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Inguinal hernia, hydrocele, and other hernias of the abdominal wall
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Sophia Abdulhai, Todd A. Ponsky
Femoral hernias are most common in girls aged between 5 and 10 years. Some individuals advocate the use of laparoscopy in the child with presumed recurrent inguinal hernias because of the concern for a missed diagnosis. The anatomic boundaries of the femoral canal can be divided into anterior, posterior, lateral, and medial. The anterior border involves the iliopubic tract and/or the inguinal ligament. Posterior includes the pectineal ligament (Cooper's) and iliac fascia. The lateral boundary involves a connective tissue septum and the femoral vein. Medially, the canal is bordered by the aponeurotic insertion of the transversus abdominis muscle and tranversalis fascia.
Complications of Abdominal Wall Surgery and Hernia Repair
Published in Stephen M. Cohn, Matthew O. Dolich, Complications in Surgery and Trauma, 2014
Ethan A. Taub, Jane Kayle Lee, James C. Doherty
The overall incidence of nerve injuries in association with laparoscopic inguinal hernia repair (TEP and TAPP) has been reported to be 3.9%–11.2%.11 The specific nerves at risk of injury are the genitofemoral nerve (most commonly), the ilioinguinal nerve, and the lateral femoral cutaneous nerve.49 In general, nerve injuries can be avoided by minimizing or eliminating the use of fixation devices or avoiding placement of fixation devices within the area lateral to the deep inguinal ring and ventral to the iliopubic tract, the so-called “triangle of pain.”49 As is true of nerve injuries after open hernia repair, those that occur after laparoscopic repair usually resolve spontaneously, but nerve blocks, surgical reexploration, or both may be required.
Complications of Orchiopexy
Published in Kevin R. Loughlin, Complications of Urologic Surgery and Practice, 2007
Sutchin R. Patel, Anthony A. Caldamone
The ilioinguinal, iliohypogastric, and genital branch of the genitofemoral nerve are the nerves of concern during orchiopexy. Both the ilioinguinal nerve and the iliohypogastric nerves arise from T12 and L1, and are responsible for sensation to the upper and medial aspects of the thigh and the skin of the base of the penis as well as the anterior portion of the thigh. The ilioinguinal nerve is typically found on the lateral aspect of the spermatic cord. It passes through the superficial inguinal ring to reach the subcutaneous tissues and the skin. The iliohypogastric nerve lies on the internal oblique abdominal muscle and penetrates the aponeurosis of the external oblique muscle near the rectus muscle to reach the subcutaneous tissue and the skin. The genital nerve has both motor and sensory components and innervates the cremaster muscle and the skin of the side of the scrotum. In the inguinal canal it lies on the iliopubic tract and is accompanied by the cremasteric vessels to form a neurovascular bundle that passes through the superficial inguinal ring.
De Garengeot hernias. Over a century of experience. A systematic review of the literature and presentation of two cases
Published in Acta Chirurgica Belgica, 2022
Michail Chatzikonstantinou, Mohamed Toeima, Tao Ding, Almas Qazi, Niall Aston
A 79-year-old woman presented with a short history of sudden onset of right groin pain, difficulty in walking and a palpable right groin lump. She had no nausea or vomiting and no other signs of bowel obstruction. On examination, her abdomen was soft and non-distended, and, in the right groin, there was an irreducible, tender lump with erythematous overlying skin. She was investigated with a CT which confirmed the diagnosis of a right femoral hernia but could not reveal the content. The patient was taken to theatre where a Lockwood incision was made and a femoral hernia containing a gangrenous appendix was identified (Figure 1). The abdomen was entered via the same skin incision and an appendicectomy was performed. Given that the hernia contained a necrotic appendix, a decision for defect repair without mesh was taken and the defect in the femoral canal was closed by suturing the iliopubic tract to Cooper’s ligament using a non-absorbable, ‘Prolene’ suture. The patient had a good recovery and was discharged on the second post-operative day.
The narrow vesicourethral angle measured on postoperative cystography can predict urinary incontinence after robot-assisted laparoscopic radical prostatectomy
Published in Scandinavian Journal of Urology, 2018
Motohiko Sugi, Hidefumi Kinoshita, Takashi Yoshida, Hisanori Taniguchi, Takao Mishima, Kenji Yoshida, Masaaki Yanishi, Yoshihiro Komai, Masato Watanabe, Tadashi Matsuda
Although not demonstrated in vivo, an oblate bladder may have better compliance than a prolate bladder, and higher storage pressure may work against urinary continence [18]. That is, the wider the vesical angle, the more compliant the bladder. These anatomical features may cause these effects by sparing the functional urethral length, bladder neck preservation, and posterior and anterior reconstruction. Tewari et al. described a reproducible technique for supporting the urethral continence mechanism by anterior and posterior reconstruction, referred to as the ‘total anatomic reconstruction’ technique; cystography showed that patients who underwent total reconstruction had minimal descent of the UVJ compared with a control group and an anterior reconstruction group [19]. However, in the current study, the position of the UVJ was not significantly associated with urinary incontinence on the 1 h pad test in multivariate analysis; it was considered that a wide vesical angle revealed the same condition. These results indicate that support of the lateral side of the vesicourethral anastomosis to the pelvic floor, such as the iliopubic tract, may be good for maintaining urinary continence.