Ligation of the Hernial Sac?

Smedberg, Sam; Broomé, A; Gullmo, Åke

doi:10.1016/s0039-6109(16)43286-x

Cited by 50 publications

(36 citation statements)

References 11 publications

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“…However, some of the earlier studies reported that there is no difference in postoperative complications rate when sac is excised or ligated. [14,[18][19] There are controversies over the difference in the recurrence rate as some of the studies reported that there is no difference in recurrence rate in both the groups. [14,16,19] , but the study conducted by G. Stylianidis et al reported that excision of the sac in indirect inguinal hernia repair is associated with lower risk of recurrence than invagination.…”

Section: Discussionmentioning

confidence: 99%

The Difference in Outcomes of Excision Versus Invagination of Hernial Sac in Management of Indirect Inguinal Hernia

Ranga¹,

Kaushik²,

Garg³

et al. 2016

jemds

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BACKGROUNDThe newer belief is that ligature of richly innervated peritoneal sac is responsible for increased postoperative pain and other complications without any advantage in terms of recurrence rate. It is mainly due to the fact that ligation of richly innervated and well vascularised peritoneum produces a miniature peritonitis contributing to the post-operative discomfort and other complications. Aim of our study was to compare the difference in outcome of two different techniques of indirect inguinal hernia sac management.

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Section: Discussionmentioning

confidence: 99%

The Difference in Outcomes of Excision Versus Invagination of Hernial Sac in Management of Indirect Inguinal Hernia

Ranga¹,

Kaushik²,

Garg³

et al. 2016

jemds

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“…[1], [2], [9], [10] In our study, during inguinal orchiopexy, we did not ligate the hernia sac. After freeing the hernia sac from the cord, we simply dissected the hernia sac as high as possible and cut the proximal end near deep inguinal ring.…”

Section: Discussionmentioning

confidence: 99%

Orchidopexy Without Ligation of Hernia Sac: Our Experience

Gajbhiye¹,

Singh²,

Singh³

et al. 2015

jemds

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AIMS:To confirm that, the ligation of hernial sac during orchiopexy is not mandatory to prevent postoperative development of hernia. METHODS: This prospective study was conducted in 40 children with an age range of six months to 12 years with a diagnosis of undescended testis. Of the 40 cases, 30 were unilateral and 10 bilateral cases. Of the 30 unilateral undescended testis, 18 were right-sided and 12 left-sided. All children underwent standard orchiopexy without the ligation of the hernia sac. RESULTS: All the patients were followed up regularly up to a period ranging from 18 months to 24 months. No inguinal hernia was detected during the regular follow-up in any child. CONCLUSION: Ligation of herinal sac is not mandatory during orchipexy. KEYWORDS: Undesended testes, inguinal hernia, orchidopexy. INTRODUCTION:Herniotomy is performed along with orchidopexy for the closure of associated patent processus vaginalis. The conventional technique for undesended testis repair is high ligation of the hernial sac after proper dissection upto the deep ring, Mohta et al. [1] Observed that there is no untoward effect on the early complications and recurrence rate, if hernia sac is not ligated during herniotomy. During laparoscopic orchidopexy performed for contralateral testicle it was found that despite nonligation, the previous de peritonalized site got reperitonalized by itself and the sac which is dissected and left open deep to deep ring is not having hernia later in life. This is probably due to the closer of peritoneal defect within 24 hours by metamorphosis of the in situ mesodermal cells. [2] We done a study on non-ligation of hernia sac during conventional orchiopexy in our institute to see the results and it's long term untowards effects and advantages over standard orchiopexy.

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“…Da sich die TF-Technik ausschließlich um die Reparatur des oder der Herniendefekte bemü ht, wurde bei kombinierten Hernien zusä tzlich zum LichtensteinPatch die Sicherung der Bruchsackretention mit dem Plug vorgenommen, um eine potentielle peritoneale Schmerzperception am erweiterten inneren Leistenring zu minimieren [17]. Ob fü r die Implantation dieses zusä tzlichen Plugs prinzipiell eine Indikation besteht, erscheint anhand der vorliegenden Schmerzverlaufsmessungen fraglich, kö nnte jedoch bedeutsam im Hinblick auf die Erhebung von Rezidivdaten sein.…”

Section: Ergebnisseunclassified

“…In bezug auf den Endpunkt "Schmerz" ist damit auch die These der schmerzinduzierten Bruchsackligatur nicht haltbar [17], denn in der Shouldice-Gruppe wurde dieser grundsä tzlich reseziert und basisnah ligiert.…”

Section: Abb 2 Subjektive Schmerzperception Beim Aufrichten (Vas) Nunclassified

Die „Tension-free-Technik“ bei offener Leistenhernienreparation Eine prospektive, randomisierte Studie zur postoperativen Schmerzperception („Tension-free-Rekonstruktion“ vs. Shouldice-Technik)

Schmitz

Treckmann²,

Shah³

et al. 1997

Chirurg

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A prospective randomized study was performed on 64 patients suffering from primary inguinal hernia. Two groups were formed, each consisting of 32 patients. The patients either underwent tension-free surgical treatment or Shouldice herniorraphy. The aim of the study was to determine if the tension-free operative technique on inguinal hernia patients reduces postoperative pain intensity by 2 days in comparison to the patients receiving Shouldice repair treatment. By using the VAS was shown that at no time was there any significant difference in the pain sensation levels between the two groups. The amount of pain tablets consumed among the patients was similar in each group. The number of complications in both groups was also comparable. During the postoperative follow-up of 6 days six patients in the tension-free surgical group and four patients in the Shouldice group developed uncomplicated hematomas on the 4th day, which were traced to the heparin medication. One patient from the Shouldice group suffered from temporary swelling of the scrotum. The advantage of open tension-free repair using extraperitoneally placed polypropylene mesh is that the technique is simple, size-adapted, and can be carried out easily and at any time under local anesthesia. With regard to the lower recurrence rate of hernia as published in the American literature, this can only be verified by randomized studies.

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Ligation of the Hernial Sac?

Cited by 50 publications

References 11 publications

The Difference in Outcomes of Excision Versus Invagination of Hernial Sac in Management of Indirect Inguinal Hernia

The Difference in Outcomes of Excision Versus Invagination of Hernial Sac in Management of Indirect Inguinal Hernia

Orchidopexy Without Ligation of Hernia Sac: Our Experience

Die „Tension-free-Technik“ bei offener Leistenhernienreparation Eine prospektive, randomisierte Studie zur postoperativen Schmerzperception („Tension-free-Rekonstruktion“ vs. Shouldice-Technik)

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