Is inguinal hernia a defect in human evolution and would this insight improve concepts for methods of surgical repair?

McArdle, Gilbert

doi:10.1002/(sici)1098-2353(1997)10:1<47::aid-ca9>3.0.co;2-q

Cited by 26 publications

(6 citation statements)

References 23 publications

(20 reference statements)

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“…This condition is observed more often in males than in females. In both humans and NHHs with inguinal hernias, there is a defect of the posterior rectus muscle sheath and a poorly developed transversalis fascia (33). In humans, the gravitational effects of upright posture probably increase the frequency of herniation through the inguinal canal (33).…”

Section: Inguinal Herniasmentioning

confidence: 99%

Biomedical Differences Between Human and Nonhuman Hominids: Potential Roles for Uniquely Human Aspects of Sialic Acid Biology

Varki

Strobert

Dick

et al. 2011

Annu. Rev. Pathol. Mech. Dis.

105

110

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Although humans are genetically very similar to the evolutionarily related nonhuman hominids (chimpanzees, bonobos, gorillas, and orangutans), comparative studies suggest a surprising number of uniquely human differences in the incidence and/or severity of biomedical conditions. Some differences are due to anatomical changes that occurred during human evolution. However, many cannot be explained either by these changes or by known environmental factors. Because chimpanzees were long considered models for human disease, it is important to be aware of these differences, which appear to have been deemphasized relative to similarities. We focus on the pathophysiology and pathobiology of biomedical conditions that appear unique to humans, including several speculative possibilities that require further study. We pay particular attention to the possible contributions of uniquely human changes in the biology of cell-surface sialic acids and the proteins that recognize them. We also discuss the metabolic incorporation of a diet-derived nonhuman sialic acid, which generates a novel xeno-autoantigen reaction, and chronic inflammation known as xenosialitis.

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Section: Inguinal Herniasmentioning

confidence: 99%

Biomedical Differences Between Human and Nonhuman Hominids: Potential Roles for Uniquely Human Aspects of Sialic Acid Biology

Varki

Strobert

Dick

et al. 2011

Annu. Rev. Pathol. Mech. Dis.

105

110

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“…In view of the low recurrence rate, the Nyhus Type IIIA, IIIB, and IV hernias appear to have a better risk-to-benefit ratio, especially if the mesh was inserted posteriorly, either by open or closed surgeries [7]. A large Fruchaud's area would arise from a low-lying pubic tubercle, therefore a tension-free repair with some form of prosthetic material would be desirable [6,13]. Given the intrinsic stress induced within the tissues when performing a primary repair, any attempt to restore this large posterior part of the inguinal canal without mesh insertion would be more likely to fail.…”

Section: Discussionmentioning

confidence: 99%

Impact of Pelvic Bone Anatomy on Inguinal Hernia and the Role of Radiological Pelvimetry

Rajeev¹,

Vinod²,

John³

et al. 2022

Cureus

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IntroductionOne of the most prevalent disorders treated by general surgeons is inguinal hernias. Many of the etiological factors that lead to hernia development are unknown. This study looked at the role of pelvic bone anatomy in the development of inguinal hernia. The pubic tubercle's location (as measured by the Radoievitch angle) and its relationship to the formation of inguinal hernia, as well as its function in the pathophysiology of various forms of inguinal hernia, were investigated. Materials and methodsFrom October 2019 to June 2021, a prospective case-control study with 70 individuals over the age of 18 years in each arm was conducted in the Department of General Surgery at our tertiary care institution. Plain digital X-ray radiography of the pelvis, including bilateral hips, was taken in the anteroposterior (AP) view with the patient in the supine position, and the Radoievitch angle and Ami line were measured using suitable measuring instruments. The required information for patients in both groups was tallied and examined in a data sheet. ResultsBetween the case and control groups, there was a statistically significant difference in the mean Radoievitch angles and the mean length of the Ami line (42.46 +/-2.442 degrees vs 40.91 +/-2.547 degrees; p<0.05); (8.54+/-1.059 cm vs 7.27+/-1.034 cm; p<0.05). There was a statistically significant increase in the Radoievitch angle of patients with bilateral hernias compared to unilateral hernias (p-value <0.01), as well as indirect hernias compared to other forms of hernias (p-value <0.05). ConclusionThe probability of having an inguinal hernia was higher when the Fruchaud region was increased, as indicated by a larger Radoievitch angle or a longer Ami line. A low-lying pubic tubercle increased the likelihood of bilateral and indirect inguinal hernias. Pelvimetry is an easy test that should be considered on a routine basis and can be applied accurately in all patients. Surgeons can employ pelvimetry to identify patients who are more likely to benefit from non-mesh repairs.

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“…As the mankind evolved from Neanderthal man to homoerectus/ homosapiens (upright man), there is thought to be apparent lack of the evolutionary development of a strong posterior rectus sheath and transversalis fascia in lower abdomen which is thought to represent a significant specific anatomic defect. 3 There are various defensive mechanisms of the inguinal canal to prevent the formation of hernia which are based on anatomical factors are obliquity of inguinal canal forming flap valve mechanism, ball valve mechanism of cremasteric muscle, slit valve mechanism and conjoint tendon at superficial inguinal ring, fleshy fibres of internal oblique muscle at deep ring. Along with above all factors, the shutter-like mechanism at the internal inguinal ring is provided by contraction of the arching fibres of the internal oblique muscle, which, when shortened, approximate themselves to the inguinal ligament and compress the spermatic cord.…”

Section: Introductionmentioning

confidence: 99%

Role of low-lying pubic tubercle in the development of inguinal hernia

Jakhar¹,

Singh²,

Kumar³

et al. 2020

Int Surg J

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Background: Hernia is defined as abnormal protrusion of whole or a part of a viscus through the wall that contains it. Among all external abdominal hernias, inguinal hernia is one most commonly encountered. Many factors are responsible for the formation of the inguinal hernia but, what makes a few people more susceptible to this situation is still clearly not proved. The lowness of pubic tubercle is associated with narrow origin of internal oblique muscle from lateral inguinal ligament which fails to protect the deep inguinal ring consequently lead to inguinal hernia.Methods: The study was conducted in Sardar Patel Medical College and attached hospital, Bikaner for duration of 12 months from March 2018 to February 2019. It is a case-control study with 50 cases and 50 control meeting inclusion criteria. In all patients, following parameters SS line, ST line, height, weight was recorded and evaluated.Results: The mean value of ST line in our study group is 7.37±0.182 cm which is significantly greater (p=0.0001) than the controls the mean value being 7.01±0.262 cm. In our study, 98% of cases were having ST line >7.01 cm whereas 66% of controls were ST line under 7.01 cm.Conclusions: Group of people with low lying pubic tubercle are at high risk of developing inguinal hernia.

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Is inguinal hernia a defect in human evolution and would this insight improve concepts for methods of surgical repair?

Cited by 26 publications

References 23 publications

Biomedical Differences Between Human and Nonhuman Hominids: Potential Roles for Uniquely Human Aspects of Sialic Acid Biology

Biomedical Differences Between Human and Nonhuman Hominids: Potential Roles for Uniquely Human Aspects of Sialic Acid Biology

Impact of Pelvic Bone Anatomy on Inguinal Hernia and the Role of Radiological Pelvimetry

Role of low-lying pubic tubercle in the development of inguinal hernia

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