approach, there’s no distinctively superior practice between local anaesthetic (LA) and general anaesthetic (GA). Therefore, the objective was to review IHR under both LA and GA and investigate which method is conductive to optimal patient outcomes. Method Systematically reviewed randomised control trials (RCTs) evaluating the benefits of LA over GA in IHR, by comparing factors such as post-operative nausea, urinary retention (UR), haematoma, wound infection (WI), pain, and operating time. PubMed was utilised for finding suitable studies, and data was obtained and summarised appropriately. Results Data assembled from RCTs evaluating benefits of LA over GA in IHR indicated no significant difference between groups when comparing nausea, UR, haematoma, WI and pain [4]. Supporting studies reviewing RCTs juxtaposing GA and LA in IHR elucidated no significant variance in operating time, haematoma and WI [5]. Patients did show less rates of UR, reduced pain scores and greater patient satisfaction under LA [5]. Conclusions LA is used in specialised hernia clinics due to less cardiovascular risk however development of short-acting GA’s allows for suitability for day-case surgery. Future investigation is required taking into account factors like surgeon experience, patient anatomy and economic viability for a definitive gold standard.

scholarly journals The presence of a low lying pubic tubercle in patients with indirect inguinal hernia

2018 ◽  
Vol 5 (6) ◽  
pp. 2074 ◽  
Author(s):  
Ashwin Aby Thomas ◽  
Amrita Prasad ◽  
D. S. A. Mahadevan
Keyword(s):  
Inguinal Hernia ◽  
Research Centre ◽  
Indirect Inguinal Hernia ◽  
Pubic Tubercle ◽  
Protective Mechanisms ◽  
Medical College ◽  
Significant Difference ◽  
Prostatic Enlargement ◽  
Positive Correlations ◽  
Surgery Department

Background: Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Factors like chronic cough, constipation, prostatic enlargement etc. contribute to its development. Various defensive mechanisms of the inguinal canal like shutter and slit valve mechanisms help prevent its formation. In this study, a comparison has been made between the anthropometric measurements of the pelvis in patients with and without indirect inguinal hernia to look for a statistically significant difference in the position of the pubic tubercle which in turn affects the various protective mechanisms. Other measurements such as Height, Weight and interspinal distance have been included to look for positive correlations between the disease and said measurements.Methods: This study was conducted in the General Surgery Department of SRM Hospital, Medical College and Research Centre, Kattankulathur after ethics committee clearance. It is a case control study conducted on 140 consenting patients and meeting the inclusion criteria from March 2016 to August 2017, of which 70 each were patients of indirect inguinal hernia and patients without inguinal hernia.Results: Results developed using SPSS Software show majority of the subjects with a low lying pubic tubercle were inguinal hernia patients. There was also a positive correlation between the ratios of weight and ST length as well as Height and ST length between cases and controls.Conclusions: It can be concluded from this study that factors such as a low lying pubic tubercle and other related anthropometric variables predispose patients to develop indirect inguinal hernia.

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