scholarly journals Infekcija u hirurgiji kila

2005 ◽  
Vol 52 (1) ◽  
pp. 9-26 ◽  
Author(s):  
M. Zuvela ◽  
M. Milicevic ◽  
D. Galun ◽  
N. Lekic ◽  
D. Basaric ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Antibiotic Prophylaxis ◽  
Inguinal Hernia Repair ◽  
Infection Type ◽  
Type I ◽  
Type Ii ◽  
Mesh Infection ◽  
Hernia Surgery ◽  
Type Iii

Traditionally, the operation of hernia is considered as a clean operation due to expected, low incidence of infection, on the spot of surgical work (SSI). The incidence of SSI in hernia surgery is more frequent then it is assumed. The important risk factors for SSI are the following: type of hernia (inguinal, incisional), operative approach (open - laparoscopic), usage of the prosthetic material and drainage. Comparing to inguinal hernia repair, incisional hernia repair, is more frequently followed by the infection. The laparoscopic operations are followed with the lower incidence of SSI then in the case of open operation. The usage of the mesh does not increase the incidence of SSI, although the consequences of the mesh infection may be severe. A type I of the prosthesis is more resistant to the infection then prosthesis II and III. The mesh infection (type I) never involves its body but it is present around sutures and bended edges. The mesh infection Type II involves entire prosthesis while in the case of Type III it is present in its peripheral part. In the case of SSI, a prosthesis Type I is possible to be saved, while prosthesis Type II must be removed completely; and the same is for the Type III (the partial removal is rarely suggested). The defect that remained after excision of non-resorptive prosthesis is a long-term and very complicated surgical problem. In regard to the position of the mesh, SSI is more common if the mesh is placed subcutaneously then in the case of sub-aponeurotic peri-muscular, pre-aponeurotic retromuscular or pre-peritoneal mesh placemen. If the infection is present the non-tension techniques using non-resorptive prosthetic implants are not recommended. the presence of drainage and its duration increases the incidence of SSI. It is more common for incisional hernioplasty then for inguinal hernia repair. If there is an indication for drainage it should be as short as possible. The cause of SSI for elective operations are bacteria?s that arrives from the skin, while in the case of opening of various organs dominant bacteria?s originate from them. The superficial infection does not lead to the recurrence, while it is very possible in the case for deep infection. There are no prospective studies that justify the usage of antibiotic prophylaxes in hernia surgery. The antibiotic prophylaxis in hernia surgery. The antibiotic prophylaxis is indicated for the clean operations when placing the implants and when severe complication is expected. The appearance of SSI increases the price of treatment and may lead to the recurrence.

scholarly journals A Case of Late-onset Mesh Infection with Fistula Formation into the Appendix and Bladder after Inguinal Hernia Repair

2016 ◽  
Vol 77 (9) ◽  
pp. 2303-2310 ◽  
Author(s):  
Takashi SUZUKI ◽  
Nobuki ICHIKAWA ◽  
Sayuri KASHIWAKURA ◽  
Tomohiro ISHIKAWA ◽  
Takeshi TSUJI ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Late Onset ◽  
Fistula Formation ◽  
Mesh Infection

Watchful Waiting versus Surgery for Inguinal Hernia

2017 ◽  
Author(s):  
Rachel J. Kwon
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Clinical Case ◽  
Watchful Waiting ◽  
Surgical Repair ◽  
Hernia Surgery ◽  
Study Intervention ◽  
Landmark Study

This chapter provides a summary of a landmark study in hernia surgery. For men with minimally symptomatic inguinal hernias, does deferring surgical repair until symptoms develop lead to worse outcomes with respect to pain and physical function? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, gives a summary and discusses implications, and concludes with a relevant clinical case involving inguinal hernia repair.

scholarly journals Chronic Pain after Inguinal Hernia Repair

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mallikarjuna Manangi ◽  
Santhosh Shivashankar ◽  
Abhishek Vijayakumar
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Nerve Injury ◽  
Statistical Significance ◽  
Preemptive Analgesia ◽  
Preoperative Pain ◽  
Hernia Surgery

Background. Chronic postherniorrhaphy groin pain is defined as pain lasting >6 months after surgery, which is one of the most important complications occurring after inguinal hernia repair, which occurs with greater frequency than previously thought. Material and Methods. Patients undergoing elective inguinal hernioplasty in Victoria Hospital from November 2011 to May 2013 were included in the study. A total of 227 patients met the inclusion criteria and were available for followup at end of six months. Detailed preoperative, intraoperative, and postoperative details of cases were recorded according to proforma. The postoperative pain and pain at days two and seven and at end of six months were recorded on a VAS scale. Results. Chronic pain at six-month followup was present in 89 patients constituting 39.4% of all patients undergoing hernia repair. It was seen that 26.9% without preoperative pain developed chronic pain whereas 76.7% of patients with preoperative pain developed chronic pain. Preemptive analgesia failed to show statistical significance in development of chronic pain (P=0.079). Nerve injury was present in 22 of cases; it was found that nerve injury significantly affected development of chronic pain (P=0.001). On multivariate analysis, it was found that development of chronic pain following hernia surgery was dependent upon factors like preoperative pain, type of anesthesia, nerve injury, postoperative local infiltration, postoperative complication, and most importantly the early postoperative pain. Conclusions. In the present study, we found that chronic pain following inguinal hernia repair causes significant morbidity to patients and should not be ignored. Preemptive analgesia and operation under local anesthesia significantly affect pain. Intraoperative identification and preservation of all inguinal nerves are very important. Early diagnosis and management of chronic pain can remove suffering of the patient.

scholarly journals Outcomes of an innovative training course in laparoscopic hernia repair

2017 ◽  
Vol 99 (8) ◽  
pp. 614-616 ◽  
Author(s):  
D Light ◽  
S Bawa ◽  
P Gallagher ◽  
L Horgan
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
Inguinal Hernia Repair ◽  
Ventral Hernia Repair ◽  
Operative Time ◽  
Laparoscopic Inguinal Hernia Repair ◽  
Laparoscopic Ventral Hernia Repair ◽  
Hernia Surgery ◽  
The Mean

Introduction The Ethicon™ laparoscopic inguinal groin hernia training (LIGHT) course is an educational course based on three days of teaching on laparoscopic hernia surgery. The first day involves didactic lectures with tutorials. The second day involves practical cadaveric procedures in laparoscopic hernia surgery. The third day involves direct supervision by a consultant surgeon during laparoscopic hernia surgery on a real patient. We reviewed our outcomes for procedures performed on real patients on the final day of the course for early complications and outcomes. Methods A retrospective study was undertaken of patients who had laparoscopic hernia surgery as part of the LIGHT course from 2013 to 2015. A matched control cohort of patients who had elective laparoscopic hernia surgery over the study period was identified. These patients had their surgery performed by the same consultant general surgeons involved in delivering the course. All patients were followed up at 6 weeks postoperatively. Results A total of 60 patients had a laparoscopic inguinal hernia repair and 23 patients had a laparoscopic ventral hernia repair during the course. The mean operative time for laparoscopic inguinal hernia repair was 48 minutes for trainees (range 22–90 minutes) and 35 minutes for consultant surgeons (range 18–80 minutes). There were no intraoperative injuries or returns to theatre in either group. All the patients operated on during the course were successfully performed as daycase procedures. The mean operative time for laparoscopic ventral hernia repair was 64 minutes for trainees (range 40–120 minutes) and 51 minutes for consultant surgeons (range 30–130 minutes). Conclusions The outcomes of patients operated on during the LIGHT course are comparable to procedures performed by a consultant. Supervised operating by trainees is a safe and effective educational model in hernia surgery.

scholarly journals SEROMA AFTER TENSION-FREE INGUINAL HERNIA REPAIR – OUR EXPERIENCE

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Vinod Kumar Nigam ◽  
Siddarth Nigam
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Dead Space ◽  
Hernia Surgery ◽  
Tension Free ◽  
Body Tissues ◽  
Inguinal Hernia Surgery ◽  
Tissue Dissection ◽  
Low Incidence

Seroma Is a collection of fluid called serum that gets collected at the site of inguinal hernia surgery. It is common after inguinal hernia repair with a mesh. Usually seroma develops after 7 to 10 day of operation but can develop even earlier depending upon the amount of tissue dissection. More the dissection more the chances of development of seroma. The fluid in seroma is usually clear or straw colored. Seroma generally does not require any treatment; it disappears by absorption by body tissues within few weeks. Large seromas may require repeated aspiration. To avoid developing seroma after inguinal hernia surgery is to do minimal tissue dissection and avoid dead space formation. We operated 400 cases of inguinal hernia by a modified Lichtenstein tension-free procedure called NICH (Nigam’s inverted curtain hernioplasty) our incidence of development of seroma was 1.5% against international incidence of 7% which is a real low incidence. We have discussed the ways to avoid formation of seroma after open inguinal hernioplasty. Keywords: dead space, dissection, inguinal hernia, Lichtenstein, mesh, NICH, seroma.

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