Repair of massive inguinal hernia with loss of abdominal domain using laparoscopic component separation technique

Hamad, Ahmed; Marimuthu, Kanagaraj; Mothe, Bhavani Sidhartha; Hanafy, Magdi

doi:10.1093/jscr/rjt008

Cited by 11 publications

(9 citation statements)

References 8 publications

(11 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Giant hernia are a potential source of severe distress to the patient, and may hamper basic functionality by interfering with mobility and cause pressure effects manifested by urinary retention and intestinal obstruction [5] . Intertrigo and emaciation of scrotal skin progressing to scrotal skin ulceration is also frequent.…”

Section: Discussionmentioning

confidence: 99%

“…Giant inguinal hernias are defined as those that extend beyond the midpoint of the inner thigh when the patient stands erect [4] . Alternatively, an irreducible hernia present for over 10 years measuring at least 30cm on antero-posterior diameter or 50cm on a latero-lateral diameter also defines the condition [5] . These are long-standing conditions and at presentation years or even decades of herniation have compromised the local tissue integrity, thus complicating their management.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Repair of the giant inguinal hernia: More than mere reduction and reinforcement

Ramji¹

2019

Int. J. Surg. Sci.

View full text Add to dashboard Cite

Inguinal hernia repair is among the most commonly performed surgeries across the globe. Lichenstein's tension-free technique of open hernioplasty remains the gold-standard, and laparoscopic techniques have gained popularity over recent decade. Giant inguinal hernias that extend below the midpoint of the inner thigh are uncommon, challenging to manage and are more prone for post-operative complications. There is no standard treatment protocol or surgical procedure designated for the management of giant hernias which are associated with grossly disrupted local tissue architecture and compromised tissue integrity and dynamics. Large volumes of omentum and bowel make up the contents of the hernia sac, which with the natural pathological processes involved, further complicate the management. This care report and review of literature aims to elucidate a clear management protocol for Giant Inguinal Hernias.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Repair of the giant inguinal hernia: More than mere reduction and reinforcement

Ramji¹

2019

Int. J. Surg. Sci.

View full text Add to dashboard Cite

show abstract

“…Technique was proven to be good surgical alternative to address the problem of loss of domain in patients with less morbidity and mortality while it requires a highly skilled professionals and multi-disciplinary approach. 3 In 2018, Sanford et al treated a giant inguinoscrotal hernia with loss of domain by minimally invasive multidisciplinary approach. 4 weeks before the surgery botulinum toxin injections were given in abdominal muscle for relaxation then, progressive pneumoperitoneum was created followed by eTEP in adjunct with TAR release to create a large space from subcostal down to the myopectineal line.…”

Section: Inmentioning

confidence: 99%

“…1 Giant inguinoscrotal hernias are uncommon and are defined as hernias extending below the midpoint of the inner thigh in standing position or an irreducible hernia present for over 10 years measuring at least 30 cm on antero-posterior diameter or 50 cm on latero-lateral diameter. 2,3 Giant inguinal hernias significantly affect the patient's quality of life including difficulty in micturition, ambulation, bowel obstruction, scrotal skin ulceration, excoriation, etc. it doesn't only affects the patient physically but it also affects the mental health of the patient.…”

Section: Introductionmentioning

confidence: 99%

Repair of giant inguino-scrotal hernia with loss of domain using minimally invasive anterior component separation technique combined with Lichtenstein tension-free mesh hernioplasty

et al. 2020

View full text Add to dashboard Cite

Inguinal hernia repairs are most commonly performed surgical procedures across the world. Lichtenstein's tension free technique of open hernioplasty is the gold standard technique, while laparoscopic techniques gained popularity over recent decade. Giant inguinal hernias are rare. Giant inguinal hernia extends below the midpoint of the inner thigh, in the standing position. These are long standing conditions and at presentation years of herniation or even decades. We report a patient of 65 years of age presented with type-II left sided giant inguinoscrotal hernia from last 10 years with loss of domain. Contrast enhanced computed tomography (CECT) revealed, omentum and ileal loops with mesentry as contained in hernia sac, which was repaired by minimally invasive anterior component separation technique to increase the intra-abdominal volume followed by omentectomy and Lichtenstein mesh hernioplasty without any complications. He recovered uneventfully. Surgical management of giant inguinal hernia is significantly more challenging and unusual because of ‘loss of domain’ and returning herniated viscera into the empty abdominal cavity forcefully can lead to high intra-abdominal pressure, recurrence or abdominal compartment syndrome. There are several repair techniques in literatures such as resection of contents and increased intra-abdominal volume increasing procedures but there is no standard protocol or surgical procedure for the management of giant hernias. We describe a technique which is relatively simple, less expensive and less invasive used for type II unilateral giant inguinoscrotal hernia with loss of domain in patient with co-morbidities.

show abstract

“…Creation of pneumoperitoneum leads to optimal space for reduction of herniated contents into abdominal cavity and avoids abdominal morbidity in form of bowel resection, abdominal compartment, and extended abdominal wall reconstruction by the use of mesh (Vasiliadis et al 2010). Laparoscopic component separation technique has been recommended to increase the capacity of the abdominal cavity to facilitate closure and reduce postoperative complications in patients who had loss of domain (Hamad et al 2013).…”

Section: Case Reportmentioning

confidence: 99%

Giant Inguinal Hernia: A Case Report

Wani¹,

Shah²,

Malik³

et al. 2013

IJCRM

View full text Add to dashboard Cite

Giant inguinal hernia is rare. This may be asymptomatic or present with the complications. Contents vary from colon, small gut, vermiform appendix, mesentery, to omentum. A case of giant inguinal hernia in a 62-year-old male who presented with features of intestinal obstruction is reported. Patient had giant inguinoscrotal hernia which was tender, irreducible, and had no cough impulse. Emergency exploration via inguinoscrotal approach revealed that contents were small and large intestines, omentum, mesentery, and vermiform appendix. Right orchidectomy, reduction of contents into abdominal cavity after enlarging internal ring with a double layer closure of wall, and the reconstruction of scrotal skin were done. Giant inguinal hernia presenting as intestinal obstruction is rare.

show abstract

Repair of massive inguinal hernia with loss of abdominal domain using laparoscopic component separation technique

Cited by 11 publications

References 8 publications

Repair of the giant inguinal hernia: More than mere reduction and reinforcement

Repair of the giant inguinal hernia: More than mere reduction and reinforcement

Repair of giant inguino-scrotal hernia with loss of domain using minimally invasive anterior component separation technique combined with Lichtenstein tension-free mesh hernioplasty

Giant Inguinal Hernia: A Case Report

Contact Info

Product

Resources

About