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Inguinal hernia

Inguinal hernias are protrusions of abdominal cavity contents through an area of the abdominal wall, commonly referred to as the groin, and known in anatomic language as the inguinal area or the myopectineal orifice. They are very common and their repair is one of the most frequently performed surgical operations. They usually arise as a consequence of the descent of the testis from the abdomen into the scrotum during early fetal life, and are therefore far more commonly seen in men than women. They present as painless bulges in the groin area that can become more prominent when coughing, straining, or standing up. The bulge commonly disappears on lying down. more...

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The presence of pain, or the inability to "reduce" the bulge back into the abdomen, usually indicates the onset of complications.

As the hernia progresses, contents of the abdominal cavity, such as the intestine, can descend into the hernia and run the risk of being strangulated within the hernia, causing an intestinal obstruction. If the blood supply of the portion of the intestine that is caught in the hernia is compromised, gut ischemia and gangrene can result, with serious consequences. The time of occurrence of complications is not predictable; some hernias can remain static for years, others can progress rapidly from the time of onset. Therefore, provided there are no serious co-existing medical problems, patients are advised to get the hernia repaired surgically at the earliest convenience after a diagnosis is made. Emergency surgery for complications such as obstruction and strangulation carry much higher risk than planned, "elective" procedures.

Despite the profusion of medical technology that is now available, the diagnosis of inguinal hernia rests on the history given by the patient and the physician's findings on examination of the groin. No tests are needed to confirm the problem.

Surgical correction of inguinal hernia is a simple operation that is now done in most places as an ambulatory or "day surgery" procedure. A workable technique of repairing hernia was first described by Bassini in the 1800s; the Bassini technique was a "tension" repair, one in which the edges of the defect are simply sewn back together without any reinforcement or prosthesis. Although tension repairs are no longer the standard of care due to their high recurrence rates, long recovery period and severe post-operative pain, a few tension repairs are still in use today; these include the Shouldice and the Cooper's/McVay repair.

Almost all repairs done today are open "tension-free" repairs that involve the placement of a synthetic mesh to strengthen the inguinal region; some popular techniques include the Lichtenstein repair (flat mesh patch placed on top of the defect), Plug and Patch (mesh plug placed in the defect and covered by a Lichtenstein-type patch), Kugel (mesh device placed behind the defect), and Prolene Hernia System (2-layer mesh device placed over and behind the defect). The meshes used are typically made from polypropylene or polyester, although some companies market Teflon meshes and partially absorbable meshes. The operation is typically performed under local anesthesia, and patients go home within a few hours of surgery, often requiring no medication beyond over-the-counter pain relievers such as aspirin or acetaminophen. Patients are encouraged to walk and move around immediately post-operatively, and can usually resume all their normal activities within a week or two of operation. Recurrence rates are very low - one percent or less compared with over 10% for a tension repair.


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Coping With a Hernia (Overcoming Common Problems Series) $0.69 The Official Patient's Sourcebook on Inguinal Hernia: A Revised and Updated Directory for the Internet Age $32.71
Color Atlas of Inguinal Hernias and Hydroceles in Infants and Children: Single Surgical Procedures Series (Single surgical procedures series) $89.00 Tests assess urgency of inguinal, scrotal swelling: simple techniques for reducing hernias.(Children's Health) : An article from: Family Practice News $5.95
Inguinal Hernia - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References $34.95 Inguinal hernia-yesterday, today and tomorrow.(Editorial) : An article from: Indian Journal of Surgery $5.95
Laparoscopic Inguinal Hernia Repair $21.32 Kugel patch for inguinal, ventral hernia repairs. (No Patch Shrinkage). : An article from: Internal Medicine News $5.95
Laparoscopic Inguinal Hernia Repair (Laproscopic Surgical Technique) $249.97 Laparoscopic surgery of inguinal hernia in children-experience with 110 repairs.(Letter to Editor)(Letter to the Editor) : An article from: Indian Journal of Surgery $5.95

Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost
Objective: To compare tension-free open mesh hernioplasty under local anaesthetic with transabdominal preperitoneal laparoscopic hernia repair under general ...
Does Inguinal Hernia Repair Affect Sexual Function? - Brief Article
Tension-free inguinal hernia repair for augmentation of the inguinal canal used to be popular. Techniques using meshes can be performed under local anesthesia and result in excellent patient comfor
Laparoscopic versus open mesh repair of inguinal hernia
EDITOR--Our paper on hernia repair produced much correspondence.[1 2] In response to the letter from Notaras we agree that patients unfit for general ...
Correction - to "Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost" in July 11, 1998 issue - Correction
Randomised controlled trial of laparoscopic versus open mesh repair for inguinal hernia: outcome and cost An error occurred in the labelling of one of ...
Inguinal Hernia Repair in German Military Hospitals
The inguinal hernia repair continues to be the most common operation in general surgery. Discussing the latest scientific findings, we have prepared this ...
Laparoscopic surgery vs. open mesh repair of hernia
Recurrence of an inguinal hernia after surgical repair is fairly common. Tension-free repair of hernias using prosthetic mesh has been shown to reduce ...
Abdominal Wall Neurofibroma Presenting as an Inguinal Hernia
Inguinal hernias are a common cause of abdominal wall pain and are the most common abdominal wall abnormality. They can usually be differentiated from ...
Inguinal hernia in children: ultrasound vs. surgery - Tips from Other Journals
Repair of inguinal hernias is one of the most commonly performed surgical procedures in children. Because clinically inapparent inguinal hernias are found ...

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