scholarly journals Laparoscopic Examination and Transabdominal Preperitoneal (TAPP) Approach with Biologic Mesh for Strangulated Direct Inguinal Hernia Accompanied by Small Intestinal Perforation

2021 ◽  
Author(s):  
Tianhao Xie ◽  
Shujie Cheng ◽  
Yan Fu ◽  
Xinli Sun ◽  
Xiangxiang Ren ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
General Anesthesia ◽  
Intestinal Perforation ◽  
Abdominal Cavity ◽  
Biologic Mesh ◽  
Incarcerated Inguinal Hernia ◽  
Direct Inguinal Hernia ◽  
Inguinal Hernias ◽  
Small Intestinal

Abstract Background A direct inguinal hernia is caused by a weakness or defect in the floor of the Hesselbach triangle. It is believed that direct hernias are less likely to strangulate than indirect hernias, because the neck of the direct hernia is wide enough to avoid strangulation. Approximately 8.6% of all incarcerated inguinal hernia contents can be returned to the abdominal cavity spontaneously after general anesthesia, and intestinal ischemia or necrosis was detected by laparoscopic examination in approximately 40.9% of cases. However, which surgical approach or mesh for an acutely incarcerated and strangulated groin hernia is still no consensus. We retrospectively enrolled 12 patients with incarcerated inguinal hernias accompanied by small intestinal perforation who underwent laparoscopic examination when the hernia content spontaneously returned into the abdominal cavity after induction of general anesthesia in our institution.Results 1 of the 12 patients had developed temporary seroma; the other 2 had early postoperative pain. No evidence of hernia recurrence, chronic pain, infection, scrotal swelling, paralyticileus, persistent seroma, mortality, or any other complications were found during the follow-up. At 1 year and most recent follow-up, all patients were satisfied with the treatment outcome.Conclusions It is a necessary to detect abdominal viscera when incarcerated inguinal hernia contents return to the abdominal cavity spontaneously after general anesthesia, and laparoscopic examination is an efficient method. Laparoscopic TAPP technique with biologic meshes is a feasible method to treat strangulated inguinal hernias accompanied by small intestinal perforation. To better understand whether TAPP or biologic mesh apply to strangulated inguinal hernia (especially enterectomy) and evaluate its wider application, this treatment will need to be tested in larger clinical trials.

Laparoscopic cauterization of hernia sac in girls; the Burnia technique

2020 ◽  
Author(s):  
Sabriye Dayı
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Contralateral Side ◽  
Hernia Sac ◽  
Inguinal Hernias ◽  
Laparoscopic Techniques

INTRODUCTION: Inguinal hernia repair is one of the most common surgical procedures in pediatric surgery. In parallel with the advances in the field of medicine, various laparoscopic techniques have been developed in inguinal hernia repair. The Burnia technique is one of the latest published techniques and it is the cauterization of the inguinal hernia sac laparoscopically without using sutures in girls. The aim of this study is the investigation of the use of Burnia technique in clinical practice, and its postoperative outcomes. Any article concerning the use of this technique in Turkey has not been encountered. METHODS: The demographic features of patients, preoperative, peroperative, postoperative and follow-up results of 41 patients who had been operated with Burnia technique by a single surgeon within 2 years were reviewed retrospectively. Laparoscopically, the camera was first placed at an inclination of 30 degrees to the umbilical region using Hasson technique, and then, a single port was used for cauterization of the hernia sac. The Hernia sac was pulled into the abdominal cavity and cauterized. RESULTS: Burnia technique was applied to 62 inguinal hernia sacs in 41 girls. Their ages ranged from 1.5 to 16 years (median 36 months) with body weights ranging between 3.5 kg-40 kg (median 12 kg). Preoperatively 15 patients had right (37%), 19 patients left (46%), 7 patients bilateral inguinal hernias (17%). During surgery, 14 of the unilateral inguinal hernias were found to have a hernia sac on the contralateral side, and the rate of bilateral hernia increased to 51 percent. In one patient ovary was in the inguinal canal, and after its reduction, we proceeded with the operation Unexpectedly. in one patient, right ovarian torsion was detected which was detorsioned, and hernia surgery was performed in the same session. The duration of the operation was 5-35 min (median 15 min) for unilateral and 8-45 min (median 20 minutes) for bilateral hernias. None of these patients developed peroperative and postoperative complications. Follow-up time was minimum 10 months, and maximum 3 years. Recurrence was not detected. DISCUSSION AND CONCLUSION: Burnia technique seems to be effective and safe. The contralateral side and other intra-abdominal pathologies are explored. The cosmetic appearance is its another advantage. The operation time is very short due to the fact that only the hernia sac is cauterized. Comparison of this technique with other laparoscopic techniques is planned in the future study.

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.

scholarly journals INCARCERATED INGUINAL HERNIA IN NEWBORNS AND INFANTS

2021 ◽  
Vol 11 (3(41)) ◽  
pp. 41-45
Author(s):  
O. Gorbatyuk
Keyword(s):  
Inguinal Hernia ◽  
Physical Examination ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Surgical Correction ◽  
Vertical Position ◽  
Optimal Timing ◽  
Incarcerated Inguinal Hernia ◽  
Inguinal Hernias ◽  
Effective Diagnosis

Introduction. Inguinal hernias (IG) in children are a congenital pathology of the processusvaginalis and a local manifestation of the syndrome of mesenchymal insufficiency. Incarcerated IG is the most common and dangerous complication, the risk of which is significantly higher in children during the first 3 months of life. To date, there is no perfect method of pinched IG treatment in newborns and infants. Data on the optimal timing of herniotomy in newborns and infants are also insufficient and contradictory.The aim of this study is to provide our own experience in the treatment of infants with pinched inguinal hernias.Material and methods. The material of this study is 97 newborns and infants with irreducible and incarcerated inguinal hernias. Diagnosis was based on anamnesis data, physical examination methods and ultrasound data with inguinal and scrotal Doppler. Indications for review radiography of the abdominal cavity were clinical signs of acute intestinal obstruction.Results and discussion. Analyzing the obtained results, we have found that the diagnosis of hernias in 91 (93.81%) children was based on anamnestic data, complaints of parents about the presence of bulging in the groin area and physical examination of a child. The most important condition for effective diagnosis is the thorough collection of anamnestic data to determine the duration of the acute condition in a child and its dynamics. It is important to examine a child in a horizontal and vertical position. Differential diagnosis of incarcerated IG in infants was performed with acute hydrocele, torsion of the spermatic cord, inguinal lymphadenitis, etc., which are very similar to incarcerated IG in small children.Treatment of incarcerated inguinal hernias in newborns and infants has been carried out using a combined strategy, which involved the use of conservative invagination of hernia contents (49.48% of patients) followed by delayed surgical correction and emergency surgery according to urgent indications (42.27% of infants).Among 48 children treated conservatively, non- operative manual hernia invagination (Taxis - method) was effective in 46 of them or 95.83%. We used this method in children with a strangulation period up to 12 hours in the absence of inflammation signs in the pinched area.Indications for urgent herniotomy were: strangulation period of more than 12 hours (12 children), ineffectiveness of conservative treatment for 1 hour (2 patients), intractable hernia protrusion in girls (27 patients).As for the planned surgery, we support surgical correction of inguinal hernias at the age of 6-12 months, which we consider optimal.Conclusions1. Conservative manual invagination of an incarcerated inguinal hernia in newborns and infants is used in terms of pinching the contents of the hernia lasting up to 12 hours and is effective in 95.83% of cases.2.Surgical intervention for incarcerated hernia in infants should be performed in children with a duration of pinching more than 12 hours, in cases of impossibility and / or ineffectiveness of conservative invagination for 1 hour and in girls.3. Correction of a incarcerated inguinal hernia in girls is not recommended due to the high risk of ovarian damage.

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 A CASE OF GIANT INGUINO- SCROTAL HERNIA

2020 ◽  
pp. 1-2
Author(s):  
Neel B. Patel ◽  
Hitendra K. Desai ◽  
Purvesh V. Doshi ◽  
Bansil V. Javia
Keyword(s):  
At Risk ◽  
Inguinal Hernia ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Abdominal Cavity ◽  
Standing Position ◽  
Hernia Sac ◽  
Scrotal Hernia ◽  
Inguinal Area ◽  
Inguinal Hernias

• An inguinal hernia is a protrusion of the contents of the abdominal cavity or peritoneal fat through a defect in the inguinal area. • The hernia sac contents are at risk of incarceration, which may lead to more serious sequelae such as bowel obstruction, and or a circulatory strangulation of the hernia contents, leading to necrosis and possible perforation of the intestine . The chance of incarceration is relatively low, between 0.3-3% per year . • GAINT INGUINAL HERNIA IS MORE UNUSUAL (APPROX 0.5% OF INGUINAL HERNIAS) AND SIGNIFICANTLY CHALLENGING IN TERMS OF SURGICAL MANAGEMENT. • IT IS DEFINED AS AN INGUINAL HERNIA THAT EXTENDS BELOW THE MIDPOINT OF INNER THIGH WHEN PATIENT IS IN STANDING POSITION.

scholarly journals Technique of Rutkow and Robbins (plug and patch) to the reparation of inguinals hernias.

1969 ◽  
Vol 40 (3) ◽  
pp. 300-306
Author(s):  
Ángel S. Luque ◽  
José Ramón Urdaneta
Keyword(s):  
Inguinal Hernia ◽  
Hospital Stay ◽  
San Francisco ◽  
Repair Process ◽  
Daily Activities ◽  
Direct Inguinal Hernia ◽  
Inguinal Hernias ◽  
Pain Duration ◽  
Short Time ◽  
Inguinal Neuralgia

Objective: To describe the repair process of inguinal hernias according to the Rutkow and Robbins technique (plug and patch) and polypropylene mesh. Methods: A descriptive study was performed on 102 patients attending to the Surgery Clinic at Hospital Dr. Manuel Noriega Trigo, San Francisco, Venezuela. Patients had a diagnosis of primary inguinal hernia during the period of January 2002 to September, 2005. 124 hernioplasties were practiced, 11 patients received surgery for bilateral hernias. Variables in this study included: sex, age, hernia type, surgical time, postoperation pain, period of hospital staying, time for returning to daily activities, and complications. Results: Ninety one males (89.2%) and eleven females (10.8%) were included in this study. Average age was of 42.7±18.29 years (Range, 12-82) and the more frequent age group lies between 21 to 30 years (23.5%). Inguinal indirect hernia was more common on males (n=47, 25.5% right side. 20.6% left side).  The direct inguinal hernia was present on 4 females (3.9%). The duration of the surgical procedure was 32.18±6.42 minutes. Postoperative pain was reported as discomfort (33.3%), mild (39.2%), moderate (8.8%), and no patients reported severe pain.  Duration of hospital stay was 23.41±3.8 hours (Range, 3 to 40 hours), time for returning to daily activities was 21.56±6.5 days (Range, 10 to 40). The postoperative complications presented on 6.9% of the patients: 1% wound infection, 1% hematoma, 2% seromas, 1% inguinal neuralgia and 2% urinary retention. Conclusion: This is a quick technique associated with little postoperative morbidity, short hospital stay, short time for returning to daily activities and rare complications. This technique proves to be safe for the repair of inguinal hernias.

scholarly journals A Case of Inguinal Hernia Sac Abscess after Surgery for Idiopathic Small Intestinal Perforation

2018 ◽  
Vol 79 (10) ◽  
pp. 2078-2081
Author(s):  
Hideyuki DEI ◽  
Tadahiro KAMIYA ◽  
Kazuhiro HIRAMATSU ◽  
Yoshihisa SHIBATA ◽  
Motoi YOSHIHARA ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Intestinal Perforation ◽  
Hernia Sac ◽  
Small Intestinal

scholarly journals Gastric outlet obstruction secondary to incarcerated pylorus in an inguinal hernia

2014 ◽  
Vol 96 (5) ◽  
pp. e26-e27 ◽  
Author(s):  
L Creedon ◽  
O Peacock ◽  
R Singh ◽  
A Awan
Keyword(s):  
Inguinal Hernia ◽  
Small Bowel ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Incarcerated Inguinal Hernia ◽  
Common Presentation ◽  
Inguinal Hernias ◽  
Wide Range ◽  
The World ◽  
Surgical Admission

Inguinal hernias are a common presentation to surgical admission units throughout the world. The majority of presentations are due to hernias containing either fat or small bowel. However, a wide range of intra-abdominal viscera have been demonstrated in inguinal hernias. We report a case of an 87-year-old man who presented with gastric outlet obstruction secondary to an incarcerated inguinal hernia containing the gastric pylorus.

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