inguinal hernia

Inguinal hernia




It is a pathological protrusion of the peritoneum through the inguinal canal (obliquely through the abdominal wall above inguinal ligament). The inguinal canal has two mouth (inside - deep inguinal ring, external - superficial inguinal ring) and four constraints (front - aponeurosis of the external oblique muscle; back - peritoneum and transverse fascia; lower - the inguinal ligament; upper - the internal oblique muscle and transverse abdominal , these muscles fascia.


Types



a) oblique inguinal hernia - congenital or acquired. Passes through the inguinal canal penetrating through the deep inguinal ring and finding mouth through the superficial inguinal ring. Further developments were reflected in the distribution of incomplete hernias (does not go beyond the superficial inguinal ring), complete (those that left superficial inguinal ring), scrotal (find an mouth in the scrotum), labial (in the area of labia majora), slides (organ partly intraperitoneally - pulled with peritoneum to the hernia sac).

b) simple inguinal hernia – it is acquired hernia. It penetrates medial inguinal bottom, which is a hernia's gate. It is limited by lower epigastrical vessels and lateral umbilical fold. Mouth is located just under the skin, near the inguinal ligament.
Diagnostics - a physical examination can sometimes feel hernias by examination of the scrotum (putting a finger into the inguinal canal) and requiring the patient to cough. Ultrasound is also helpful.
Symptoms - they depend on the severity of the hernia. It may be asymptomatic. Some of the popular symptoms include burning, pain in the inguinal area (especially during defecation and cough) and visible protrusion.


Treatment



All of the inguinal hernia is an indication for surgery (in case of entrapment - immediately). Operations can be divided into several types:

a) classic operations with the use of their own tissues. They rely on dissection of the hernia sac, the intersection, and the escorting contents and ligation and cutting off of its residues. It is necessary to repair the posterior wall of the inguinal canal (it can be done several methods - Bassini, Halsted, Shouldice).

b) Treatment with the use of plastics - mesh reinforcing the posterior wall of the inguinal canal (Lichtenstein); cork closing hernia's gate. (Rutkow method), two meshes connected by a hyphen (Prolen hernia system).

c) laparoscopic operations - a lower frequency of relapses.

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Femoral Hernia - Inguinal Approach

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Surgical video case: femoral hernia, female patient 45year. Inguinal approach.

Open Inguinal Hernia Repair

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Didactic video open inguinal hernia repair.

Laparoscopic Inguinal Hernia Repair

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Instructional video of laparoscopic inguinal hernia repair with prosthesis  and fixation with cyanacrylate glue GLUBRAN2 GLUTACK GEM.

Minimally Invasive Mesh Fixation in a Laparoscopic...

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Didactic movie of laparoscopic inguinal hernia repair. You can appreciate the whole procedure and the minimally mesh fixation performed by Glutack.

Laparoscopic Percutaneous Inguinal Hernia Repair

views: 2267 comments: 1
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A 1.5-year-old girl with a right inguinal hernia. Both inguinal canals were opened intraoperatively. The hernia was closed percutaneously with a 4.0 non-absorbable suture. The operation time was 12 minutes....

The Case of Huge Lipoma of the Spermatic Cord

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Surgical video case: a lipoma of the cord is herniated fat that appears to originate from the retroperitoneal fat outside and posterior to the internal spermatic fascia and protrudes through the internal...

Huge Right Oblique Inguinal Hernia

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Surgical video case: huge right oblique inguinal hernia contents are to be reduced with proper positioning, and gentle traction from inside using two atraumatic instruments in addition to gentle pressure...

Acute Appendicitis with Pregnancy With Right...

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In the case of acute appendicitis with pregnancy please don't go directly to the appendix. Explore the entire abdominal cavity first. You may find a right oblique inguinal hernia, adhesions of a previous...

Open Inguinal Hernia

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Surgical video case: open onguinal hernia repair.

Saddlebag Inguinal Hernia

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Surgical video: saddlebag hernia occurs most commonly as a small indirect sac in association with an obvious direct inguinal hernia. The hernial sac pushes through both sides of the inferior epigastric...

Spermatic Cord Lipomas

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Surgical video: spermatic cord lipomas are a common incidental finding during surgical treatment for inguinal hernias. They are found in 20–70% of all inguinal hernia repairs. They appear to arise...

Laparoscopic Repair of a Missed Direct Hernia

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Case presentation: in this video we demostrate laparoscopic repair of a direct hernia very medial located in a 32 years old man with past history of open bilateral inguinal herniorrhay suffering pain...

Left Inguinal Hernia - Laparoscopic Trans-Abdominal...

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Surgical video case: laparoscopic plate repair of a left inguinal hernia, trans-abdominal pre-peritoneal approach.  

Four Times Recurrence Inguinal Hernia. Succesful...

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We show a case of recurrent hernia treated four times with anterior open approach. Laparoscopic repair was the option and was succesful done. 

TAPP Inguinal Hernia Repair by Ipsilateral Port

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This surgery demonstrates TAPP Inguinal Hernia Repair by Ipsilateral Port by Dr. R.K. Mishra at World Laparoscop[y hospital. Inguinal hernia repair is one of the most common procedures performed around...

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