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

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.

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Uncomplicated adult inguinal hernia repair under local anaesthesia and spinal anaesthesia

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2437 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3212-3221

Author(s):

Naniwadekar R G

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Spinal Anaesthesia ◽

Local Anaesthesia ◽

Control Group ◽

Early Ambulation ◽

Inguinal Hernias ◽

Hernia Inguinal ◽

The Subject ◽

Prolonged Hospital

Multiple researchers have given numerous guidelines in the clinical management of this disorder in the late nineteenth and twentieth centuries, after comprehensive works on the subject. As a result, a very wide variety of surgical procedures are now available to the surgeon to suit the requirement. There have been numerous advances in the management of inguinal hernia. Inguinal hernias can conveniently be repaired under all kinds of anaesthesia, namely general, spinal and local. Whereas the general anaesthesia requires the services of an experienced anaesthetist and new devices and spinal anaesthesia requires postoperative impairment while local anaesthesia is safe to prescribe, easy and efficient and does not cause postoperative complications. This work consisted of a study group of twenty-five adult patients of uncomplicated inguinal hernias, who after repair of hernias, which after repair of hernias were allowed early ambulation and had a short hospital, stay of one day post operatively. The second control group consisted of similar twenty-five patients who are subjected to conventional delayed ambulation and prolonged hospital stay. The results of repair in the two groups were compared; the available literature on the subject was reviewed. The implementation of ”shortstay surgery” not only relieves the waiting list in hospitals but also offers an economic boost and provides the patient with some social advantages.

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Postoperative condition of patients as a result of treatment of inguinal hernias by laparoscopic and open methods

Paediatric Surgery Ukraine ◽

10.15574/ps.2021.72.30 ◽

2021 ◽

pp. 30-35

Author(s):

V.V. Skyba ◽

◽

A.V. Ivanko ◽

N.V. Voytyuk ◽

V.V. Lysytsia ◽

...

Keyword(s):

Inguinal Hernia ◽

Surgical Treatment ◽

Open Access ◽

Hospital Stay ◽

Laparoscopic Approach ◽

Length Of Hospital Stay ◽

Lower Percentage ◽

Hernia Surgery ◽

Inguinal Hernias ◽

Inguinal Hernia Surgery

Purpose – to analyze condition of patients after surgical treatment of inguinal hernias by laparoscopic and open methods. Materials and methods. A retrospective review of medical histories and outpatient charts of all patients who underwent inguinal hernia surgery at the Kyiv City Clinical Hospital No. 1 from January 2018 to July 2020 was conducted. Results. During the above period of time in our hospital open hernioplasty was performed in 86 patients, laparoscopic hernioplasty – 138 patients. With open hernioplasty, the average duration of surgical treatment was 40±12 minutes. The laparoscopic technique was 35±12 minutes. The length of hospital stay was significantly longer in the group of patients with the open method (48±12 hours) than in the group of laparoscopic plastic surgery (12±3 hours). From the group of patients who underwent open hernioplasty, 62 patients complained of long-term pain syndrome, from the group of laparoscopy – 12 patients. The cosmetic appearance was dissatisfied with 34 patients in the open access group and only 2 patients in the laparoscopic plastic group. Postoperative complications were observed in 34 patients who underwent surgical treatment through open access, and in 15 patients – by laparoscopy. Conclusions. The laparoscopic approach of inguinal hernia surgery is superior to open access, as it reduces the length of hospital stay, postoperative recovery, improves the aesthetic effect of the operation, reduces the frequency of infection of incisions. According to the results of the study, this technique gives a better result in the early postoperative period, a lower percentage of chronic pain and a higher degree of patient satisfaction compared to open access with the same low recurrence rate. Therefore, in our opinion, laparoscopic access to hernioplasty is the optimal method of treatment and can be recommended as a method of choosing inguinal hernia surgery. Postoperative assessment of the quality of life of patients after treatment of inguinal hernia by laparoscopic and open methods. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local ethics committee of all participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: inguinal hernia, laparoscopy, open access surgery, analysis of methods, operation.

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Open discectomy versus microscopic discectomy for lumbar disc herniation

10.21203/rs.3.rs-16951/v1 ◽

2020 ◽

Author(s):

Sherwan Hamawandi ◽

Injam Ibrahim Sulaiman ◽

Ameer Kadhim Al-Humairi

Keyword(s):

Back Pain ◽

Hospital Stay ◽

Lumbar Disc Herniation ◽

Disc Herniation ◽

Lumbar Disc ◽

Postoperative Hospital Stay ◽

Daily Activities ◽

Leg Pain ◽

Significant Difference ◽

Pain Duration

Abstract Background Discectomy for symptomatic lumbar disc herniation is the most common surgical procedure in spine surgery. Lumbar discectomy can be done by traditional open method or by varieties of minimal invasive techniques mainly microscopic or endoscopic procedures. This study evaluates the effectiveness of microdiscectomy compared with open discectomy in the treatment of lumbar disc herniation as a relation to the relief of leg pain, post-operative back pain, postoperative hospital stay and returns to daily activity. Methods Sixty patients were included in this study, 30 patients underwent an open discectomy and 30 patients underwent microdiscectomy. Those patients were followed up for 12 months after surgery. Each patient was evaluated for the postoperative back pain, leg pain, duration of hospital stay postoperatively and return to sedentary daily activity. The methods used to evaluate each patient are Visual analogue scale for back pain and leg pain and Oswestry disability index. Results Results showed that there is a significant difference in the postoperative back pain, duration of postoperative hospital stay and the time of return to sedentary daily activities between open discectomy and microdiscectomy with superiority for microdiscectomy while there is no significant difference in the relieving leg pain between the open discectomy and microdiscectomy. Conclusion Microdisctomy is effective as open discectomy in the aspect of relieving the leg pain with the advantage of less postoperative back pain, less postoperative hospital stay and early return to sedentary daily activities.

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COMPLICATED INGUINAL HERNIAS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.03.3232 ◽

2019 ◽

Vol 26 (03) ◽

Author(s):

Naveed Akhtar ◽

Syed Shams- Ul-Hassan ◽

Muhammad Sabir ◽

M. Nauman Ashraf

Keyword(s):

Inguinal Hernia ◽

Hospital Stay ◽

Wound Infection ◽

P Value ◽

Emergency Setting ◽

Complication Rates ◽

Success Rates ◽

Inguinal Hernias ◽

Significant Difference ◽

The Mean

Background: Herniorrhaphy and hernioplasty are the two most common modalities used with different degree of success and complication rates in the treatment of inguinal hernia. Several studies show that use of mesh is superior to the non-mesh operations in inguinal hernia surgery.It is generally believed that the use of biomaterials should be limited to non-infected surgical fields.Now the concept regarding use of mesh in complicated hernias is changing as shown by many studies. Current study is being planned to observe the outcomes of the mesh hernioplasty in treatment of complicated inguinal hernias in emergency so that in future appropriate and safe technique may be suggested for repair of complicated hernias in emergency setting. Objectives: To compare the outcome of hernioplasty and herniorrhaphy in emergency for the treatment of complicated (Irreducible/obstructed) inguinal hernias regarding wound infection and hospital stay. Material & Methods:… Study Design: Randomized control trial. Setting: Surgical ward, Sheikh Zayed Hospital, Rahim yar khan. Period:09 months from 01-01-2016 to 30-09-2016. Sample Size: A total of 64 patients with 32 patients were included in each group, with confidence level of 95% and power of 80% and anticipated mean level of hospital stay in group 1 of 5±3.4 days versus 3±2.1 days in group 2. Sampling Technique: Non-probability, consecutive sampling. Results: In this study there were total 64 cases with 32 in each group. The mean age was 41.69±11.06 years and the mean duration of hernia obstruction was 12.83±4.97 hours. There was no significant difference in terms of age, duration of hernia and hernial obstruction between both groups. Seroma was seen in 5 (7.81%) out of 64 cases while wound infection was seen in 8 (12.50%) of cases. Seroma was seen in 2 (6.25%) out of 30 cases in herniorrhaphy as compared to 3 (9.38%) out of 32 cases with hernioplasty with p value of 0.64. Wound infection was seen in equally 4 (12.50%) out of 32 cases in both groups with p value of 1.0. Duration of hospital stay was 4.66±1.36 in patients with herniorrhaphy as compared to 4.53±1.37 days with hernioplasty with p value= 0.82. There was no significant difference in terms of age groups, duration of hernia and its obstruction between both groups regarding seroma. There was also no significant association among any of the confounding factors regarding the wound infection and length of the hospital stay between the both groups. Conclusion: We can perform hernioplasty as compared to herniorrhaphy for complicated inguinal hernia with similar complications and better success rates in the same emergency setting.

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Direct inguinal hernias in children

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care ◽

10.17816/psaic949 ◽

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.

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Inguinal hernias in patients of 50 years and above. Pattern and outcome

Revista do Colégio Brasileiro de Cirurgiões ◽

10.1590/s0100-69912013000500005 ◽

2013 ◽

Vol 40 (5) ◽

pp. 374-379 ◽

Cited By ~ 1

Author(s):

Devajit Chowlek Shyam ◽

Amy Grace Rapsang

Keyword(s):

Inguinal Hernia ◽

Elderly Patients ◽

Hospital Stay ◽

Elective Surgery ◽

Uneventful Recovery ◽

Tension Free ◽

Inguinal Hernias ◽

One Year ◽

Operative Assessment

OBJECTIVE: to evaluate a one year experience with inguinal hernia repair, in patients of > 50years, with respect to the type of inguinal hernia, type of surgery, postoperative complications and recurrence. METHODS: a prospective descriptive study of patients (n=57) > 50 years operated for inguinal hernia during a one year period. Tension-free meshplasty and herniorrhaphy, using 3"x6" polypropylene mesh and 2-0 polypropylene suture, were performed in elective and emergency surgery respectively. Follow-up visits were scheduled at six weeks, three and six months postoperatively. RESULTS: the most representative age group was 61-70 years, and all patients were male. 52 (91.22%) patients had unilateral inguinal hernias, while five (8.77%) had bilateral hernias. In 50 (87.71%) patients, the hernia was uncomplicated, while seven (12.28%) patients presented with some complication such as obstruction or strangulation. Elective surgery was performed in 50 (87.71%) patients while seven (12.28%) patients were operated in emergency. Postoperatively, 50 (87.7%) patients had uneventful recovery, while seven (12.28%) patients developed some complications which were treated conservatively. Mean hospital stay was six days. One recurrence was observed and there was no peri/postoperative death. CONCLUSION: tension-free meshplasty and herniorrhaphy are safe, simple and applicable even in elderly patients after adequate pre-operative assessment and optimization. Although associated with longer hospital stay, the mortality rate is nil and complication as well as recurrence rate is low. Hence, timely repair is necessary in elderly patients even in those with comorbid conditions.

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

10.21203/rs.3.rs-225002/v1 ◽

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.

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Laparoscopic totally extra peritoneal (TEP) inguinal hernia repair: A series of 47 cases

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v5i4.18608 ◽

2017 ◽

Vol 5 (4) ◽

pp. 120-123

Author(s):

Suman Kumar Shrestha

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

College Teaching ◽

Operation Time ◽

Medical College ◽

Inguinal Hernias ◽

Total Extraperitoneal ◽

The Mean

Background: Over the past years, several surgical techniques have been evolved, among which total extraperitoneal inguinal hernia repair is the laparoscopic technique which is more popular now.Objective: To evaluate the outcome of totally extra peritoneal laparoscopic hernioplasty in terms of operation time, hospital stay and complications.Methods: The prospectively designed descriptive study was carried out at Department of Surgery Unit III, Kathmandu Medical College Teaching Hospital from February 2014 to April 2015. Forty seven consecutive patients above 15 years of age underwent totally extra peritoneal repairs for inguinal hernias. The selection criteria were reducible primary or recurrent, unilateral, direct and indirect inguinal hernias. All the relevant details of each patient were noted subsequently and analyzed statistically using Statistical Program for Social Sciences (SPSS) version 15.Results: The mean age of patient was 49±2.5 years. The mean operation time was 65±5.3 minutes. There were no serious complications except four (8.5%) cases of groin seroma which resolved after single time aspiration. Three (6.3%) cases had developed recurrence, two (4.2%) had developed hydrocele in a median follow up period of 6±1.5 (range, 3-9months). The mean inpatient hospital stay was 1.7±0.2 (range, 1-2.4days).Conclusion: Total extra peritoneal hernioplasty is safe and feasible with acceptable complications and recurrence rates.Journal of Kathmandu Medical College, Vol. 5, No. 4, Issue 18, Oct.-Dec., 2016, page: 120-123

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A study of outcome and complications of emergency inguinal hernias repair

International Surgery Journal ◽

10.18203/2349-2902.isj20200290 ◽

2020 ◽

Vol 7 (2) ◽

pp. 419

Author(s):

Dinesh Prasad ◽

Yash Patel

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Hospital Stay ◽

Inguinal Hernia Repair ◽

Length Of Hospital Stay ◽

Seroma Formation ◽

Site Infection ◽

Wound Site ◽

Inguinal Hernias ◽

Mesh Hernioplasty

Background: Mesh hernioplasty in patients undergoing emergency inguinal hernia repair is considered practically, irrespective of complications. The main aim of this study was to assess the morbidity of Lichtenstein mesh hernioplasty in treating obstructed inguinal hernias. Primary outcome measures were post-operative wound site infection, seroma formation, length of hospital stay, hanging testis, testicular infarct, inguinodynia and recurrence.Methods: This study was undertaken in the department of General Surgery, SMIMER, Surat, Gujarat, India from August 2016 to July 2019. Fifteen patients were operated and included in the study. All patients underwent standard Lichtenstein mesh hernioplasty for obstracted inguinal hernia repair in emergency operating room.Results: 5 patients (33%) developed wound site infection, 4 patients (27%) developed inguinodynia, 2 patient (13%) developed seroma formation, 1 patient (6%) developed hanging testis. 1 patient (6%) developed testicular infarct. Average postoperative hospital stay was 5.6 days (range =2-18 days).Conclusions: Mesh repairs can be safely performed in emergency inguinal hernia repair with acceptable morbidity.

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The incidence and analysis of ipsilateral occult hernia in patients undergoing hernia repair: a single institution retrospective study of 1066 patients

BMC Surgery ◽

10.1186/s12893-021-01181-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jun He ◽

Ying-jie Xu ◽

Peng Sun ◽

Jue Wang ◽

Cheng-guang Yang

Keyword(s):

Inguinal Hernia ◽

Hernia Repair ◽

Femoral Hernia ◽

Inguinal Region ◽

Anatomical Site ◽

Indirect Inguinal Hernia ◽

Direct Inguinal Hernia ◽

Occult Hernia ◽

Inguinal Hernias ◽

Pain Symptoms

Abstract Background Misdiagnosis or failure to intraoperatively detect occult hernia in the inguinal region can lead to the recurrence of postoperative hernia and the appearance of local pain symptoms, which affect the patient’s quality of life and make it difficult to reperform hernia repair. Methods This study included 1066 inguinal hernia patients who underwent surgical treatment at Shanghai Tongren Hospital between January 2016 and October 2018 to investigate ipsilateral occult hernia epidemiology, to analyze the characteristics of ipsilateral occult hernias with regards to patient age, gender, classification and anatomical site, and to explore the superiority and inferiority of the expert hernia surgeons/ non-expert hernia surgeons group and of operation methods in finding occult inguinal hernias. Results The incidence of ipsilateral occult hernia in the surgical population was 8.26%. Ipsilateral occult hernia included indirect inguinal hernia, direct inguinal hernia, femoral hernia, obturator hernia, and spigelian hernia, among which the highest incidence was direct inguinal hernia (4.11%), followed by indirect inguinal hernia (2.45%). There was no difference in the incidence of ipsilateral occult hernia between males and females, but there were significant differences in the incidence of ipsilateral occult hernia, which decreased gradually with increasing age in patients younger than 70 years-old; there was no difference in incidence in patients over 70 years-old. There were significant differences in the incidence of ipsilateral occult hernia in the bilateral inguinal region between direct and femoral hernia, with the higher incidence found on the right side; in contrast, there was no difference in the incidence of indirect inguinal hernia in the bilateral inguinal region. There was no difference in the ability of experienced physicians to detect ipsilateral occult inguinal hernias, either professionally or by surgery. Conclusions Ipsilateral occult inguinal hernia has a higher incidence in patients with inguinal hernia, especially older patients; therefore, it is necessary for experienced surgeons to carefully detect for possible occult hernia during the operation and in elderly patients.

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