Management of the hernial sac in inguinal hernia repair

Stylianidis, G.; Haapamäki, Markku M; Sund, Malin; Nilsson, Erik; Nordin, Pär

doi:10.1002/bjs.6890

Cited by 28 publications

(18 citation statements)

References 8 publications

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“…During a TEP repair, the hernia sac is invaginated, but a recent analysis of 48,433 operations for indirect inguinal hernia revealed that the 5-year cumulative reoperation incidence was 1.7% for hernial sac excision or division but 2.7% for invagination. 42 From randomized trials and meta-analyses, it appears that LIHR is superior to OIHR in the early postoperative period, being associated with less pain, and a shorter convalescence 5,6,37,43 but the long-term results are less clear. The present study has demonstrated that overall there is reduced postoperative chronic groin pain and numbness in those undergoing LIHR relative to an OIHR.…”

Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of Surgical Morbidity and Recurrence After Laparoscopic and Open Repair of Primary Unilateral Inguinal Hernia

2012

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Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of Surgical Morbidity and Recurrence After Laparoscopic and Open Repair of Primary Unilateral Inguinal Hernia

2012

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“…Recurrence rates after suture repair have been reported as high as 62% [4,25,26]. When Lichtenstein introduced the open tension-free mesh repair in the 1970s, recurrence rates were greatly reduced to 0-10% [25,[27][28][29][30]. In the early 1990s, laparoscopic techniques using a tension-free mesh were developed for groin hernia repair.…”

Section: Morbidity and Mortality Of Elective Groin Hernia Repairmentioning

confidence: 99%

Is surgical repair of an asymptomatic groin hernia appropriate? A review

Heuvel

Dwars

Klassen

et al. 2011

Hernia

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Purpose Groin herniorrhaphy is the most common operation performed by general surgeons. Annually, more than 20 million groin hernias are repaired worldwide. The general approach towards groin hernias is surgical repair regardless of the presence of symptoms. The rationale to recommend surgery for asymptomatic groin hernias is prevention of visceral strangulation. The goal of this review is to evaluate the appropriateness of surgery in patients with asymptomatic groin hernias. Methods The review was based on an extensive literature search of Pubmed, Medline and the Cochrane Library. Results The risk of incarceration is approximately 4 per 1,000 patients with a groin hernia per year. Risk factors for incarceration are age above 60 years, femoral hernia site and duration of signs less than 3 months. Morbidity and mortality rates of emergency groin hernia repair are higher in patients who are older than 49 years, have a delay between onset of symptoms and surgery of more than 12 h, have a femoral hernia, have nonviable bowel and have an ASA-class of 3 or 4. The recurrence rate after tension-free mesh repair in the management of emergency groin hernias is comparable to that of elective repair. There is no diVerence in pain and quality of life after elective repair compared to watchful waiting. There is no advantage in cost-eVectiveness of elective repair compared to watchful waiting. ConclusionWatchful waiting for asymptomatic groin hernias is a safe and cost-eVective modality in patients who are under 50 years old, have an ASA class of 1 or 2, an inguinal hernia, and a duration of signs of more than 3 months.

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“…[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. [20] The present study had certain limitations, i.e. less number of cases, poor follow-up, short duration of follow-up, lack of parameters like quality of life after surgery.…”

Section: Discussionmentioning

confidence: 80%

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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Management of the hernial sac in inguinal hernia repair

Abstract: Excision of the indirect hernial sac in inguinal hernia repair is associated with a lower risk of hernia recurrence than division or invagination.

Cited by 28 publications

References 8 publications

A Meta-Analysis of Surgical Morbidity and Recurrence After Laparoscopic and Open Repair of Primary Unilateral Inguinal Hernia

A Meta-Analysis of Surgical Morbidity and Recurrence After Laparoscopic and Open Repair of Primary Unilateral Inguinal Hernia

Is surgical repair of an asymptomatic groin hernia appropriate? A review

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

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