Abstract
Purpose: Simultaneous surgeries are increasingly applied in all surgical fields. They bring cost and health advantages to the patient and the economy. Pregnancy is one of the risk factors of hernia in females. We conducted a study for simultaneous tissue repairs of inguinal and umbilical hernias during cesarean section. Methods: Between January 1997 and August 2013 we have operated 42 patients with 45 hernias either umbilical or inguinal. We performed the repairs from the Pfannenstiel incision. Data about maternal age, parity, cause of cesarean section, length of operation, length of stay, complications and patient satisfaction were collected. Results: Within this period there were 19,904 deliveries in total. Incidence of umbilical hernia was found 0.2% and it was 0.1% for the inguinal hernia. Simultaneous hernia repairs significantly prolonged the operative time. There was no recurrence and complication. Conclusions: Our results showed that hernia repair can be performed without any additional risks during cesarean section. We believe that if there is an indication for cesarean section in a pregnancy complicated by an abdominal wall hernia, patients should be informed that it would be safe and effective to repair these hernias during cesarean section. This approach also enables tension-free pure tissue repairs.
Highlights
In the 1980s, surgeons cautioned that simultaneous surgical treatment of more than one disorder was associated with increased risk and cumulative postoperative complication rates in these cases can be up to 50% higher than for single procedures [1]
Increased early postoperative morbidity was a concern in such situations, it has been suggested that combined hernioplasty and open prostatectomy may increase the risk of infection as a result
4 other pregnant women with hernias (3 umbilical, 1 inguinal) had repairs done by other surgeons who used different surgical techniques, and these cases were excluded from our study
Summary
In the 1980s, surgeons cautioned that simultaneous surgical treatment of more than one disorder was associated with increased risk and cumulative postoperative complication rates in these cases can be up to 50% higher than for single procedures [1]. Increased early postoperative morbidity was a concern in such situations, it has been suggested that combined hernioplasty and open prostatectomy may increase the risk of infection as a result. S. Carilli of combining clean and contaminated surgeries [2]. Advances in anesthetic drugs and surgical techniques, the introduction of minimally invasive methods, have made combined surgical procedures more popular. Today, it is not unusual for a second surgery to be piggy-backed on an elective procedure such as cholecystectomy, hernia repair, or prostatectomy
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