Cases Of Inguinal Hernia Research Articles

A Case of Interparietal Inguinal Hernia with Cryptorchidism in an Adult

A Case of Interparietal Inguinal Hernia with Cryptorchidism in an Adult

SURGICAL TACTICS IN RECURRENT INGUINAL HERNIAS AT THE CHILDREN

The aim: Is to increase effectiveness of treatment at the children with recurrent inguinal hernias by improving surgical tactics. Materials and methods: Method of laparoscopic correction of the recurrent inguinal hernias in children. For a period from 2017 to 2020 years in the surgical department of Municipal Establishment «Dnipro specialized clinical center of mother and child named by professor M. F. Rudnev» of Dnipro Regional Council» situated in the city Dnipro were carried out 48 laparoscopic procedures in a case of recurrent inguinal keel in children at the age of 3 years. Results: We proposed an innovative method of laparoscopic correction the recurrent inguinal hernias, which allows to eliminate a hernial pocket without additional injury structures of the inguinal canal. At the analysis cases of recurrent inguinal hernias was concluded, that recrudescence appeared among young children and more frequently, after surgical interference on the strangulated inguinal hernias, which were operated by traditional ways. Conclusions: According to the results of our research, it had been proved, that among numerous measures, focused on a restoration drainage system violation in the testicle, in a case of infringement obliteration of vaginal sprouts of a peritoneum in the boys and to keep safe ovarium vascularization in the girls.

A Re-recurrent Case of Inguinal Bladder Hernia Treated by Transabdominal Preperitoneal Repair

A Re-recurrent Case of Inguinal Bladder Hernia Treated by Transabdominal Preperitoneal Repair

A Case of Left Inguinal Hernia with Endoscopic Incarceration During Colonoscopy Treated by Laparoscopic Surgery and Intraoperative Colonoscopy

A Case of Left Inguinal Hernia with Endoscopic Incarceration During Colonoscopy Treated by Laparoscopic Surgery and Intraoperative Colonoscopy

To evaluate the efficacy of N-butyl cyanoacrylate glue for mesh fixation in laparoscopic inguinal hernia repair

Method: A Prospective observational study of Laprascopic Repair of Inguinal Hernia by using N-Butyl Cyanoacrylate Glue for mesh fixation without tackers” was an observational study conducted on 50 patients with Inguinal hernia admitted in Department of General Surgery, M.G.M Medical College and M.Y Hospital Indore (M.P.) during the study period from December 2018 to February 2019.Result: Majority of the cases of inguinal hernia presented were in the age group 39-48 and 49-58 with the same percentage (26% each). Thus, common age group for inguinal hernia is from 39-58 years which accounts for 52% of the cases. The least no. of cases occurred in the age group 79-88 years with 4%. The mean age was 50.6 years with minimum age being 19 years and maximum age being 85 years. The ratio of direct to indirect inguinal hernia is 1:3.Conclusion: The field of inguinal hernia repair has undergone a paradigm shift over a period. Laparoscopic repair has become a preferred approach for inguinal hernia repair. The latest advancements in the field of prosthetic materials and various means of mesh fixation have brought about significant improvement in the quality of life of the patient who often suffered chronic pain post hernia repair. Majority of inguinal hernias occurred on the right side in the case study which accounted for 52% of the cases.

Exceptional case of surgical treatment of huge inguinal hernia at the woman

Despite significant progress in a health care system the started cases of huge inguinal hernias still meet. For successful treatment of such patients objective diagnostics, preoperative preparation, the choice of suitable tactics of surgery and treatment in the postoperative period is important. The clinical case of treatment by not reducible huge inguinal hernia at the patient of 73 years is presented in article. The patient showed complaints to presence of the big sizes of the hernia in the bottom of a stomach limiting movement of the patient and self-service reducing quality of life. For the first time hernial protrusion in inguinal area has appeared in 2008 which gradually increased in sizes. Since 2015 I have noted the intensive growth of hernia. I didn’t ask for medical care. To clinic it is brought by an ambulance crew with the diagnosis of The Restrained Inguinal Hernia direction. At the time of survey data for infringement weren’t. After comprehensive examination to the patient surgery in volume has been executed: a gryzhesecheniye on the right, plasticity across Liechtenstein. The postoperative period proceeded without complications. The patient is written out for the 13th days after operation. Extremely exceptional clinical case, the choice of adequate stage-by-stage preoperative inspection and treatment, optimum surgical tactics and postoperative kuration is shown. The chosen approach led to prevention of development of a cascade of the complications including a compartment syndrome, to elimination of cosmetic defect and restoration of quality of life.

A comparative study of inguinal hernia using monofilament non-absorbable suture versus monofilament absorbable suture in Lichtenstein tension free hernia repair at tertiary care government hospital

Background: The surgical treatment of inguinal hernias has evolved through several stage, history of groin hernia is the history of surgery itself. But, chronic pain is still a major irritating post-operative complain of the patient. The objective of the present study was to compare post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in terms of postoperative pain, chronic groin pain, seroma formation, wound infection, scrotal oedema and recurrence in Lichtenstein hernioplasty.Methods: This is a single center, prospective randomized controlled study of 152 cases of inguinal hernia comparing post-operative outcomes of mesh fixation with monofilament non-absorbable v/s monofilament absorbable suture material in Lichtenstein hernioplasty at Baroda Medical College and S.S.G. Hospital, between 1st November 2017 to 30th November 2018.Results: Total 152 patients of unilateral or bilateral inguinal hernia were studied 76 in each group. Chronic groin pain mean visual analogue scale score at 3 months was higher in group with non-absorbable suture compared to monofilament absorbable group (1.3±0.9 v/s 0.95±0.8 p value <0.05).Conclusions: Monofilament absorbable suture is associated with less chronic groin pain and compared to monofilament non-absorbable sutures.

INGUINAL HERNIA – LAPAROSCOPIC VERSUS OPEN – A SINGLE CENTER EXPERIENCE

Inguinal hernia is one of the most common surgical pathologies, which appears mainly due to the weakening of the abdominal muscles. Currently, the gold standard in the repair of inguinal hernias by open approach is the Lichtenstein procedure, while the gold standard of laparo-endoscopic procedures are the pre-peritoneal transabdominal technique (TAPP) and the total extraperitoneal technique (TEP). The purpose of this study is to evaluate, for a period of 4 years, the cases of inguinal hernias operated both by laparoscopic and open procedures to analyze their characteristics, under the conditions in which none was imposed as absolute gold standard for groin hernias. The present study was retrospective and descriptive, including a number of 214 cases hospitalized with the diagnosis of inguinal hernia. In the surgery of the groin hernia, both laparoscopic and open procedures have demonstrated their feasibility. Our study shows the preference for open surgery in elderly patients and those with comorbidities, as well as a faster evolution, with earlier discharge in the case of laparoscopic interventions.

Clinical and Therapeutic characteristics of patients with abdominal hernias at the savalou Banté Hospital in Republic of Bénin

Background: Abdominal hernias are frequent conditions in African’s countries and mostly at Savalou-Bantè Hospital in the Republic of Benin. The objective of this study was to determine the prevalence, clinical and therapeutic characteristics of abdominal hernias at Savalou-Bantè Hospital in the Republic of Benin. Methods: This was a prospective study carried out from March 15, 2013 to August 31, 2018 including all patients with abdominal hernia. Results: Out of 146 procedures done in department of surgery at Savalou-Bantè Hospital, 77 were abdominal hernias repair either 56.84%. Inguinal hernia was the commonest (88.76% of cases). Strangulated hernia was the main complication in 17.98% of cases (16/77). Herniorrhaphy was done in all hernias and Bassini technique was used for all cases of inguinal hernia. Mortality was observed in 6.5% (5 patients / 77). The median of staying in hospital was of 4.60 days. We noted a case of recurrence (5.26%). Conclusion: there still a dire need in management of abdominal hernias and hernia repair using mesh is in need. Early consultation will avoid the arising of complications.

Comparison of outcome of Desarda versus Bassini repair in management of complicated inguinal hernia

Background: Complicated inguinal hernia is a common problem faced by surgeons across the world. Various methods of surgical repair have been described. It is important to identify the best repair technique of inguinal hernia to have better post-operative outcome.Methods: This randomised controlled study consisted of 84 cases of complicated inguinal hernias presenting to surgical emergency department of Maulana Azad Medical College. Patients were randomly allocated to two repair groups- Desarda and Bassini and various intra/post-operative parameters were compared.Results: Duration of surgery and postoperative pain scores were less in Desarda group. Time to return to strenuous daily activities was also less with Desarda repair. Desarda repair was associated with less incidence of chronic inguinodynia and post-operative complications.Conclusions: Desarda repair was found to be superior to Bassini group due to shorter duration of surgery. Patients required less analgesics following Desarda repair as compared to Bassini group. There was no recurrence in any group at four months follow up.

Effectiveness of open pre-peritoneal approach in the treatment of inguinal hernia in adults

Background: Bassini (1844–1924) transformed inguinal hernia repair into a successful venture with minimal morbidity. The success of the Bassini repair over its predecessors ushered in an era of tissue-based repairs. Inguinal hernia repair underwent its most recent transformation. Laparoscopic inguinal hernia repair as the Trans Abdominal Pre Peritoneal (TAPP) repair, and the Totally Extra Peritoneal repair (TEP). The most significant advances to inguinal hernia have been repair through open pre-peritoneal approach. The most significant advances to inguinal hernia have been repair through open pre-peritoneal approach. The advantage of pre-peritoneal approach is that the prosthetics can be placed between hernial contents and hernial defects. The need for present study is to review the effectiveness and complications of open pre-peritoneal approach in inguinal hernia repair. Methods: A prospective observational study in patients who had undergone open pre-peritoneal mesh repair in Narayana medical college, Nellore. Sample size- a total of 50 patients are taken in this study. Results:In this present study 50 cases of inguinal hernia were taken and operated by open pre-peritoneal approach. Conclusion:In this present study the effectiveness of pre-peritoneal approach in Inguinal hernia was studied in terms of post-operative pain, wound complications, time to return to pre-operative physical activities and short term recurrence.There was no recurrence rate on follow-up, Post operative pain was low compared to other approaches from various studies, and time to return to normal activities was significantly less than the other repairs.

A Jack or Two in the Box in a Case of Recurrent Inguinal Hernia

Occult herniae are difficult to diagnose clinically and hence require pre-operative imaging. There is a need to inspect all the hernia orifices at the operating table to facilitate their needful repairs. A laparoscopic approach to repair these defects is essential as in this view, all the hernial orifices can be visualized. We are presenting a case of bilateral recurrent inguinal hernia, where two occult herniae were discovered on the table, all of which were repaired either by plication alone or Lichtenstein’s tension-free mesh repair.

Application of ice bag cold dressing area after total extraperitonal herniorrhaphy

Objective To evaluate the effects of total extraperitonal herniorrhaphy on pain and effusion in patients with surgical area. Methods The clinical data of 58 cases of inguinal hernia admitted to the First Hospital of Shanxi Medical University from January 2017 to January 2018 were retrospectively analyzed.Complete extraperitoneal inguinal oblique hernia repair was performed under laparoscopy under general anesthesia.The patients were divided into two groups by the single or double of admission date number.The observation group(A group, 32 cases) received post-operative intraoperative pressure homemade ice bags, the control group(B group, 26 patients) was placed in normal temperature saline bag after operation.The degree of pain in patients was evaluated by numerical scoring method.The time of exit, discharge, accumulation rate and recurrence rate of hernia were analyzed. Results The differences in pain score, pain score during floor movement, and regional efflux rate between A group and B group were statistically significant[(2.11±0.97)points vs.(2.45±1.21)points, (2.63±1.89)points vs.(2.76±1.95)points, 0 case vs.2 cases, t=2.745, 4.189; χ2=1.15, all P 0.05). Conclusion After laparoscopic repair of total extraperitonal herniorrhaphy, the area ice pack can achieve the purpose of relieving pain in the surgical area and reducing the accumulation of fluid in the surgical area. Key words: Laparoscopy; Total extraperitonal herniorrhaphy; Hernia, inguinal; Cold compresses; Pain; Hydrops; Numerical rating scale

Effect of inbreeding on reproduction, weight and survival of Tazegzawt sheep lambs

This study evaluated the effects of inbreeding on the reproduction, weight, and survival of Tazegzawt Kabylian lambs. The study focused on the growth performance of 67 lambs born during 2013 to 2015 at the level of the herd of INRAA experimental station of Bejaia. Because of the difficulty in finding breeding males, the rams used for mating came from individuals of the same herd. Analysis of the results indicated a decrease in reproductive parameters of 6 points for fertility, 16 points for prolificacy and 4 points for fecundity respectively between the first and third lambing. The mortality rate increased with inbreeding for the first, second and third lambing. This mortality was characterized by mortality pre-partum and post-partum, before the age of 10 days and before weaning. The appearance of anterior limb abnormalities and cases of blindness and inguinal hernia were observed. The change of males and the use of cryopreservation as a means of reducing inbreeding and for the preservation and conservation of this lesser known genetic potential thus becomes imperative.

Bladder Hernia, Bladder Stone and Contralateral Bowel Hernia: An Usual Combination

We report and discuss a rare case of inguino-scrotal urinary bladder herniation (IBH) complicated with a big urinary bladder stone and contralateral indirect inguinal bowel hernia. A 68-year male patient presented to the outpatient urology department with a 4-year history of right inguino-scrotal pain and swelling, which was gradually increasing in size, and of intermittent swelling in the left groin. Physical examination revealed right irreducible inguino-scrotal hernia and reducible left inguinal hernia extending to the groin. Computerised Tomography (CT) revealed that the right side of urinary bladder was herniating through the inguinal canal into the right hemiscrotum along with a 22 mm urinary bladder stone. The patient underwent bilateral Lichtenstein tension-free mesh hernioplasty through inguinal incisions and transurethral laser cystolithotripsy in the same session. To the best of the authors' knowledge, this is the first reported case of bilateral inguinal hernia with concomitant bladder stone in the literature.

Inguinal bladder hernia, a rare cause of inguinal herniation: Report of two cases

Hernia surgery is the most frequent in visceral surgery. The bladder is rarely involved in groin hernia. This is when a diverticulum or a part of the bladder wall is incarcerated within the hernia. This affection is often asymptomatic. The diagnosis is made per-or post-operatively following complications. We report 2 cases of inguinal hernia involving the bladder in which the first case was diagnosed preoperatively whereas the second was diagnosed intraoperatively.

Effect of hernia ring filling tension-free repair in the treatment of inguinal hernia and its influence on prognosis

Objective To explore the clinical efficacy of hernia ring filling tension-free repair in the treatment of inguinal hernia and its influence on prognosis. Methods From September 2015 to September 2016, 96 cases of inguinal hernia admitted to the Second People's Hospital of Yaodou District were selected and divided into control group(n=48) and observation group(n=48) according to randomized double-blind method.The control group was treated with routine hernia repair, and the observation group was given hernia ring filling tension-free repair.The clinical efficacy, complication rate and recurrence rate were compared between the two groups. Results The postoperative bed-out time and average length of hospital stay in the observation group were (10.38±2.35)h and (6.14±1.96)d, respectively, which were shorter than those in the control group[(21.21±4.46)h and (7.95±2.30)d], and there were statistically significant differences between the two groups(t=14.88, 4.15, all P<0.05). The incidence rate of complications and postoperative recurrence rate in the observation group were 6.25% and 2.08%, respectively, which were significantly lower than those in the control group(27.08% and 14.58%), and the differences between the two groups were statistically significant(χ2=7.50, 4.91, all P<0.05). Conclusion Inguinal hernia patients with tension-free repair hernia ring can effectively reduce postoperative recovery time, reduce pain, with low incidence rate of complications and high safety, and patients with low recurrence rate, the effect is better than routine hernia repair. Key words: Hernia, inguinal; Herniorrhaphy; Muscle tonus; Prostheses and implants; Prognosis

Decreasing operating room costs via reduction of surgical instruments

Rising costs in health care demand waste reduction and improved efficiency throughout the hospital. Surgeons have an important role in regardto the number of instruments used in procedures. Previous studies have demonstrated instrument maintenance and sterilization cost approximately $0.51-$0.77 per instrument and found that only 13-21.9% of instruments opened are used. The aim of the study was to reduce the surgical trays so that more than 50% of the instruments are used leading to a cost savings of at least 20% per tray. This was begun with the minor urology tray which is primarily used for orchiopexy and hernia repair. This was a single-site, prospective study. A Plan, Do, Study, Act cycle was used. A multidisciplinary team including urologists, surgical technicians, and a central processing department representative was developed. Inguinal orchiopexy with hernia, scrotal orchiopexy, and inguinal hernia cases were randomly chosen to count the total instruments used in each procedure. The exact instruments were recorded every third case to obtain a sample of variable patients and surgeon preferences. The percentage of utilization was calculated, and a list of instruments used was created. Those not used or used less than 20% of the time were removed. The new list was reviewed with the option to add or eliminate instruments. The approved reduced list was then implemented as the genitourinary (GU) minor tray. Finally, the instruments used in 10 inguinal orchiopexy with hernia cases, 10 scrotal orchiopexy cases, and 10 inguinal hernia cases were counted. The percentage of utilization was calculated. This process was then replicated in other surgical trays. The GU minor instrument tray was reduced from 57 to 35 instruments, a 39% reduction in size. Scrotal orchiopexy uses the least instruments (16.9), a utilization percentage of 48.3% after reduction. Inguinal orchiopexy with hernia repair uses the most number of instruments (25.1) with 71.7% utilization after reduction, compared with 43% before reduction. Using the cost analysis performed by Stockert and Langerman, $11.22 was saved during each procedure; this translates to a cost savings of $3489.42 annually. After reduction, only 10% of the cases required an extra instrument to be opened. Three other surgical trays were reduced using the same method, yielding a potential savings of $14,588. Baseline data demonstrates low average instrument utilization rangin from 21.1% to 49.1% per case. It is estimated that each instrument costs from $0.51 to $3.19. Decreasing the number of instruments opened with each surgical procedure is a viable way to decrease costs and efficiency in the operating room. Initially, the GU minor tray was successfully reduced by 39%, followed by the other surgical trays. A multidisciplinary approach is critical for success. This study showed an excellent opportunity for cost savings by decreasing reusable waste in the operating room.

Invagination of inguinal hernial sac in comparison with ligation and excision in indirect inguinal hernia

Background: To evaluate the incidence of early recurrence and chronic groin pain in the two groups of patients (group A=ligation and excision, group B=invagination) with indirect inguinal hernia and to observe different intraoperative and post-operative parameters in both groups.Methods: This prospective randomized study was done in SSG Hospital and Government Medical College, Vadodara from 1st December 2016 to 30th November 2017. All the cases of indirect inguinal hernia attending the surgical OPD in SSG hospital were enrolled in this study. All the patients underwent Lichtenstein tension free repair. A total of 50 patients were enrolled in this study. MedCalc Software Version 12.5.0 was used for the analysis of the data and Microsoft word and Excel was used to generate graphs and tables.Results: 50 patients of indirect inguinal hernia with more than 18 years of age were enrolled and divided into two groups. Intra operative complications, post-operative pain by VAS and post-operative complication observed, which was found insignificant. There was no seroma and induration on both the study group at 3 months and 6 months interval. No local swelling (recurrence) in inguinal region was seen in patients (both group A and group B) during the 6 months follow up period.Conclusions: This study shows no difference in outcome of results in Lichtenstein tension free hernia repair for indirect inguinal hernia with two different technique in dealing with sac except less postoperative pain in invagination of sac as compare to ligation and excision.

Analysis of clinical effect on 19 cases of inguinal hernia treated by laparoscopic totally extraperitoneal repair

Objective To investigate the effect of laparoscopic total extraperitoneal tension-free hernia repair (TEP) in the treatment of inguinal hernia with absorbable biological mesh. Methods A retrospective analysis of the clinical data of 19 patients with inguinal hernia with biological mesh was performed from September 2015 to September 2016 in Shengjing Hospital of China Medical University. The average operative time, average incision pain time, average postoperative venting time, average hospital stay, average operative cost, and long-term chronic pain, postoperative complications, and recurrence rate were observed. Results All the 19 patients were successfully operated. The average operation time was (35.0±4.0) min, the average incision pain time was (1.5±0.6) d, and the average postoperative venting time was (1.5±1.2) d. The average hospital stay was (4.5±0.9) d, the average surgery cost was (23 534.6±1 259.9) yuan. Two patients developed swelling of the scrotum after surgery, and one patient developed postoperative fat liquefaction. All patients were followed up for 1 year by telephone, with no recurrence, no serious complications, and chronic pain discomfort. Conclusions The application of absorbable biopsy TEP is a good and reliable way to treat inguinal hernia. Postoperative patients have mild pain and low complication rate. There is no recurrence in recent follow-up, and the short-term effect is satisfactory. It is a reliable method for the treatment of inguinal hernia. The cost is high, and can be selected according to age and individual needs. Key words: Hernia, inguinal; Laparoscopes; Laparoscopic totally extraperitoneal repair; Biological mesh; Tension-free repair