scholarly journals Inguinal Hernia Repairs in a Rural Setting in East Africa

2021 ◽  
pp. 13-19
Author(s):  
Richard Wismayer
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
East Africa ◽  
Enterocutaneous Fistula ◽  
Signs And Symptoms ◽  
Morbidity And Mortality ◽  
Rural Setting ◽  
Male Predominance ◽  
Inguinal Hernias ◽  
Rural Africa

Background: Inguinal hernias are a major cause of morbidity and mortality in the developing world. In resource limited settings in rural Africa the clinical management of inguinal hernias may pose a therapeutic challenge to the surgeon due to the late presentation of this condition and lack of availability and affordability of mesh and laparoscopy. In our environment there is a lack of data and literature regarding the surgical management of inguinal hernias. The purpose of this study was to outline the clinical profile and outcomes among patients undergoing inguinal hernia repairs in our hospital. Methods: A descriptive retrospective study was carried out between 1st April 2008 to the 31st July 2012 on all patients ≥15 years of age that underwent an inguinal hernia repair were eligible in this study. The patients were reviewed on the surgical ward postoperatively and in the surgical out-patients clinic 3 months post-operatively. Data was collected using a pretested questionnaire on the following variables: age, sex, recurrence of hernia, post-operative pain and post-operative complications. Physical examination was used to determine post-operative recurrence and evidence of haematomas, seromas or severe wound sepsis requiring operative intervention. Results: One hundred and fifty eight patients following repair of inguinal hernia using the Modified Bassini technique were analyzed. Mean age was 44.84 years. The male:female ratio was 3.65:1 with male predominance. Emergency inguinal hernia repairs were carried out in 4(2.53%) and the majority of patients, 154(97.47%) were elective inguinal hernia repairs. One(0.63%) mortality and the morbidity included 1(0.63%) seroma, 1(0.63%) haematoma, 1(0.63%) necrotizing fasciitis and 1(0.63%) enterocutaneous fistula. The overall complication rate was 3.16%. Conclusions: In rural Africa patients with inguinal hernias should be encouraged to present early with signs and symptoms of inguinal hernia. Elective hernia repair of inguinal hernias, irrespective of the type of repair, will reduce the morbidity and mortality from this common problem in East Africa.

scholarly journals A Case of Rare Complication of Inguinal Parietoplasty according to Lichtenstein: Entero Cutaneous Fistula

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
K. B. Kouakou ◽  
K. I. Anzoua ◽  
M. Traore ◽  
B. K. I. Leh ◽  
A. B. N’Dri ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Rare Complication ◽  
Enterocutaneous Fistula ◽  
Local Approach ◽  
Cutaneous Fistula ◽  
Treatment Experience ◽  
Lichtenstein Procedure ◽  
Rural Africa

Lichtenstein intervention is currently the classic model of the regulated treatment of inguinal hernias by direct local approach. This “tension-free” technique satisfies both patients and practitioners. However, it does not often evade severe complications of parietal surgery. The authors report their treatment experience in rural Africa of a late enterocutaneous fistula which aggravated an inguinal hernia repair according to the Lichtenstein procedure. Physiopathology, diagnosis, and treatment of that disease are analyzed in the light of literature.

scholarly journals Management of Inguinal Hernia in a Tertiary Center, a two-year Retrospective Study.

2021 ◽  
Vol 5 (2) ◽  
pp. 854-858
Author(s):  
Dritan Cobani ◽  
Agron Dogjani ◽  
Arben Gjata ◽  
Kastriot Haxhirexha ◽  
Hysni Bendo
Keyword(s):  
Inguinal Hernia ◽  
Retrospective Study ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Surgical Management ◽  
Morbidity And Mortality ◽  
Early Presentation ◽  
Inguinal Hernias ◽  
Elective Repair ◽  
Tertiary Center

Background: Inguinal hernia repair remains the most common surgery performed by general surgeons worldwide. There is a lot of published data on the surgical management of inguinal hernias in our country. This study aims to describe our experiences in the surgical management of inguinal hernias and compare our results with those reported in the literature. Material and Method: A descriptive retrospective study was conducted at the University Hospital of Trauma in Albania. From April 2016 - March 2018 were recorded all the data for patients who presented to our hospital and underwent inguinal hernia repair in our hospital, under the conditions of elective surgery. Statistical data analysis was done using SPSS software version 17.0. Results: In this period had a total of 542 patients with inguinal hernias were enrolled in the study. The median age of patients was 46,12 years (range 14 to 92 years old). Males outnumbered females by a ratio of 18.3:1. This gender difference was statistically significant (p = 0.004). Most patients 130 (23.9%) presented late (more than one year of onset of hernia). At presentation, 208 (38.4%) patients had a reducible hernia, 101(18.6%) had an irreducible hernia. The majority of patients 303(55.9 %) had a right-sided inguinal hernia, and 156(28.7 %) had left-sided inguinal hernia with a right-to-left ratio of 1.94: 1. Eighty-three 83(15.3%) patients had bilateral inguinal hernias. 319 (58.8%) patients had an indirect hernia, Conclusion: Inguinal hernias continue to be a source of morbidity and mortality in our center. Early presentation and elective repair of inguinal hernias is pivotal in order to eliminate the morbidity and mortality associated with this very common problem.

scholarly journals A comparative study of Desarda’s mesh free inguinal hernia repair with modified Bassini’s repair

2021 ◽  
Vol 6 (2) ◽  
pp. 104-115
Author(s):  
Hosni Mubarak Khan ◽  
◽  
Tirumal Rao Patwari
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Open Approach ◽  
Medical College ◽  
Inguinal Hernias ◽  
Mesh Free ◽  
Hospital Stays ◽  
A Prospective Study ◽  
Repair Techniques

Objective. This is a prospective study of 50 cases of inguinal hernias which were treated through open inguinal hernia repair techniques. The study was conducted with the objective of comparing the effectiveness of these procedures and complications. Materials and Methods. A number of 50 cases of inguinal hernias admitted to Dr. BR Ambedkar Medical College and Hospital were selected on the basis of the non-probability (purposive) sampling method. All the patients with direct and indirect uncomplicated hernias treated by means of an open approach were included. After the preoperative preparation, they were randomly chosen either for Desarda’s or Modified Bassini’s repair techniques. Results. In the postoperative period, moderate pain was experienced by 19 patients included in the Desarda group and 17 patients included in the Modified Bassini’s repair group on day 1. The postoperative wound infection developed in 2 cases of Desarda and 3 cases of Modified Bassini’s, erythema was observed in 2 cases of Desarda and 3 cases of Modified Bassini’s, 3 cases reported the occurrence of seroma in the Desarda group and 4 cases of seroma were recorded in the Modified Bassini’s group. Conclusions. The patients who underwent Desarda repair complained of a higher intensity of pain, which could probably be attributed to the extensive dissection involved. The duration of Desarda repair was longer due to the learning curve of the surgeons in our hospital. The return to normal gait and normal activities was significantly lower in the Desarda group. The duration of hospital stays and the postoperative complications was not significantly different in the two groups. There were no recurrences in either of the groups until the current study.

scholarly journals Contralateral exploration and repair of occult inguinal hernias during laparoscopic inguinal hernia repair: systematic review and Markov decision process

BJS Open ◽  
2020 ◽  
Vol 5 (2) ◽  
Author(s):  
N H Dhanani ◽  
O A Olavarria ◽  
S Wootton ◽  
M Petsalis ◽  
N B Lyons ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Markov Decision Process ◽  
Decision Process ◽  
Expectant Management ◽  
Contralateral Exploration ◽  
Unilateral Inguinal Hernia ◽  
Inguinal Hernias ◽  
Markov Decision

Abstract Background Contralateral clinically occult hernias are frequently noted at the time of laparoscopic unilateral inguinal hernia repair. There is no consensus on the role of contralateral exploration and repair. This systematic review assessed the safety and efficacy of operative repair of occult contralateral inguinal hernias found during unilateral repair. Methods PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from inception to February 2020. Adults diagnosed with a unilateral inguinal hernia undergoing laparoscopic repair were included. The primary outcome was the incidence of occult contralateral hernias. Summative outcomes of operative and expectant management were reported along with development of a Markov decision process. Results Thirteen studies (1 randomized trial, 12 observational cohorts) with 5000 patients were included. The incidence of occult contralateral inguinal hernias was 14.6 (range 7.3–50.1) per cent. Among patients who underwent repair, 10.5 (4.3–17.0) per cent experienced a postoperative complication. Of patients managed expectantly, 29 per cent later required elective repair for symptoms. Mean follow-up was 36 (range 2–218) months. Using a Markov decision process, it was calculated that, for every 1000 patients undergoing unilateral inguinal hernia repair, contralateral exploration would identify 150 patients with an occult hernia. Repair would result in 15 patients developing a postoperative complication and 105 undergoing unnecessary repair. Alternatively, expectant management would result in 45 patients requiring subsequent repair. Conclusion Contralateral repair is not warranted in patients with occult hernias diagnosed at the time of elective hernia repair. The evidence is largely based on observational studies at high risk of bias.

scholarly journals P035 EMERGENCY BILATERAL GORIN HERNIA REPAIR IN UNILATERAL COMPLICATED INGUINAL HERNIA REAPIR WITH CONCOMITNAT CONTRALATERAL HERNIA. COHORTS COMPARATIVE OUTCOMES ANALYSIS USING PROPENSITY SCORE MATCHING

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Alejandro Bravo-Salva ◽  
Francisco Rómulo Ochoa-Segarra ◽  
Ana María Gonzálz-Castillo ◽  
Joan Sancho-Insenser ◽  
Miguel Pera-Roman ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Propensity Score ◽  
Hernia Repair ◽  
Hospital Stay ◽  
Propensity Score Matching ◽  
Inguinal Hernia Repair ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Bilateral Inguinal Hernia ◽  
Bilateral Hernia

Abstract Aim Aim of our study was to analyze outcomes and safety of bilateral inguinal hernia repair in unilateral groin complicated hernia with contralateral groin hernia. Material and Methods Retrospective cohorts study following STROBE statements on a prospective Emergency Surgery Department database. Inclusion criteria were: patients with emergency hernia repair from 2008 to 2018, 18 years old. Unilateral or bilateral inguinal hernia repair without other abdominal wall hernia repairs. Comparative analysis between two group unilateral hernia repair (UH) vs bilateral hernia repair (BH) those patients with unilateral complicated inguinal hernia with contralateral inguinal hernia. Propensity score matching (PSM) between groups was performed to eliminate statistically groups differences. Outcomes between groups were analyzed with special attention to postoperative morbimortality and hernia recurrence. Results 341 patients were included, 38(11.1%) were performed bilateral hernia repair. Groups differences were: higher rate of inguinoscrotal inguinal hernia (36.8 vs 22.8), prophylactic antibiotics use (94.7 vs 81.8) and general Anesthesia use (52.6% vs 50.2%). General high rates of morbidity and mortality were observed (5.9% and 41.9) and 22 (6.5%) hernia repair recurrence were detected. After PSM no differences between surgery outcomes groups were observed with similar morbidity, recurrence or hospital stay. Conclusions Emergency inguinal hernia repair has high morbidity and mortality rates in our experience. Emergency Bilateral inguinal hernia repair in context of hernia complication seems safe without recurrence or hospital stay increase.

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 INGUINAL HERNIA REPAIR AND MALE HEALTH

2019 ◽  
Vol 6 (3) ◽  
pp. 65-73
Author(s):  
N. G. Kulchenko
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Negative Impact ◽  
Russian Literature ◽  
Common Disease ◽  
Male Health ◽  
Inguinal Hernias ◽  
Different Types

Inguinal hernia is a common disease affecting about 5-10% of the population. About 370 000 inguinal hernia repair per year is registered in Russia. Surgeons have reduced recurrence of hernias to a minimum after the widespread introduction of non-tension hernia repair. However, today other complications of inguinal hernias have become prevalent: infection, pain and paresthesia in the scrotum, pathospermia. Opinion about the negative impact on spermatogenesis of both herniation and surgery for hernia is still controversial. This article provides an overview of modern foreign and Russian literature on the аssociation of different types of inguinal hernia repair with pathospermia.

scholarly journals Laparoscopic inguinal hernia repairs: comparison between TAPP and TEP at a tertiary center of Nepal

2018 ◽  
Vol 5 (11) ◽  
pp. 3719
Author(s):  
Komal B. Gurung ◽  
Niroj Banepali ◽  
Rakesh R. Sthapit ◽  
Baikuntha Adhikari
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Tep Repair ◽  
Laparoscopic Inguinal Hernia ◽  
Inguinal Hernias ◽  
Tertiary Center ◽  
Duration Of Surgery

Background: Laparoscopic inguinal hernia repair has been proven to be a safe and effective procedure for groin hernias. In recent years, many of the tertiary centers in Nepal have started performing laparoscopic hernia repair. With the availability of resources and the facilities, the laparoscopic repairs for inguinal hernias are going to be more accessible in near future in Nepal. The aim of this study was to compare the intraoperative events and postoperative complications of transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques of laparoscopic inguinal hernia repairs.Methods: Out of 56 patients, 30 underwent TAPP and 26 TEP repairs for primary unilateral inguinal hernias and were prospectively analyzed. Patient demographics, past medical and surgical history, intraoperative, and postoperative events were recorded. Patients were followed-up for two years.Results: Demographic parameters were comparable in both the groups. The difference in mean operating time was statistically significant (longer in the TAPP group). Intraoperative events such as port-site bleeding and peritoneal tear were comparable in both groups. The immediate postoperative complications like skin ecchymosis, cord hematoma, and scrotal edema were comparable in both repairs.  Immediate postoperative pain was significantly lesser in TEP repair whereas the hospital stays and time to return to the normal physical activity were comparable in both groups.Conclusions: Both TAPP and TEP laparoscopic techniques are safe and effective for inguinal hernia repair. However, there are few advantages of TEP repair such as shorter duration of surgery and less postoperative pain.

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.

Inguinal Hernia in the Premature Infant: Management of a Common Problem

2002 ◽  
Vol 21 (7) ◽  
pp. 39-44 ◽  
Author(s):  
Angela Burd ◽  
Randall Burd
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Premature Infant ◽  
Inguinal Hernia Repair ◽  
Premature Infants ◽  
Nursing Care ◽  
Surgical Procedures ◽  
Survival Rates ◽  
Inguinal Hernias

Inguinal hernia repair is one of the most common surgical procedures performed on premature infants. Improved survival rates in the NICU have led to an increase in the incidence of premature infants with inguinal hernias. The NICU nurse, often the first to notice an inguinal hernia in a premature infant, should understand the etiology, basic pathophysiology, and nursing care for this condition.

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