Pub Date : 2021-07-29DOI: 10.5772/intechopen.98954
M. Shamim
Femoral hernia comes out of abdominal cavity through the femoral canal and descends vertically to saphenous opening, and once escapes this opening it expands considerably, sometimes rising above the inguinal ligament. Due to its tortuous course, the hernia is usually irreducible and liable to strangulate. There are different open surgery choices. In low (Lockwood) operation, the sac is dissected out below the inguinal ligament via a groin-crease incision. In high (McEvedy) operation, the hernia is accessed via a horizontal (or vertical) incision made in lower abdomen at the lateral edge of rectus muscle. In Lotheissen’s operation, the hernia is approached through the inguinal canal. The last one is my preferred approach, as it also helps in dealing if the contents are strangulated. The laparoscopic approaches include both transabdominal preperitoneal repair (TAPP) and total extraperitoneal repair (TEP). This chapter will give an account of the advantages and disadvantages of these different surgical techniques.
{"title":"Femoral Hernia: Open and Laparoscopic Surgery Approaches","authors":"M. Shamim","doi":"10.5772/intechopen.98954","DOIUrl":"https://doi.org/10.5772/intechopen.98954","url":null,"abstract":"Femoral hernia comes out of abdominal cavity through the femoral canal and descends vertically to saphenous opening, and once escapes this opening it expands considerably, sometimes rising above the inguinal ligament. Due to its tortuous course, the hernia is usually irreducible and liable to strangulate. There are different open surgery choices. In low (Lockwood) operation, the sac is dissected out below the inguinal ligament via a groin-crease incision. In high (McEvedy) operation, the hernia is accessed via a horizontal (or vertical) incision made in lower abdomen at the lateral edge of rectus muscle. In Lotheissen’s operation, the hernia is approached through the inguinal canal. The last one is my preferred approach, as it also helps in dealing if the contents are strangulated. The laparoscopic approaches include both transabdominal preperitoneal repair (TAPP) and total extraperitoneal repair (TEP). This chapter will give an account of the advantages and disadvantages of these different surgical techniques.","PeriodicalId":121119,"journal":{"name":"The Art and Science of Abdominal Hernia [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131211918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-17DOI: 10.5772/intechopen.98380
M. Shamim
Hernia is defined as protrusion of a viscus or part of a viscus through a weakening or defect in the wall of its containing cavity. Areas of potential anatomical weakness includes inguinal canal, femoral canal, linea alba, umbilical scar, as well as acquired surgical trauma. The weakening/defect may be acquired (like surgical scar) or congenital (like deep inguinal ring). Raised intraabdominal pressure is the most important factor that leads to the development of hernia through the weak areas. Clinically, the hernia usually presents with an abdominal swelling that progresses gradually over time. The sites of hernia are characteristic and usually points towards the diagnosis. While evaluating a hernia clinically, it is important to identify the content of the hernia sac and whether it suffers any complication, as well as the cause of the hernia development. Failing to identify these prior to surgery, will likely result in morbidity as well as recurrence. This chapter will focus on the clinical art of history taking and examination of different abdominal hernias.
{"title":"Clinical Evaluation of Abdominal Wall Hernias","authors":"M. Shamim","doi":"10.5772/intechopen.98380","DOIUrl":"https://doi.org/10.5772/intechopen.98380","url":null,"abstract":"Hernia is defined as protrusion of a viscus or part of a viscus through a weakening or defect in the wall of its containing cavity. Areas of potential anatomical weakness includes inguinal canal, femoral canal, linea alba, umbilical scar, as well as acquired surgical trauma. The weakening/defect may be acquired (like surgical scar) or congenital (like deep inguinal ring). Raised intraabdominal pressure is the most important factor that leads to the development of hernia through the weak areas. Clinically, the hernia usually presents with an abdominal swelling that progresses gradually over time. The sites of hernia are characteristic and usually points towards the diagnosis. While evaluating a hernia clinically, it is important to identify the content of the hernia sac and whether it suffers any complication, as well as the cause of the hernia development. Failing to identify these prior to surgery, will likely result in morbidity as well as recurrence. This chapter will focus on the clinical art of history taking and examination of different abdominal hernias.","PeriodicalId":121119,"journal":{"name":"The Art and Science of Abdominal Hernia [Working Title]","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132018092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-04-12DOI: 10.5772/INTECHOPEN.97266
C. F. Ploneda-Valencia, C. A. Bautista-López, Carlos Alberto Navarro-Montes, Juan Carlos Verdugo-Tapia
The minimally invasive surgical technique for inguinal hernia repair (eTEP and TAPP) are gaining acceptance among surgeons worldwide. With the superior benefits of the laparoendoscopic techniques (less postoperative pain, numbness, and chronic pain, fewer complications, and faster return to normal activities), the protocolization and standardization of these approaches are essential to improve patient outcomes and reduce costs. Improved laparoscopic skills, well-selected patients, simulator training, and anatomy knowledge of the groin are the cornerstone for these approaches. We recommend starting the learning curve with the TAPP procedure, because it is easier to get familiarized with the anatomical landmarks of the pelvis and groin.
{"title":"Minimally Invasive Surgery of the Groin: Inguinal Hernia Repair","authors":"C. F. Ploneda-Valencia, C. A. Bautista-López, Carlos Alberto Navarro-Montes, Juan Carlos Verdugo-Tapia","doi":"10.5772/INTECHOPEN.97266","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.97266","url":null,"abstract":"The minimally invasive surgical technique for inguinal hernia repair (eTEP and TAPP) are gaining acceptance among surgeons worldwide. With the superior benefits of the laparoendoscopic techniques (less postoperative pain, numbness, and chronic pain, fewer complications, and faster return to normal activities), the protocolization and standardization of these approaches are essential to improve patient outcomes and reduce costs. Improved laparoscopic skills, well-selected patients, simulator training, and anatomy knowledge of the groin are the cornerstone for these approaches. We recommend starting the learning curve with the TAPP procedure, because it is easier to get familiarized with the anatomical landmarks of the pelvis and groin.","PeriodicalId":121119,"journal":{"name":"The Art and Science of Abdominal Hernia [Working Title]","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125736853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-13DOI: 10.5772/INTECHOPEN.95533
Roberto Sanisidro Torre
Groin pain is the most common cause of surgical intervention. There are 3 parameters that increase the chances of chronic pain. On the one hand, starting the surgery with high intensity pain that has not been previously controlled. On the other, insufficient anesthetic and analgesic control during the surgical procedure. Finally, an inadequate management of acute postoperative pain. The presence of groin pain and its poor control before the intervention predisposes to difficulties during the perioperative process. Thus, the appearance of acute postoperative pain not adequately controlled will prevent its remission in a natural way in the usual period (approximately 1 month) and will cause it to progress in intensity and continuity (from 1 month to 3 months after surgery), transforming into a chronic pain (from 3 months after the intervention). In this process of chronification, in which pain goes from nociceptive to neuropathic, different physiological sensitization mechanisms are involved, both peripheral and central. The chronification of the painful process and, ultimately, the therapeutic approach that we will have to use to try to prevent this process depends to a large extent on these modifications that facilitate the change in the nature of pain.
{"title":"Abdominal Hernia Pain: Chronification Mechanisms after Hernia Surgery","authors":"Roberto Sanisidro Torre","doi":"10.5772/INTECHOPEN.95533","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.95533","url":null,"abstract":"Groin pain is the most common cause of surgical intervention. There are 3 parameters that increase the chances of chronic pain. On the one hand, starting the surgery with high intensity pain that has not been previously controlled. On the other, insufficient anesthetic and analgesic control during the surgical procedure. Finally, an inadequate management of acute postoperative pain. The presence of groin pain and its poor control before the intervention predisposes to difficulties during the perioperative process. Thus, the appearance of acute postoperative pain not adequately controlled will prevent its remission in a natural way in the usual period (approximately 1 month) and will cause it to progress in intensity and continuity (from 1 month to 3 months after surgery), transforming into a chronic pain (from 3 months after the intervention). In this process of chronification, in which pain goes from nociceptive to neuropathic, different physiological sensitization mechanisms are involved, both peripheral and central. The chronification of the painful process and, ultimately, the therapeutic approach that we will have to use to try to prevent this process depends to a large extent on these modifications that facilitate the change in the nature of pain.","PeriodicalId":121119,"journal":{"name":"The Art and Science of Abdominal Hernia [Working Title]","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116294274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-06DOI: 10.5772/intechopen.94501
I. Konaté, A. Ndong, J. Tendeng
The literature on umbilical hernias in adults remains less extensive compared to other types of hernias. Adult umbilical hernias are frequently asymptomatic. The most frequent reasons for consultation are pain and esthetic discomfort. The diagnosis is most often evident on physical examination of the abdomen with tumefaction in the umbilicus. Despite the recent advances in terms of mesh varieties and minimally invasive surgery (laparoscopic and robotic surgery), there is still no real consensus on the optimal method for repair of umbilical hernia. Based on the patient characteristics and the context, “tailored and optimized surgery” should always be used to have the best results.
{"title":"Umbilical Hernias in Adults: Epidemiology, Diagnosis and Treatment","authors":"I. Konaté, A. Ndong, J. Tendeng","doi":"10.5772/intechopen.94501","DOIUrl":"https://doi.org/10.5772/intechopen.94501","url":null,"abstract":"The literature on umbilical hernias in adults remains less extensive compared to other types of hernias. Adult umbilical hernias are frequently asymptomatic. The most frequent reasons for consultation are pain and esthetic discomfort. The diagnosis is most often evident on physical examination of the abdomen with tumefaction in the umbilicus. Despite the recent advances in terms of mesh varieties and minimally invasive surgery (laparoscopic and robotic surgery), there is still no real consensus on the optimal method for repair of umbilical hernia. Based on the patient characteristics and the context, “tailored and optimized surgery” should always be used to have the best results.","PeriodicalId":121119,"journal":{"name":"The Art and Science of Abdominal Hernia [Working Title]","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134265361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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