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What is best method to repair small inguinal hernia in young man?
Wiki User
∙ 10y ago
An inguinal hernia is a defect in the opening of the musculo-tendinous opening of the abdomen. It can be due to a tear ("direct", the less common type), or due to a stretching of a normal orifice (the inguinal ring) through which the scrotal cord naturally passes ("indirect", the more common type).
The hole must be closed (in the case of a "direct" hernia), or tightened back to its normal small dimension (in the case of a "indirect" hernia).
Older methods of inguinal hernia repair involve mobilizing the tissues that surround the hole and bringing them together under tension, holding them together with sutures. These methods (which include the Bassini (and modified Bassini), McVay, and Shouldice methods), have a high incidence of recurrence (variably between 8 and 20%) due to the tension of tissues pulling at the sutures. Such tension causes the sutures to erode through tissues (much as a wire cheese cutter cuts through cheese), which is the eventual cause for recurrence.
"Tension-free" methods include patching the holes with a piece of plastic mesh (and, experimentally, with bio-mesh materials), plugging the hole with a piece of plastic, or both.
Plastic mesh sheets can be placed from the outside (open Lichtenstein method) or from the inside (laparoscopic method). A single sheet of a plastic patching mesh has a higher risk of recurrence than using a method that involves a combination of both plugging the hole and patching it as well. This is because the sheet of plastic can "wad up" into the hole, can pull loose from the edges, and can shift position (sliding sideways so that the hole is again exposed).
Securing a large plastic sheet in an attempt to avoid this is necessary, but placement can involve a wide area of dissection and therefore increased post-operative pain. Furthermore, laparoscopic methods involve securing the mesh with staples close to critical nerves and small blood vessels; the complication rate of laparoscopic methods can be as high as 30% because of this. Experimental methods of securing the mesh using glue instead of staples may reduce these complication rates in the future.
Plug-and-patch methods currently include the Per-fix method and the Prolene hernia system. The Prolene hernia system has the lowest demonstrated recurrence rate but requires a greater dissection for placement and therefore carries a higher risk of post-operative pain. The device consists of two disks of mesh connected by a stalk of mesh connecting them, that acts as a plug. When the defect is larger, this system may be preferable.
The Perfix plug and patch requires the smallest incision for placement and the least dissection. It is basically a Badminton-birdie (shuttlecock) -shaped cone of plastic (avaialble in various sizes) placed nose first into the defect. It is additionally covered by a smaller sheet of plastic (on the outside), placed separately. There is still a risk of post-operative pain with this method, even though dissection is less. This can occur especially if the hole is tightened too much, so that nerves are impinged during repair and/or become entrapped by scar tissue that necessarily occurs around the plastic mesh.
Currently the preferred method for initial inguinal hernia repair should either be the Perfix plug/patch mesh method (especially for smaller defects) or the Prolene hernia system (better for larger defects).
When an inguinal hernia repair is recurrent, however, there is often scar tissue from the original hernia repair. If the original repair was "open" (i.e. through an external incision) instead of laparoscopic, the scar tissue will be external. In such situations, a laparoscopic method for repair of the recurrence allows an approach through areas (from the "inside", or abdominal side) of the recurrent hernia that presumably are not scarred. This is usually easier to perform. Laparoscopic hernia repair ought to be done by a surgeon experienced not only in laparoscopic surgery, but specifically in laparoscopic hernia repair. Complication rates by non-experienced surgeons is unacceptably high.
It is unclear which is the best way to repair a recurrent inguinal hernia that was initially done laparoscopically. Logically, scar tissue from the original repair will in this instance be on the "inside" (or abdominal side) of the hernia defect following laparoscopic repair. Repair of a recurrence is therefore logically easier using an external ("open") approach. Whether a patch only (Lichtenstein) or plug/patch (Perfix Plug or Prolene hernia system) method is preferable in such instances is not clear, but a logical extension of results from other comparisons (of initial hernia repair methods) of the Lictenstein method versus the plug/patch methods likely favors the latter for repair of laparoscopic recurrences as well.
Wiki User
∙ 15y ago
Wiki User
∙ 13y agoOpen surgical repair of an indirect hernia begins with sterilizing and draping the inguinal area of the abdomen just above the thigh. An incision is made in the abdominal wall and fatty tissue removed to expose the inguinal canal.
Wiki User
∙ 11y agoLaparoscopic repair is the best (minimal invasive surgery)
Wiki User
∙ 10y agoIn young man the common hernia in indirect inguinal hernia. Reduction of hernia, excision of the sac and narrowing of the internal inguinal ring is the best method.
Wiki User
∙ 11y ago"Mesh Fixation" by Laparoscopic Surgery.
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What term describes the protrusion of a small loop of bowel through a weak place in the lower abdomal wall?
Herniation. A inguinal hernia is a protrusion of any bowel content (including omental fat) through the lower abdominal musculature.inguinal hernia
What anaesthetic for inguinal hernia?
Small hernias can be repaired under a local anaesthetic as a day case. Laparoscopic hernia repairs will be done under a General anesthetic. Unfit patients can be considered for repair under a regional anaesthesia combined with some sedation.
What is involved in hernia repair surgery?
Hernias occur when a weakness in the wall of the abdomen allows an organ, usually the intestines, to bulge out of place. Hernias may result from a genetic predisposition toward this weakness. They can also be the result of weakening the muscle.
What is cpt code 49590?
repair of a spigelian hernia. This type of hernia is in the layers of the abdominal wall, usually small, and requires repair for preventionof incarceration.
You had a sports hernia 2 years ago you reinjured the same area 8 months ago you went to a surgeon and he did a catscan on you and found nothing but you sill hert in that area somedays and very bad th?
I am not an MD but have had my bouts with sports hernia's. After playing ice hockey for 30 years, I have had 2 and re-injured another after a full mesh repair. Typically sports hernia's are very difficult to find on a CT scan. In males, a sports hernia is the pain caused at the inception of an inguinal hernia. As the peritoneum weakens and your intestines push through the inguinal canal, it provides enough pressure onto this nerve that will cause pain. I have heard this nerve controls feeling in the front and inside of your upper thigh. Some can be very pain full. Usually the pain will subside with rest (laying down to reposition your intestines) to relieve the pressure. That's why its difficult to see b/c it's only a small amount of movement. If you did not have surgery on the 1st sports hernia, I am surprised you made it this far. Typically they will become a full inguinal hernia's within 6 months of the diagnosis with the same level of activity. At least it was this way for me. If you look hard you will find a doctor that will do a full hernia mesh repair even for sports hernia symptom's. This is becoming more common. If you do have a full inguinal hernia repair. Make sure to limit your pain killers and take lots of stool softeners. You won't be able to move much after the hernia repair and constipation could possible lead to re-injury in the early stages.
Inguinal hernia repair - series?
Normal anatomyA hernia occurs when part of an organ protrudes through a weak point or tear in the thin muscular wall that holds the abdominal organs in place.IndicationsHernia repair may be recommended for:large bulges through a small hole (increased risk of incarceration and strangulation)painful hernia Inguinal hernia repair is indicated when the bulge through the inguinal canal is large or painful.ProcedureWhile the patient is sleepy (sedated) and pain-free (local anesthesia or spinal anesthesia) or deep asleep and pain-free (general anesthesia), an incision is made over the hernia. The bulging tissue or organ is replaced inside the muscle wall, the muscle tissue is repaired, and the skin is closed.AftercareMoving and walking are recommended the day of surgery. Small children require no restrictions following routine hernia repair. Older children should avoid body contact sports for at least 3 weeks. The hernia repair is not at risk, but a blow to the incision could burst the skin closure. Expect complete recovery from surgery in about 2 to 4 weeks. Avoid heavy lifting or straining for several weeks after surgery. Avoid tub baths for at least 5 days after the operation, because soaking will separate the skin tapes and the wound could break open. Sponge bathing for infants and showering for older children are permitted the day after surgery. The wound tapes should be carefully patted dry after showering.Reviewed ByReview Date: 11/21/2011Shabir Bhimji MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
Hernia Surgery: The Best Way to Repair a Hernia?
Hernias are so common that some where around 500,000 surgeries are performed each year in the country to repair them. Hernias happen when the innermost layers of the muscles in the abdomen weaken. This causes the lining of the abdomen to protrude and form a sac. At this point, either abdominal tissue or part of the intestine can push their way into that sac. Hernias usually manifest in the groin area where it is known as an inguinal hernia; as an umbilical hernia in the navel; or at the spot of an incision from surgery. Almost all hernias are the inguinal type and surgery is the most common way to repair them. This is the best way to prevent complications like having a loop of the intestine become so tightly caught up in the sac that the blood supply is cut off to that section of intestine. The object of inguinal hernia surgery is to remove the hernia sac. A few stitches may be required to close the opening that has been left near the abdominal cavity. Normally, a patch made of mesh is attached in order to make the wall of the abdomen stronger so that the hernia will not come back. Using the patch makes it about half as likely the hernia will recur than if the open were merely stitched closed. The surgery can be performed as an open surgery or a laparoscopic surgery. For an inguinal hernia, open surgery requires a large incision at the point where the abdomen meets the thigh. If the surgery is performed laparoscopically, four or five very small incisions are made around the hernia rather than one long incision. A tiny scope with a video camera attached, called a laparoscope, is put into one of these incisions, allowing the surgeon to view the hernia on a video screen. The other incisions are used to insert the tools required to fix the hernia just as is done during an open surgery. Laparoscopic surgery is a much better options because the recovery time is much shorter and there is less pain after the operation. In fact this type of surgery is done on an outpatient basis, allowing the patient to go home within a few hours.
How is a hiatal hernia repair done?
An incision is made in the groin area. The tissues are separated from the hernia sac, and the intestines are returned to the abdomen. The area is often reinforced with webbing before it is sewn shut. The skin is closed with sutures or.
What can happened if you have a hernia beside your ball sack?
This is likely an inguinal hernia - one that follows a small canal made by the testes descending into the scrotum during development. If you have a hernia it will most likely hurt like crazy - the worst case scenario is called strangulation - where the hernia pushing through cuts off its own blood supply and the tissue begins to die. Hernias are mainly composed of small intestinal tissue and if this begins to die it could have serious consequences. The surgical treatment for a hernia is now a very simple, routine operation. The muscle it is pushing through is cut, the hernia placed back inside the abdomen and a small piece of strong mesh is sewn into the area under the skin. This mesh reinforces the area the hernia pushed through and stops it happening again. If you have a hernia you should see a doctor - they see tons of them so there's nothing to worry about!
Why do men get inguinal hernias?
Right sided Inguinal hernias are more common because right sided testis descends later than left side. This is turn causes increased likelihood of patent processes vaginalis on right side causing higher incidence of right sided inguinal hernia. It is still not clear why right testis descends later than left (may be anatomical reasons).
Can a small hernia heal itself?
Yes, if it is very small. For me it was 3 months no physical activities.
How do you spell groin?
You have spelled it correctly, groin.The groin is the small area just above the thighs and before the lower abdomen.He pulled a muscle in his groin.An inguinal hernia occurs in the groin.NOTE: An easy way to remember the location of the groin, on both sides, is to think of where the elastic of normal underwear sits, in the dip just above the thighs.
