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.

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 Case report of a giant inguinal hernia causing intestinal obstruction

2021 ◽  
Vol 8 (8) ◽  
pp. 2463
Author(s):  
R. Sanjay ◽  
Farukh Khan ◽  
Shalu Gupta ◽  
Prashant . ◽  
Akash .
Keyword(s):  
Inguinal Hernia ◽  
Abdominal Cavity ◽  
Standing Position ◽  
Abdominal Pressure ◽  
Hernia Sac ◽  
Modern Times ◽  
The Past ◽  
Abdominal Hypertension ◽  
History Of ◽  
Abdominal Compartment

Inguinal hernia is one of the ancient diseases that haunted the humanity from its very beginning to the modern times. Giant inguinal hernia is defined as an inguinal hernia that extends below the midpoint of inner thigh when the patient is in standing position. A 43 years old healthy male was affected by long standing, progressively enlarging right sided inguinal hernia for the past 21 years. His symptoms of abdominal discomfort and pain in lower abdomen after meal had worsened over time and he had lost 13 kg of weight in past 2 years. He had difficulty in micturition and gave history of constipation. Giant inguinal hernia is a type of hernia with massive contents inside the hernia sac and limited domain of abdominal cavity. The surgeon’s decision regarding the prevention of intra-abdominal hypertension is a crucial stage of overall management. Giant inguinal hernia is a very rare. It is defined as hernia sac extending below mid inner thigh in the standing position. Surgical repair is very challenging and has significant morbidity and mortality due to increased intra-abdominal pressure and abdominal compartment syndrome.

scholarly journals Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

2020 ◽  
Author(s):  
Jia You ◽  
Gang Li ◽  
Shuang Li ◽  
Haitao Chen ◽  
Jun Wang
Keyword(s):  
Inguinal Hernia ◽  
Doppler Ultrasound ◽  
Vas Deferens ◽  
Abdominal Cavity ◽  
Undescended Testes ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Patent Processus Vaginalis ◽  
Contralateral Patent Processus Vaginalis ◽  
Laparoscopic Orchiopexy

Abstract Background Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination. Conclusion Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

Surgical treatment of inguinal hernia in childhood

1927 ◽  
Vol 23 (9) ◽  
pp. 972-972
Author(s):  
I. Tsimkhes
Keyword(s):  
Early Childhood ◽  
Inguinal Hernia ◽  
Surgical Treatment ◽  
Inguinal Canal ◽  
Older Children ◽  
Processus Vaginalis ◽  
Hernia Sac ◽  
Absolute Certainty ◽  
Inguinal Hernias

The author finds that the number of inguinal hernias in early childhood, due to incomplete overgrowth of the processus vaginalis peritonei, greatly prevails over the number of the same in older children. Some of these hernias heal spontaneously due to overgrowth of proc. vaginalis and lengthening of the inguinal canal itself. Bandage treatment, even in the most cultured setting, cannot guarantee with absolute certainty the budding of the hernia sac.

scholarly journals Perforated necrotic appendix in Amyand’s hernia treated with appendicectomy and simple suture repair of the inguinal hernia

2019 ◽  
Vol 12 (11) ◽  
pp. e231765 ◽  
Author(s):  
Muhamamd Isfandyar Khan Malik ◽  
Joshua Abbas ◽  
Paul Shuttleworth ◽  
Nafees Qureshi
Keyword(s):  
Inguinal Hernia ◽  
Amyand’S Hernia ◽  
Suture Repair ◽  
Small Bowel Mesentery ◽  
Good Recovery ◽  
Hernia Sac ◽  
Blood Tests ◽  
Testicular Pain ◽  
Scrotal Hernia ◽  
Scrotal Swelling

A 50-year-old man was referred to the emergency department by his general practitioner with a tender right-sided irreducible inguinal hernia (previously reducible), right-sided testicular pain and scrotal swelling. Clinical examination revealed a non-reducible, tender right inguinal-scrotal hernia and swollen right scrotum. Blood tests showed raised inflammatory markers. The patient went on to have a CT scan which was reported to show an indirect right inguinal-scrotal hernia possibly containing terminal ileum and small bowel mesentery. The scan also showed increased infiltrate changes within the hernia sac suggesting incarceration with possible early strangulation but no obvious evidence of bowel obstruction. The patient was taken to the operating theatre and found to have a large right inguinal-scrotal hernia containing pus and a perforated necrotic appendix. He went to have an appendicectomy and sutured repair of the hernia. Postoperatively, the patient made a good recovery and was discharged 2 days postsurgery.

Management of Ureters Involved in Inguinal Hernias

2018 ◽  
Vol 5 ◽  
pp. 21-25
Author(s):  
Sarah Perz ◽  
Timothy Suttle ◽  
Puneet Sindhwani
Keyword(s):  
Inguinal Hernia ◽  
English Language ◽  
Case Reports ◽  
Relevant Literature ◽  
Case Series ◽  
Ureteral Injury ◽  
Hernia Sac ◽  
Medline Search ◽  
Inguinal Hernias ◽  
Year 2000

Background: The presence of a ureter in a hernia sac presents a unique surgical challenge and can increase the likelihood of ureteral injury at the time of surgery as they are often not identified pre-operatively. Here we present our institutional experience and thorough systematic review in order to provide guidance on the urologist’s role in this situation.Materials and Methods: A PubMed and Medline search was conducted to identify relevant literature published in the year 2000 or later. Case reports and case series in the English language were included using terms “ureter and hernia”, “herniated ureter”, “ureteral hernia”, inguinal hernia and ureter”.Results: The presence of a ureter in an inguinal hernia sac is an uncommon finding. When present, many are not identified pre-operatively, which places the patient at risk for ureteral injury during herniorrhaphy.Patients with ureters contained in their inguinal hernias, that were identified pre-operatively or intra-operatively and not injured, recovered well. Post-operative imaging, when performed, showed stabilization or improvement of hydronephrosis and a more normal course of the ureter. One case reported the identification of ureteral involvement post-operatively after injury, which resulted in worsened renal function and required a re-operation.Conclusions:The presence of a ureter in an inguinal hernia can be differently managed. The primary goal should be avoidance of injury intra-operatively.

scholarly journals Development and current status of treatment for pediatric indirect inguinal hernia

2020 ◽  
pp. 1-8
Author(s):  
Zhifeng Mo ◽  
Yuanfei Tan ◽  
Hanzhong He ◽  
Zhuorong Zhang ◽  
Wenbin Yang
Keyword(s):  
Inguinal Hernia ◽  
Pediatric Surgery ◽  
Current Status ◽  
High Ligation ◽  
Laparoscopic Technique ◽  
Common Disease ◽  
Indirect Inguinal Hernia ◽  
Hernia Sac ◽  
Inguinal Hernias ◽  
Hernia Inguinal

To investigate the development and current status of the treatment of pediatric indirect inguinal hernia. Inguinal hernias include indirect hernias and direct inguinal hernias, but there are almost indirect inguinal hernias in children . Pediatric indirect inguinal hernia that the most common disease in pediatric surgery is almost caused by patent processus vaginali which incidence ranges from 0.8% to 4.4%.The treatment of pediatric indirect inguinal hernia reflects the process of pediatric surgery development, which from conservative non-surgical treatment to high ligation of the longitudinal incision hernia sac. In recent years, with the continuous improvement of medical level in China, laparoscopic technique has been applied in hospitals all over China, and laparoscopic high ligation of indirect inguinal hernia sac has become the standard for the treatment of pediatric indirect inguinal hernia.

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 The use of prosthetic mesh in adult inguinal hernia repair

2019 ◽  
Vol 6 (5) ◽  
pp. 1745
Author(s):  
Laith Qauis Majeed ◽  
Mohammed Hillu Surriah ◽  
Amine Mohammed Bakkour ◽  
Ayaad Makki Saaid
Keyword(s):  
Inguinal Hernia ◽  
Groin Hernia ◽  
Abdominal Cavity ◽  
Age Groups ◽  
Abdominal Wall Hernia ◽  
Prosthetic Mesh ◽  
Age Group ◽  
Tension Free ◽  
Inguinal Hernias ◽  
Mesh Technique

Background: An abdominal wall hernia is a protrusion of a viscus or part of a viscus through an abnormal opening in the wall of the abdominal cavity. Different approaches have been described in regards to management and repair of hernia. The present study aims at showing the rate of frequency to use the prosthetic mesh versus classical repair in adult inguinal hernia.Methods: A retrospective study lasted from October 2014 to July 2018 in Al-Karama Teaching Hospital. The study Samples consist of 315 patients with inguinal hernia, the age group (20-70) years old they were diagnosed according to clinical examination. There are 76 patients operated on using mesh technique (tension free).Results: All patients in our series were male, with age group (20-70) years. However, the inguinal hernia more frequent with increase age. In age groups; (40-49) was 25 patients (32.89%). The indirect inguinal hernias are most common in the young 65% whereas direct hernias are most common in the old. In our series sixty-one (80.26%) patients with indirect inguinal hernias, eleven (11.82%) patients with direct hernias and six (5.263%) patients with pantaloon type.Conclusions: The frequent uses of mesh in inguinal hernioplasty increasing with age. Tension –free hernioplasty is technically simple surgical operation, which can be used to repair any groin hernia. The use of mesh patch with or without plug is technically easier to work than the classical methods and far simple to secure to surrounding tissues.

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.

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