Component Separation in the Repair of a Giant Inguinoscrotal Hernia

Challenging surgical management of a giant inguinoscrotal hernia: Report of a case

“…Indeed, some authors recently reported that intestinal resection should be avoided and that tension-free repair of a giant hernia is possible using mesh or musculocutaneous fl aps or, when soft tissue coverage is inadequate, with regional or distant fl aps, alone or in combination with mesh. 4,5,[15][16][17][18] We should point out that the success of these techniques has only been reported in single case reports or small case series and that there is not a standard surgical procedure for the management of giant inguinoscrotal hernias. In this case, the use of PPP and bowel resection proved to be safe and successful, allowing the immediate reduction of hernial contents and sound closure of the abdominal wall defects without undue tension.…”

“…1,2 Furthermore, the lack of a standard surgical procedure, regardless of the various techniques that have been reported, results in diffi cult surgical decision-making. [3][4][5] Nevertheless, surgical therapy represents the only mode of treatment that can offer these patients a satisfactory level of function and quality of life. We describe our surgical management of a giant inguinoscrotal hernia to highlight the specifi c diffi culties encountered in the treatment of these hernias.…”

Scrotal Abdomen: A Case Report

“…3 Progressive, artificially induced pneumoperitoneum has been attempted, but usually causes enlargement of the hernia sac, rather than the abdominal cavity and is therefore not very effective. Increasing the abdominal capacity by creating midline defects and closing it with component separation technique 6 or inguinoscrotal flap as described by Merret et al, 7 or tensor lata flap as reported by Mehendale et al 8 Preoperative chest physiotherapy and delayed extubation to overcome the respiratory distress which complicates the post-operative period due to rise of intra-abdominal pressure secondary to reduction. Bladder pressure monitoring to check for the rise in intraabdominal pressure during post-operative period.…”

Simple repair of a giant inguinoscrotal hernia

“…This is associated with a high mortality. 5 Several techniques have been described to address this loss of domain including debulking of abdominal contents or enlarging the abdominal cavity. Extensive bowel resections, for example total or hemicolectomy as well as omentectomy and even small bowel resections, have been described.…”