Surg Clin North Am. Dec;78(6) Inguinal hernia repair. The Nyhus posterior preperitoneal operation. Patiño JF(1), García-Herreros LG, Zundel N. The Nyhus Posterior Preperitoneal Operation The repair of inguinofemoral hernias constitutes the most widely performed general surgical procedure. Adapted with permission from Nyhus LM, Klein MS, Rogers FB. Inguinal hernia. Curr Probl Surg ;
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Nyhus and Condon’s Hernia. Type II—indirect herniass hernia. The anatomic region known as Hesselbach’s triangle is defined laterally by the inferior epigastric artery, medially by the lateral border of the rectus muscle and inferiorly by the inguinal ligament Figure 1. Note the lush innervation of this region. The writing is rich with details and illustrations.
The long-term impact of complications secondary to untreated herniation is not fully known. Seven steps to local anesthesia for inguino femoral hernia repair. In most reports, the recurrence rate varies from 5 to 8 percent for indirect hernias and is slightly higher for direct hernias.
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Three major types of open repair are currently used, and laparoscopic techniques are also employed. The TAPP approach involves placing laparoscopic trocars in the abdominal cavity and approaching the inguinal region from the hernia.
Minimal tension is used to bring tissues together.
The hernial sac can then migrate down along the femoral vessels into the anterior thigh. The most common hernia in both sexes nynus the indirect inguinal hernia.
Nyhus and Condon’s Hernia, 5th Edition
The genital branch of the genitofemoral nerve hermias within the spermatic cord to provide sensation to the scrotum and the medial thigh. The presence of incarceration or strangulation usually mandates urgent operative repair. Recurrence is the most common long-term complication of inguinal herniorrhaphy. Excellent results have been achieved with this approach, and reported recurrence rates have been less than 1 percent.
However, individual preference yernias be ignored, and this technique may be advisable for initial hernia repair in selected patients.
Nyhus and Condon’s Hernia, 5th Edition
It is the first edition not edited by the original authors, Nyhus and Condon. In this circumstance, preperitoneal fat can protrude through the femoral ring, with its accompanying pelvic peritoneum. N Engl J Med. The lifetime risk of inguinal herniation is approximately 10 percent. Average of 3 years, herniqs a range of 1 to 5 years.
Surgical Options in the Management of Groin Hernias – – American Family Physician
Consequently, the bowel or vascular structures may be injured during the procedure Figure 8. Since inguinal herniorrhaphy can be performed using a variety of techniques, the approach can be individualized. Both the ilioinguinal nerve and the genitofemoral nerve traverse the usual hernia-repair operative field. These procedures have not provided pain relief in all patients. The choice of technique depends on several factors, including the type of hernia, anesthetic considerations, cost, period of postoperative disability and the surgeon’s expertise.
Email Alerts Don’t miss a single issue. Again, all are very well written and loaded with information regarding repair and management. Recurrent inguinal hernia treated by classical hernioplasty. Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts.
Either general or regional spinal anesthesia may be used in these patients. Diagnosing inguinal hernias in children can be very difficult.
In both the TAPP and TEP approaches, the hernia sac is reduced, and a large piece of mesh is placed to cover the indirect, direct and femoral areas of the inguinal region.
The disadvantages of spinal anesthesia include the time required for the anesthetic to be placed and the possibility of incomplete sensory blockade. Several studies have demonstrated that this approach is safe and involves only minimal use of pain medication. Laparoscopic mesh repair, viewed from inside the pelvis toward the direct and indirect sites. Almost all groin hernias should be surgically repaired.
The major nerves in the inguinal region are the ilioinguinal, iliohypogastric and genitofemoral nerves. Comparison of conventional anterior surgery and laparoscopic surgery for inguinal-hernia repair.
The complications following herniorrhaphy are generally minor and self-limited.