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Complications of open aortofemoral bypass
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Primary indications for hernia repair generally include size, pain, or incarceration of bowel or omentum. There any many options for surgical repair, including primary repair, component separation, and use of mesh or other prosthetics in either an open or laparoscopic approach. Often a combination of component separation and mesh are used for optimal results.
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
Pain and ipsilateral leg swelling may be the result of compression of the iliac or femoral vein. This can be obviated or minimized with meticulous attention while placing the hernia repair sutures as previously described.
Anterior Component Separation
Published in Jeff Garner, Dominic Slade, Manual of Complex Abdominal Wall Reconstruction, 2020
Elizabeth Tweedle, James Wheeler
ACS is particularly useful when the plane between the transversalis aponeurosis and peritoneum has been disrupted, preventing the development of the PCS plane. This can occur after previous attempts at hernia repair either abdominally or in the groin (such as totally extraperitoneal [TEP] approach); it is also common following radical pelvic cancer surgery such as cystectomy or bowel resection with peritonectomy. It is also very quick to perform and should be considered in patients who may not tolerate the additional surgical time required to perform a PCS.
Genetic Analysis Reveals Complete Androgen Insensitivity Syndrome in Female Children Surgically Treated for Inguinal Hernia
Published in Journal of Investigative Surgery, 2021
Nurin A. Listyasari, Gorjana Robevska, Ardy Santosa, Aurore Bouty, AZ Juniarto, Jocelyn van den Bergen, Katie L. Ayers, Andrew H. Sinclair, Sultana MH Faradz
These cases illustrate the complexities associated with complete androgen insensitivity syndrome (CAIS). In particular, we find that female infants diagnosed with inguinal hernia should have further investigation into a possible diagnosis of CAIS, something previously suggested [12]. We also show how a timely diagnosis of CAIS may result in subsequent testing within family. In this report, all of the presenting patients had had inguinal hernias with palpable gonads in childhood but were only diagnosed with CAIS during puberty. Unfortunately, the surgeons who performed the hernia repair did not carry out further investigation of the inguinal hernia, such as ultrasound to evaluate the content of the hernial sac and the Mullerian structures, histological confirmation of the gonads, immunohistochemistry, karyotyping, hormonal analysis, or molecular analysis. General surgeons who are not familiar with the occurrence of CAIS may overlook gonadal features during hernia repair. When performing hernia repair in girls with inguinal hernia, clinicians need to identify atypical gonadal features macroscopically so that further investigation could be carried out [13]. However, the reluctance to do further investigations, may result from a lack of awareness about this condition because of its relatively low prevalence [14,15]. Indeed, in females with a bilateral inguinal hernia the incidence of CAIS is estimated to be 1%–2% [16].
Achieving the Learning Curve in Laparoscopic Inguinal Hernia Repair by Tapp: A Quality Improvement Study
Published in Journal of Investigative Surgery, 2019
Umberto Bracale, Giovanni Merola, Antonio Sciuto, Giuseppe Cavallaro, Jacopo Andreuccetti, Giusto Pignata
Many papers report that laparoscopic repair of groin hernia is safe and effective presenting several clear advantages over open repair, including less pain, quicker recovery time and better cosmetic outcome.5,10 Despite this, few surgeons still employ this technique on a routine basis. This may be due to the fact that laparoscopic groin hernia repair is a demanding procedure requiring advanced skills in laparoscopic surgery and a good knowledge of pelvic anatomy in order to complete the procedure effectively and avoid complications. Moreover, several aspects can complicate or contraindicate a laparoscopic approach such as obesity (BMI > 35), ASA 3 or 4 class, scrotal hernias, strangulated or incarcerated hernias, patients on anticoagulation treatment, or having history of previous pelvic surgery.6,7,16
Incisional Hernia Repair of Medium- and Large-Sized Defects: Laparoscopic IPOM Versus Open SUBLAY Technique
Published in Acta Chirurgica Belgica, 2019
Patrick Hamid Alizai, Eric Lelaona, Anne Andert, Ulf Peter Neumann, Christian Daniel Klink, Marc Jansen
Incisional hernia repair is among the most frequently performed surgical procedures. Although the use of new prosthetic mesh materials and operative techniques has improved abdominal wall hernia repair outcomes, postoperative complications remain an intractable problem. Over the past two decades, laparoscopic approach has become widely used for the repair of incisional hernias. Laparoscopic repair seems to provide acceptable outcomes in terms of morbidity, length of hospital stay, postoperative pain and recurrence rate [8]. However, most of the published studies include very heterogeneous type of hernias, varying from small, primary fascial defects to large incisional hernias. Small hernias can be repaired without substantial morbidity, but larger defect sizes are associated with increased postoperative complications [14]. The aim of this study was to evaluate if morbidity rates of laparoscopic repair compared to open surgery when larger defects are repaired. We therefore analyzed prospectively collected data of patients with medium- and large-sized incisional hernias according to the EHS classification [11]. Morbidity rate in patients who underwent SUBLAY was twice as high as in the IPOM group. Comparable to laparoscopic repair of small fascial defects, laparoscopic repair reduced the postoperative complications when applied to medium and large-sized defects. This is in line with a Cochrane collaboration report by Sauerland and colleagues, which found significantly less postoperative complications after laparoscopic hernia repair [8].