where is mesh placed in inguinal hernia repair
abdominal wall
15732929
wall is very often reinforced with mesh. There are many techniques that do not utilize mesh and have their own situations where they are preferable. Open repairs are classified via whether prosthetic mesh is utilized or whether the patient's own tissue is used to repair the weakness. Prosthetic repairs enable surgeons to repair a hernia without causing undue tension in the surrounding tissues while reinforcing the abdominal wall. Repairs with undue tension have been shown to increase the likelihood that the hernia will recur. Repairs not using prosthetic mesh are preferable options in patients with an above-average risk of infection
Inguinal hernia surgery
15732929
wall is very often reinforced with mesh. There are many techniques that do not utilize mesh and have their own situations where they are preferable. Open repairs are classified via whether prosthetic mesh is utilized or whether the patient's own tissue is used to repair the weakness. Prosthetic repairs enable surgeons to repair a hernia without causing undue tension in the surrounding tissues while reinforcing the abdominal wall. Repairs with undue tension have been shown to increase the likelihood that the hernia will recur. Repairs not using prosthetic mesh are preferable options in patients with an above-average risk of infection
Inguinal hernia surgery
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Inguinal hernia surgery Inguinal hernia surgery is an operation to repair a weakness in the abdominal wall that abnormally allows abdominal contents to slip into a narrow tube called the inguinal canal in the groin region. Surgery remains the ultimate treatment for all types of hernias as they will not get better on their own, however not all require immediate repair. Elective surgery is offered to most patients taking into account their level of pain, discomfort, degree of disruption in normal activity, as well as their overall level of health. Emergency surgery is typically reserved for patients with life-threatening complications
Inguinal hernia surgery
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infection determines the appropriate use of the antibiotics. Post-op development of any of the following should warrant timely reporting via phone: Most indirect inguinal hernias in the abdominal wall are not preventable. Direct inguinal hernias may be able to be prevented by maintaining a healthy weight, refraining from smoking, preventing straining during bowel movements, and maintaining proper lifting techniques when heavy lifting. There is no evidence that indicates physicians should routinely screen for asymptomatic inguinal hernias during patient visits. Inguinal hernia surgery Inguinal hernia surgery is an operation to repair a weakness in the abdominal wall that abnormally allows abdominal
Inguinal hernia surgery
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surgeons exploring the medial inguinal fossa during laparoscopic inguinal hernia repair. Other than this, it has no purpose in an adult and it may be cut or damaged with impunity. The supravesical fossa, and therefore a supravesical hernia, is medial to this structure. The medial inguinal fossa, and therefore a direct inguinal hernia, is lateral to it. Medial umbilical ligament The medial umbilical ligament (or cord of umbilical artery) is a paired structure found in human anatomy. It is on the deep surface of the anterior abdominal wall, and is covered by the medial umbilical folds ("plicae umbilicales mediales"). It
Medial umbilical ligament
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performed surgery within the United States. A combined 20 million cases of both inguinal and femoral hernia repair are performed every year around the world with 800,000 cases in the US as of 2003. The UK reports around 70,000 cases performed every year. Groin hernias account for almost 75% of all abdominal wall hernias with the lifetime risk of an inguinal hernia in men and women being 27% and 3% respectively. Men account for nearly 90% of all repairs performed and have a bimodal incidence of inguinal hernias peaking at 1 year of age and again in those over the
Inguinal hernia surgery
16500276
indications in which their use has been suggested. The presence of contamination may limit the applicability of permanent synthetic mesh in some procedures such as hernia repair. Biologic mesh may be acceptable for this purpose or for placement in open wounds as a staged closure in complex abdominal wall reconstruction. There is limited data in both of these areas, with some noting a high risk of hernia recurrence and associated infection. The data is mostly limited to animal models and case series. However, the lack of suitable alternatives has made biologic mesh attractive for contaminated field hernia repair. Biomesh Biologic
Biomesh
3586033
a Meckel's diverticulum. Clinical classification of hernia is also important according to which hernia is classified into Irreducible hernias are further classified into The direct inguinal hernia enters through a weak point in the fascia of the abdominal wall, and its sac is noted to be medial to the inferior epigastric vessels. Direct inguinal hernias may occur in males or females, but males are ten times more likely to get a direct inguinal hernia. A direct inguinal hernia protrudes through a weakened area in the transversalis fascia near the medial inguinal fossa within an anatomic region known as the inguinal
Inguinal hernia
7500945
because of the large size of the incision required to perform this surgery. A mesh infection after this type of hernia repair most frequently requires a complete removal of the mesh and ultimately results in surgical failure. In addition, large incisions required for open repair are commonly associated with significant postoperative pain. Reported recurrence rates after open repair are up to 20% and influenced by mesh size and fixation type. Regenerative technique used to regenerate the abdominal wall aponeurosis using adult autologous tissue stem cells (B G Matapurkar et all)is a unique method published in World J of Surgerry in
Incisional hernia
829048
may turn red, purple or dark and pink. In the diagnosis of abdominal hernias, imaging is the principal means of detecting internal diaphragmatic and other nonpalpable or unsuspected hernias. Multidetector CT (MDCT) can show with precision the anatomic site of the hernia sac, the contents of the sac, and any complications. MDCT also offers clear detail of the abdominal wall allowing wall hernias to be identified accurately. Complications may arise post-operation, including rejection of the mesh that is used to repair the hernia. In the event of a mesh rejection, the mesh will very likely need to be removed. Mesh
Hernia
829051
aponeurotic extensions from the transversus abdominis aponeurotic arch. Abdominal wall hernia may occur due to trauma. If this type of hernia is due to blunt trauma it is an emergency condition and could be associated with various solid organs and hollow viscus injuries. By far the most common hernias (up to 75% of all abdominal hernias) are the so-called inguinal hernias. Inguinal hernias are further divided into the more common indirect inguinal hernia (2/3, depicted here), in which the inguinal canal is entered via a congenital weakness at its entrance (the internal inguinal ring), and the direct inguinal hernia type
Hernia
17130610
body area they become a part of. Hernia surgery is one of the most common current applications of surgical mesh. Hernias occur when organs or fatty tissue bulge through openings or debilitated areas of muscle, usually in the abdominal wall. Surgical mesh is implanted to strengthen tissue repair and minimize the rate of recurrence. The surgery can be performed laparoscopic (internally) or open with a variety of materials available for prosthesis. Polypropylene (PP) is the most frequently used type of mesh, although it may be uncomfortable for the patient after implantation. Another type that is less utilized in hernia surgery
Surgical mesh
6387456
in a small area of ischemic bowel. This "fix" does not help and germs may accumulate under the tape, causing infection. The use of bandages or other articles to continuously reduce the hernia is not evidence-based. An umbilical hernia can be fixed in two different ways. The surgeon can opt to stitch the walls of the abdomen or he/she can place mesh over the opening and stitch it to the abdominal walls. The latter is of a stronger hold and is commonly used for larger defects in the abdominal wall. Most surgeons will not repair the hernia until 5–6 years
Umbilical hernia
12246195
of intercostal nerve roots, anterior cutaneous nerve entrapment, rib-tip syndrome, myofascial pain, trigger points and rectus sheath hematomas. All abdominal wall hernias may be associated with pain and Carnett's test may be useful in their evaluation. The hernias of the anterior abdominal wall include: epigastric hernias, umbilical hernias, spigelian hernias and incisional hernias. Those of the groin include: direct inguinal hernia, indirect inguinal hernia, femoral hernia and sports hernia. Those of the pelvic wall include: sciatic hernia, obturator hernia and perineal hernia. The support hernias include: vault prolapse, enterocele, cystocele, rectocele and uterine decensus. Although most hernias can be detected
Carnett's sign
7500828
to insinuate in the femoral ring, a consequence of which is development of a femoral peritoneal sac. Femoral hernia A hernia is caused by the protrusion of a viscus (in the case of groin hernias, an intra-abdominal organ) through a weakness in the abdominal wall. This weakness may be inherent, as in the case of inguinal, femoral and umbilical hernias. On the other hand, the weakness may be caused by previous surgical incision through the muscles and fascia in the area; this is termed an incisional hernia. Femoral hernias occur just below the inguinal ligament, when abdominal contents pass through
Femoral hernia
7500816
Femoral hernia A hernia is caused by the protrusion of a viscus (in the case of groin hernias, an intra-abdominal organ) through a weakness in the abdominal wall. This weakness may be inherent, as in the case of inguinal, femoral and umbilical hernias. On the other hand, the weakness may be caused by previous surgical incision through the muscles and fascia in the area; this is termed an incisional hernia. Femoral hernias occur just below the inguinal ligament, when abdominal contents pass through a naturally occurring weakness in the abdominal wall called the femoral canal. Femoral hernias are a relatively
Femoral hernia
2521590
of the abdominal wall, thereby bypassing the inguinal canal, is known as a direct inguinal hernia. In males with strong presentation of the cremasteric reflex, the testes can—during supine sexual activity or manual manipulation—partially or fully retract into the inguinal canal for a short period of time. In juveniles and adults with inguinal injury, retraction can be prolonged and potentially lead to overheating-related infertility. ^ Adam Mitchell; Drake, Richard; Gray, Henry David; Wayne Vogl (2010). Gray's anatomy for students. Elsevier/Churchill Livingstone. pp. 286. . Inguinal canal The inguinal canals are the two passages in the anterior abdominal wall which in
Inguinal canal
15732942
the procedure as a whole proves to be relatively safe for the majority of patients. Risks inherent in almost all surgical procedures include: Risks that are specific to inguinal hernia repairs include such things as: Post-herniorrhaphy inguinodynia is a condition where 10-12% of patients experience severe pain after inguinal hernia repair, due to a complex combination of different forms of pain signals. It can occur with any inguinal hernia repair technique, and if unresponsive to pain medications, further surgical intervention is often required. Removal of the implanted mesh, in combination with bisection of regional nerves, is commonly performed to address
Inguinal hernia surgery
15732937
longer procedure times and length of hospital stay. Despite being the superior non-mesh technique, the Shouldice method results much higher rates of hernia recurrence in patients when compared to repairs that utilize mesh. The first efficient inguinal hernia repair was described by Edoardo Bassini in the 1880s. In the Bassini technique, the conjoint tendon (formed by the distal ends of the transversus abdominis and internal oblique muscles) is approximated to the inguinal ligament and closed. The Shouldice technique was itself an evolution of prior techniques that had greatly advanced the field of inguinal hernia surgery. Such classic open non-mesh repairs
Inguinal hernia surgery
3586042
is likely to increase, as many individuals with small, painless hernias are now delaying hernia surgery due to the risk of post-herniorrhaphy pain syndrome. The elasticised pants used by athletes also provide useful support for the smaller hernia. Surgical correction of inguinal hernias is called a hernia repair. It is not recommended in minimally symptomatic hernias, for which watchful waiting is advised, due to the risk of post herniorraphy pain syndrome. Surgery is commonly performed as outpatient surgery. There are various surgical strategies which may be considered in the planning of inguinal hernia repair. These include the consideration of mesh
Inguinal hernia
5292481
Laparoscopic hernia repair is when minimally invasive cameras and equipment are used and the hernia is repaired with only small incisions adjacent to the hernia. These techniques are similar to the techniques used in laparoscopic gallbladder surgery. An operation in which the hernia sac is removed without any repair of the inguinal canal is described as a herniotomy. When herniotomy is combined with a reinforced repair of the posterior inguinal canal wall with autogenous (patient's own tissue) or heterogeneous material such as prolene mesh, it is termed hernioplasty as opposed to herniorrhaphy, in which no autogenous or heterogeneous material is
Hernia repair
15732936
suture technique, and tension technique. All involve bringing together the tissue with sutures and are a viable alternative when mesh placement is contraindicated. Such situations are most commonly due to concerns of contamination in cases where there are infections of the groin, strangulation or perforation of the bowel. The Shouldice technique is the most effective non-mesh repair thus making it one of the most commonly utilized methods. Numerous studies have been able to validate the conclusion that patients have lower rates of hernia recurrence with the Shouldice technique as compared to other non-mesh repair techniques. However this method frequently experiences
Inguinal hernia surgery
16500272
Biomesh Biologic mesh (or biomesh) is a type of surgical mesh made from an organic biomaterial (such as porcine dermis, porcine small intestine submucosa, bovine dermis or pericardium, and the dermis or fascia lata of a cadaveric human). Biologic mesh is primarily indicated for several types of hernia repair, including inguinal and ventral hernias, hernia prophylaxis, and contaminated hernia repairs. However, it has also been used in pelvic floor dysfunction, parotidectomy, and reconstructive plastic surgery. The development of biologic mesh largely has derived from the need of a biocompatible material that addresses "the problems associated with a permanent synthetic mesh,
Biomesh
15732927
people from being candidates for laparoscopic approaches to repair. Examples of such include: Techniques to repair inguinal hernias fall into two broad categories termed "open" and "laparoscopic". Surgeons tailor their approach by taking into account factors such as their own experience with either techniques, the features of the hernia itself, and the person's anesthetic needs. The cost associated with either approach varies widely across regions. As an example the UK's NHS spends £56 million a year in repairing inguinal hernias 96% of which were repaired via the open mesh approach while only 4% were done laparoscopically. Updated guidelines published by
Inguinal hernia surgery
15732931
local anesthesia particularly for people with ongoing medical conditions. Repairs that utilize mesh are usually the first recommendation for the vast majority of patients including those that undergo laparoscopic repair. Procedures that employ mesh are the most commonly performed as they have been able to demonstrate greater results as compared to non-mesh repairs. Approaches utilizing mesh have been able to demonstrate faster return to usual activity, lower rates of persistent pain, shorter hospital stays, and a lower likelihood that the hernia will recur. Options for mesh include either synthetic or biologic. Synthetic mesh provides the option of using "heavyweight" as
Inguinal hernia surgery
8601715
Post herniorraphy pain syndrome Post herniorrhaphy pain syndrome, or inguinodynia is pain or discomfort lasting greater than 3 months after surgery of inguinal hernia. Randomized trials of laparoscopic vs open inguinal hernia repair have demonstrated similar recurrence rates with the use of mesh and have identified that chronic groin pain (>10%) surpasses recurrence (<2%) and is an important measure of success. Chronic groin pain is potentially disabling with neuralgia, parasthesia, hypoesthesia, and hyperesthesia. Patients may be unable to work, have limited physical & social activities, sleep disturbances, and psychologic distress. The management of inguinodynia is a difficult problem for many
Post herniorraphy pain syndrome
15732935
preferred method. Recent studies have indicated that mesh attachment with the use of adhesive glue is faster and less likely to cause post-op pain as compared to attachment via suture material. The plug and patch tension-free technique has fallen out of favor due to higher rates of mesh shift along with its tendency to irritate surrounding tissue. This has led to the European Hernia Society recommending that the technique not be used in most cases. A variety of other tension-free techniques have been developed and include: Techniques in which mesh is not used are referred to as tissue repair technique,
Inguinal hernia surgery
3586043
use (e.g. synthetic or biologic), open repair, use of laparoscopy, type of anesthesia (general or local), appropriateness of bilateral repair, etc. Laparoscopy is most commonly used for non-emergency cases, however, a minimally invasive open repair may have a lower incidence of post-operative nausea and mesh associated pain. During surgery conducted under local anaesthesia, the patient will be asked to cough and strain during the procedure to help in demonstrating that the repair is without tension and sound. Constipation after hernia repair results in strain to evacuate the bowel causing pain, and fear that the sutures may rupture. Opioid analgesia makes
Inguinal hernia
15732934
2011. It only has one 3-year pre-clinical evidence on sheep. Meshes made of mosquito net cloth, in copolymer of polyethylene and polypropylene have been used for low-income patients in rural India and Ghana. Each piece costs $0.01, 3700 times cheaper than an equivalent commercial mesh. They give results identical to commercial meshes in terms of infection and recurrence rate at 5 years. The Lichtenstein tension-free repair has persisted as one of the most commonly performed procedures in the world. The European Hernia Society recommends that in cases where an open approach is indicated, the Lichtenstein technique be utilized as the
Inguinal hernia surgery
15732932
well as "lightweight" variations according to the diameter and number of mesh fibers. Lightweight mesh has been shown to have fewer complications related to the mesh itself than it's heavyweight counterparts. It was additionally correlated with lower rates of chronic pain while sharing the same rates of hernia recurrence as compared to heavyweight options. This has led to the adoption of lightweight mesh for minimizing the chance of chronic pain after surgery. Biologic mesh is indicated in cases where the risk of infection is a major concern such as cases in which the bowel has become strangulated. They tend to
Inguinal hernia surgery
15732926
pain in the area of the hernia 4 warm hernia bulge with surrounding skin redness 5 can no longer pass gas or stool Surgical repair within 6 hours of the above symptoms may be able to save the strangulated portion of intestine. The person with the hernia should be given an opportunity to participate in the shared decision-making with their physicians as almost all procedures carry significant risks. The benefits of inguinal hernia repair can become overshadowed by risks such that elective repair is no longer in a person's best interest. Such cases include: Additionally, certain medical conditions can prevent
Inguinal hernia surgery
18284005
The Mercedes-Benz OM604 engine has an optional repair kit to help replace seals. The 1905 Gale Model A came with a repair kit. In aerospace, kits have been developed for repairing the thermal protection tiles on the Space Shuttle and to fix space suits. Professionals who repair and maintain electronic equipment may have a kit containing a soldering iron, wire, and components such as transistors and resistors. In medicine, a repair kit consisting of a plug and plastic mesh may be used during inguinal hernia surgery. A particular trade may use a repair kit as part of normal work, such
Repair kit
7500946
1991 and 1999 for repair of large incisional hernia. It not only obviates causative factors responsible for herniation but utilises these factors to strengthen repair and regeneration of traumatised tissues. The technique is now published in R. Maingot's Text Book of abdominal operations in 1997. Laparoscopic incisional hernia repair is a new method of surgery for this condition. The operation is performed using surgical microscopes and specialized instruments. The surgical mesh is placed into the abdomen underneath the abdominal muscles through small incisions to the side of the hernia. In this manner, the weakened tissue of the original hernia is
Incisional hernia
829053
when abdominal contents pass into the weak area at the posterior wall of the femoral canal. They can be hard to distinguish from the inguinal type (especially when ascending cephalad): however, they generally appear more rounded, and, in contrast to inguinal hernias, there is a strong female preponderance in femoral hernias. The incidence of strangulation in femoral hernias is high. Repair techniques are similar for femoral and inguinal hernia. A "Cooper's hernia" is a femoral hernia with two sacs, the first being in the femoral canal, and the second passing through a defect in the superficial fascia and appearing almost
Hernia
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repair at 5-year and 7.5-year marks respectively. The use of a truss is an additional non-surgical option for men. It resembles a jock-strap that utilizes a pad to exert pressure at the site of the hernia in order prevent excursion of the hernia sack. It has little evidence to support its routine use and has not been shown to prevent complications such as incarceration (bowel can no longer slide back into abdomen) or strangulation of bowel (constriction causing loss of blood supply). However some patients do report a soothing of symptoms when utilized. Inguinal hernia repair complications are unusual, and
Inguinal hernia surgery
829059
The mesh is placed either over the defect (anterior repair) or under the defect (posterior repair). At times staples are used to keep the mesh in place. These mesh repair methods are often called "tension free" repairs because, unlike some suture methods (e.g., Shouldice), muscle is not pulled together under tension. However, this widely used terminology is misleading, as there are many tension-free suture methods that do not use mesh (e.g., Desarda, Guarnieri, Lipton-Estrin, etc.). Evidence suggests that tension-free methods (with or without mesh) often have lower percentage of recurrences and the fastest recovery period compared to tension suture methods.
Hernia
15732939
as they cause smaller incisions, resulting in less bleeding, less infection, faster recovery, reduced hospitalization, and reduced chronic pain. Recurrence rates are identical when laparoscopy is performed by an experienced surgeon. When performed by a surgeon less experienced in inguinal hernia lap repair, recurrence is larger than after Lichtenstein. Studies have demonstrated that men whose hernias cause little to no symptoms can safely continue to delay surgery until a time that is most convenient for patients and their healthcare team. Research shows that the risk of inguinal hernia complications remains under 1% within the population. Watchful waiting requires that patients
Inguinal hernia surgery
7597357
A laparoscopic hernia repair is when the hiatial hernia is corrected using a covering for the mesh that is used to repair the weakened area. The defect is then measured and the mesh is stapled into place. A benefit of performing Laparoscopic hernia repair is shorter recovery times compared to other methods. However, it is a longer procedure than most other methods of repair. The Nissen fundoplication procedure consists of a 360 degree transabdominal fundoplication. A fundoplication is the suturing of the fundus located in the stomach and around the esophagus. The procedure itself is performed with the patient in
Laparoscopic hiatal hernia repair
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of inguinal hernias such as incarceration and strangulation. Incarceration occurs when intra-abdominal fat or small intestine becomes stuck within the canal and cannot slide back into the abdominal cavity either on its own or with manual maneuvers. Left untreated, incarceration may progress to bowel strangulation as a result of restricted blood supply to the trapped segment of small intestine causing that portion to die. Successful outcomes of repair are usually measured via rates of hernia recurrence, pain and subsequent quality of life. Surgical repair of inguinal hernias is one of the most commonly performed operations worldwide and the most commonly
Inguinal hernia surgery
3586041
hernia. The more modern variety of truss is made with non-intrusive flat pads and comes with a guarantee to hold the hernia securely during all activities. Although there is as yet no proof that such devices can prevent an inguinal hernia from progressing, they have been described by users as providing greater confidence and comfort when carrying out physically demanding tasks. A truss also increases the probability of complications, which include strangulation of the hernia, atrophy of the spermatic cord, and atrophy of the fascial margins. This allows the defect to enlarge and makes subsequent repair more difficult. Their popularity
Inguinal hernia
12179152
involving esophageal surgery and hernia repair. In 1897 he was the first surgeon to suture the conjoint tendon to Cooper's (pectineal) ligament, an operation he performed on a patient with a recurrent inguinal hernia. Decades later, American surgeon Chester McVay (1911–1987) popularized the operation, and this procedure is now referred to as a "Lotheissen-McVay herniotomy". His name is also associated with "Lotheissen's operation", sometimes known as "Lotheissen‘s trans-inguinal approach". This surgery involves operating for femoral hernia through the posterior wall of the inguinal canal. Georg Lotheissen Georg Lotheissen (September 14, 1868 – October 28, 1941) was an Austrian surgeon born
Georg Lotheissen
2122638
the 1950s, which helped create a market for this plastic. It is now used surgically as a reinforcing mesh in inguinal hernia repair. Marlex Marlex is a trademarked name for crystalline polypropylene and high-density polyethylene (HDPE). These plastics were invented by J. Paul Hogan and Robert Banks, two research chemists at the Phillips Petroleum company. The material was originally interesting in the 1950s because its high melting point and tensile strength were more desirable than that of the more common form of polyethylene. For example, the medical community was eager to make use of its high melting point; objects made
Marlex
7500826
Three approaches have been described for open surgery: The infra-inguinal approach is the preferred method for elective repair. The trans-inguinal approach involves dissecting through the inguinal canal and carries the risk of weakening the inguinal canal. McEvedy’s approach is preferred in the emergency setting when strangulation is suspected. This allows better access to and visualization of the bowel for possible resection. In any approach, care should be taken to avoid injury to the urinary bladder which is often a part of the medial part of the hernial sac. Repair is either performed by suturing the inguinal ligament to the pectineal
Femoral hernia
15732938
include: There are two main methods of laparoscopic repair: "transabdominal preperitoneal" ("TAPP") and "totally extra-peritoneal" ("TEP") repair. When performed by a surgeon experienced in hernia repair, laparoscopic repair causes fewer complications than Lichtenstein, particularly less chronic pain. However, if the surgeon is experienced in general laparoscopic surgery but not in the specific subject of laparoscopic hernia surgery, laparoscopic repair is not advised as it causes more recurrence risk than Lichtenstein while also presenting risks of serious complications, as organ injury. Indeed, the TAPP approach needs to go through the abdomen. All that said, many surgeons are moving to laparoscopic methodologies
Inguinal hernia surgery
829052
(1/3), where the hernia contents push through a weak spot in the back wall of the inguinal canal. Inguinal hernias are the most common type of hernia in both men and women. In some selected cases, they may require surgery. There are special cases in which the hernia may contain both direct and indirect hernia simultaneously pantaloon hernia, or, though very rare, may contain simultaneous indirect hernias. Pantaloon hernia (Saddle Bag hernia) is a combined direct and indirect hernia, when the hernial sac protrudes on either side of the inferior epigastric vessels. Femoral hernias occur just below the inguinal ligament,
Hernia
3586027
hernias which have more complications. If strangulation occurs immediate surgery is required. Repair may be done by open surgery or by laparoscopic surgery. Open surgery has the benefit of possibly being done under local anesthesia rather than general anesthesia. Laparoscopic surgery generally has less pain following the procedure. In 2015 inguinal, femoral and abdominal hernias affected about 18.5 million people. About 27% of males and 3% of females develop a groin hernia at some time in their life. Groin hernias occur most often before the age of one and after the age of fifty. Globally, inguinal, femoral and abdominal hernias
Inguinal hernia
3586025
Inguinal hernia An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. Symptoms are present in about 66% of affected people. This may include pain or discomfort especially with coughing, exercise, or bowel movements. Often it gets worse throughout the day and improves when lying down. A bulging area may occur that becomes larger when bearing down. Inguinal hernias occur more often on the right than left side. The main concern is strangulation, where the blood supply to part of the intestine is blocked. This usually produces severe pain and tenderness of the area. Risk factors for
Inguinal hernia
3586035
middle-aged and elderly. This is in contrast to indirect hernias which can occur at any age including the young, since their etiology includes a congenital component where the inguinal canal is left more patent (compared to individuals less susceptible to indirect hernias). Additional risk factors include chronic constipation, overweight/obesity, chronic cough, family history and prior episodes of direct inguinal hernias. An indirect inguinal hernia results from the failure of embryonic closure of the deep inguinal ring after the testicle has passed through it. It is the most common cause of groin hernia. In the male fetus, the peritoneum gives a
Inguinal hernia
3586045
for asymptomatic patients. A direct inguinal hernia is less common (~25–30% of inguinal hernias) and usually occurs in men over 40 years of age. Men have an 8 times higher incidence of inguinal hernia than women. Inguinal hernia An inguinal hernia is a protrusion of abdominal-cavity contents through the inguinal canal. Symptoms are present in about 66% of affected people. This may include pain or discomfort especially with coughing, exercise, or bowel movements. Often it gets worse throughout the day and improves when lying down. A bulging area may occur that becomes larger when bearing down. Inguinal hernias occur more
Inguinal hernia
3586037
the spermatic cord. When the opening is larger than necessary for passage of the spermatic cord, the stage is set for an indirect inguinal hernia. The protrusion of peritoneum through the internal inguinal ring can be considered an incomplete obliteration of the processus. In an indirect inguinal hernia, the protrusion passes through the deep inguinal ring and is located lateral to the inferior epigastric artery. Hence, the conjoint tendon is not weakened. There are three main types In the female, groin hernias are only 4% as common as in males. "Indirect inguinal hernia" is still the most common groin hernia
Inguinal hernia
3586026
the development of a hernia include: smoking, chronic obstructive pulmonary disease, obesity, pregnancy, peritoneal dialysis, collagen vascular disease, and previous open appendectomy, among others. Hernias are partly genetic and occur more often in certain families. It is unclear if inguinal hernias are associated with heavy lifting. Hernias can often be diagnosed based on signs and symptoms. Occasionally medical imaging is used to confirm the diagnosis or rule out other possible causes. Groin hernias that do not cause symptoms in males do not need to be repaired. Repair, however, is generally recommended in females due to the higher rate of femoral
Inguinal hernia
829061
injuries, injury to nearby organs, and hernia recurrence. Pain that lasts more than three months occurs in about 10% of people following hernia repair. About 27% of males and 3% of females develop a groin hernia at some time in their life. In 2013 about 25 million people had a hernia. Inguinal, femoral and abdominal hernias resulted in 32,500 deaths globally in 2013 and 50,500 in 1990. Hernia A hernia is the abnormal exit of tissue or an organ, such as the bowel, through the wall of the cavity in which it normally resides. Hernias come in a number of
Hernia
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are met. It is not uncommon for patients to experience residual soreness for a couple of days after surgery. Patients are encouraged to make strong efforts in getting up and walking around the day after surgery. Most patients can resume their normal routine of daily living within the week such as driving, showering, light lifting, as well as sexual activity. Long work absences are rarely necessary and length of sick days tend to be dictated by respective employment policies. In general, it is not recommended to administer antibiotics as prophylaxis after elective inguinal hernia repair. However, the rate of wound
Inguinal hernia surgery
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intermittent mass, localized pain, or signs of bowel obstruction. Ultrasonography or a CT scan can establish the diagnosis, although CT scan provides the greatest sensitivity and specificity. These hernias should be repaired because of the high risk of strangulation; surgery is straightforward, with only larger defects requiring a mesh prosthesis. Varied Spigelian hernia mesh repair techniques have been described, although evidence suggests laparoscopy results in less morbidity and shorter hospitalization compared with open procedures. Mesh-free laparoscopic suture repair is feasible and safe. This novel uncomplicated approach to small Spigelian hernias combines the benefits of laparoscopic localization, reduction, and closure without
Spigelian hernia
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size and anatomy of the appendix, and in case of appendicitis, standard appendectomy and herniorrhaphy without a mesh should be the standard of care. Amyand's hernia is commonly misdiagnosed as an ordinary incarcerated hernia. Symptoms mimicking appendicitis may occur. Treatment consists of a combination of appendectomy and hernia repair.. The inflammatory status of the appendix determines the type of hernia repair and the surgical approach. Incidental appendicectomy in the case of a normal appendix is not favoured. Sharma, H., Gupta, A., Shekhawat, N.S. et al. Hernia (2007) 11: 31. https://doi.org/10.1007/s10029-006-0153-8. Amyand's hernia Amyand's hernia is a rare form of an
Amyand's hernia
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A weakening of the conjoint tendon can precipitate a direct inguinal hernia. A direct inguinal hernia will protrude through Hesselbach's triangle, whose borders are the rectus abdominis (medially), inferior epigastric artery and vein (superolaterally), and the inguinal ligament (inferiorly). The hernia will lie medial to the inferior epigastric artery. This is in contrast to an indirect inguinal hernia, which will protrude laterally to the inferior epigastric artery and is most commonly due to an embryological defect in the closure of the deep inguinal ring. Conjoint tendon The conjoint tendon (previously known as the inguinal aponeurotic falx) is a structure formed
Conjoint tendon
9955375
Stoppa operation for hernia repair The Stoppa Repair is a tension-free type of hernia repair. It is performed by wrapping the lower part of the parietal peritoneum with prosthetic mesh and placing it at a preperitoneal level over Fruchaud's myopectineal orifice. It was first described in 1975 by Rene Stoppa. This operation is also known as "giant prosthetic reinforcement of the visceral sac" (GPRVS). This technique has met particular success in the repair of bilateral hernias, large scrotal hernias, and recurrent or rerecurrent hernias in which conventional repair is difficult and which carries a high morbidity and failure rate. The
Stoppa operation for hernia repair
9955376
most recent reported recurrence rate (involving 230 patients with 420 hernias and a maximum of 8 years follow-up) was 0.71%.The totally extra-peritoneal repair (TEP) uses exactly the same principles as the Stoppa repair, except that it is performed laparoscopically. Stoppa operation for hernia repair The Stoppa Repair is a tension-free type of hernia repair. It is performed by wrapping the lower part of the parietal peritoneum with prosthetic mesh and placing it at a preperitoneal level over Fruchaud's myopectineal orifice. It was first described in 1975 by Rene Stoppa. This operation is also known as "giant prosthetic reinforcement of the
Stoppa operation for hernia repair
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maintain a close follow-up schedule with providers to monitor the course of their hernia for any changes in symptoms and can be safely offered for up to 2 years. Patients who do elect watchful waiting eventually undergo repair within five years as 25% will experience a progression of symptoms such as worsening of pain. Elective repair discussions should be revisited if patient's begin to avoid aspects of their normal routine due to their hernia. After 1 year it is estimated that 16% of patients who initially opted for watchful waiting will eventually undergo surgery. Furthermore, 54% and 72% will undergo
Inguinal hernia surgery
3586030
men are 25 times more likely to have an inguinal hernia than women. Although several mechanisms such as strength of the posterior wall of the inguinal canal and shutter mechanisms compensating for raised intra-abdominal pressure prevent hernia formation in normal individuals, the exact importance of each factor is still under debate. The physiological school of thought thinks that the risk of hernia is due to a physiological difference between patients who suffer hernia and those who do not, namely the presence of aponeurotic extensions from the transversus abdominis aponeurotic arch. There are two types of inguinal hernia, "direct" and "indirect",
Inguinal hernia
2521589
it) Note that the ilioinguinal nerve passes through the superficial ring to descend into the scrotum, but does not formally run through the canal. Abdominal contents (potentially including intestine) can be abnormally displaced from the abdominal cavity. Where these contents exit through the inguinal canal, having passed through the deep inguinal ring, the condition is known as an indirect or oblique inguinal hernia. This can also cause infertility. This condition is far more common in males than in females, owing to the inguinal canal's small size in females. A hernia that exits the abdominal cavity directly through the deep layers
Inguinal canal
10838151
with Thomas Spencer Wells (1818–1897) and Joseph Lister (1827–1912). Afterwards, he was in charge of the surgical department at the hospital La Spezia, and in 1878 became a lecturer in surgery at Parma. In 1882 he became head of surgical pathology at the University of Padua, where he later succeeded Tito Vanzetti (1809–1888) as the chair of clinical surgery (1888). Bassini is remembered for his operative techniques involving inguinal hernia repair. In 1884 he introduced a surgical procedure that allowed for reconstruction of the inguinal canal and restoration of the patient's anatomy following removal of the hernial sac. It was
Edoardo Bassini
1634183
fashion designers have adapted polypropylene to construct jewelry and other wearable items. Its most common medical use is in the synthetic, nonabsorbable suture Prolene, manufactured by Ethicon Inc. Polypropylene has been used in hernia and pelvic organ prolapse repair operations to protect the body from new hernias in the same location. A small patch of the material is placed over the spot of the hernia, below the skin, and is painless and rarely, if ever, rejected by the body. However, a polypropylene mesh will erode the tissue surrounding it over the uncertain period from days to years. A notable application
Polypropylene
7500823
The incidence of strangulation in femoral hernias is high. A femoral hernia has often been found to be the cause of unexplained small bowel obstruction. The cough impulse is often absent and is not relied on solely when making a diagnosis of femoral hernia. The lump is more globular than the pear-shaped lump of the inguinal hernia. The bulk of a femoral hernia lies below an imaginary line drawn between the anterior superior iliac spine and the pubic tubercle (which essentially represents the inguinal ligament) whereas an inguinal hernia starts above this line. Nonetheless, it is often impossible to distinguish
Femoral hernia
3586040
is currently no medical recommendation about how to manage an inguinal hernia condition in adults, due to the fact that, until recently, elective surgery used to be recommended. The hernia truss is intended to contain a reducible inguinal hernia within the abdomen. It is not considered to provide a cure, and if the pads are hard and intrude into the hernia aperture they may cause scarring and enlargement of the aperture. In addition, most trusses with older designs are not able effectively to contain the hernia at all times, because their pads do not remain permanently in contact with the
Inguinal hernia
3586032
a result, the possibility for hernias through the inguinal canal in males is much greater because they have a larger opening and therefore a much weaker wall through which the intestines may protrude. Inguinal hernias, in turn, belong to groin hernias, which also includes femoral hernias. A femoral hernia is not via the inguinal canal, but via the femoral canal, which normally allows passage of the common femoral artery and vein from the pelvis to the leg. In Amyand's hernia, the content of the hernial sac is the vermiform appendix. In Littre's hernia, the content of the hernial sac contains
Inguinal hernia
3586038
for females. If a woman has an indirect inguinal hernia, her internal inguinal ring is patent, which is abnormal for females. The protrusion of peritoneum is not called "processus vaginalis" in women, as this structure is related to the migration of the testicle to the scrotum. It is simply a hernia sac. The eventual destination of the hernia contents for a woman is the labium majus on the same side, and hernias can enlarge one labium dramatically if they are allowed to progress. After the diagnosis is suspected, it is often confirmed by imaging. When assessed by ultrasound or cross
Inguinal hernia
15732943
such cases. There remains ongoing discussion amongst surgeons regarding the utility of planned resections of regional nerves as an attempt to prevent its occurrence. Mortality rates for non-urgent, elective procedures was demonstrated as 0.1%, and around 3% for procedures performed urgently. Other than urgent repair, risk factors that were also associated with increased mortality included being female, requiring a femoral hernia repair, and older age. Upon awakening from anesthesia, patients are monitored for their ability to drink fluids, produce urine, as well as their ability to walk after surgery. Most patients are then able to return home once those conditions
Inguinal hernia surgery
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these are rare in North America and Europe. Masculinizing surgery for completely virilized individuals with XX sex chromosomes and CAH is even rarer. Orchiopexy for repair of undescended testes (cryptorchidism) is the second most common surgery performed on infant male genitalia (after circumcision). The surgeon moves one or both testes, with blood vessels, from an abdominal or inguinal position to the scrotum. If the inguinal canal is open it must be closed to prevent hernia. Potential surgical problems include maintaining the blood supply. If vessels cannot be stretched into the scrotum, or are separated and cannot be reconnected, a testis
Intersex medical interventions
15732933
have lower tensile strength than their synthetic counterparts lending them to higher rates of mesh rupture. Biomeshes are increasingly popular since their first use in 1999 and their subsequent introduction on the market in 2003. Some meshes have a price comparable to the high end of synthetic meshes, the cheapest ($500) being Surgisis-Biodesign, manufactured by Cook Group, made from the extra cellular matrix of pig small intestinal submucosa. Currently, there exists one synthetic totally absorbable mesh, Tigr Matrix, manufactured by Novus Scientific, on the US market (510(k) Food and Drug Administration clearance) since 2010 and on the EU market since
Inguinal hernia surgery
3586039
sectional imaging with CT or MRI, the major differential in diagnosing indirect inguinal hernias is differentiation from spermatic cord lipomas, as both can contain only fat and extend along the inguinal canal into the scrotum. On axial CT, lipomas originate posterolateral to the cord, and are located inside the cremaster muscle, while inguinal hernias lie anteromedial to the cord and are not intramuscular. Large lipomas may appear nearly indistinguishable as the fat engulfs anatomic boundaries, but they do not change position with coughing or straining. Differential diagnosis of the symptoms of inguinal hernia mainly includes the following potential conditions: There
Inguinal hernia
3586028
resulted in 60,000 deaths in 2015 and 55,000 in 1990. Hernias present as bulges in the groin area that can become more prominent when coughing, straining, or standing up. The bulge commonly disappears on lying down. Mild discomfort can develop over time. The inability to "reduce", or place the bulge back into the abdomen usually means the hernia is 'incarcerated' which requires emergency surgery. Significant pain is suggestive of strangulated bowel (an incarcerated indirect inguinal hernia). As the hernia progresses, contents of the abdominal cavity, such as the intestines, can descend into the hernia and run the risk of being
Inguinal hernia
15732924
age of 40. Although women account for roughly 70% of femoral hernia repairs, indirect inguinal hernias are still the most common subtype of groin hernia in both males and females. Society guidelines recommend that indications for surgery take into account the severity of symptoms, the type of hernia, previous surgeries, hernia size, bowel incarceration (bowel can no longer return to the abdomen) and the overall general health of the person. Elective surgery is planned in order to help relieve symptoms, respect the person's preference, and prevent future complications that may require emergency surgery. Surgery is offered to the majority of
Inguinal hernia surgery
3586034
or Hesselbach's triangle, an area defined by the edge of the rectus abdominis muscle, the inguinal ligament and the inferior epigastric artery. These hernias are capable of exiting via the superficial inguinal ring and are unable to extend into the scrotum. When a patient suffers a simultaneous direct and indirect hernia on the same side, the result is called a "pantaloon" hernia (because it looks like a pair of pants, with the epigastric vessels in the crotch), and the defects can be repaired separately or together. Since the abdominal walls weaken with age, direct hernias tend to occur in the
Inguinal hernia
17130607
Surgical mesh Surgical mesh is a loosely woven sheet which is used as either a permanent or temporary support for organs and other tissues during surgery. Surgical mesh is created from both inorganic and biological materials and is used in a variety of surgeries. Though hernia repair surgery is the most common application, it can also be used for reconstructive work, such as in pelvic organ prolapse. Permanent meshes remain in the body, whereas temporary ones dissolve over time. For example, TIGR Matrix test mesh was shown in 2012 to fully dissolve after three years in a scientific trial on
Surgical mesh
7828231
clinical significance in hernia repair. Iliopubic tract The iliopubic tract is a thickened band of fibers curving over the external iliac vessels, at the spot where they become femoral, on the abdominal side of the inguinal ligaments and loosely connected with it. It is apparently a thickening of the transverse fascia joined laterally to the iliac crest, and arching across the front of the femoral sheath to be inserted by a broad attachment into the pubic tubercle and pectineal line, behind the conjoint tendon. In some subjects this structure is not very prominently marked, and not infrequently it is altogether
Iliopubic tract
16078944
to nearby organs, nerves or blood vessels. Other complications of hernia repair can occur with or without the mesh, including infection, chronic pain and hernia recurrence.” However, these polymers are often associated with foreign body reaction; implant failure; and hernia recurrence (over 42%). Moreover, leaking chemicals of these polymers are often deleterious to the surrounding cells and tissue and immobilise post-operative drug treatments. NFB develops nano-fibrous meshes with well-defined nanotopography and drug loading capabilities to enhance functional repair. Corneal diseases are the major cause of vision loss worldwide. Every year approximately 10,000,000 people are affected by various eye disorders and
Network of Excellence for Functional Biomaterials
10682903
Amyand's hernia Amyand's hernia is a rare form of an inguinal hernia (less than 1% of inguinal hernias) which occurs when the appendix is included in the hernial sac and becomes incarcerated. The condition is an eponymous disease named after a French surgeon, Claudius Amyand (1660-1740), who performed the first successful appendectomy in 1735. Most of the cases are diagnosed intraoperatively and a preoperative diagnosis is rarely made in such cases. Management should be individualized according to appendix's inflammation stage, presence of abdominal sepsis, and comorbidity factors. The decision should be based on factors such as the patient's age, the
Amyand's hernia
3586029
pinched within the hernia, causing an intestinal obstruction. If the blood supply of the portion of the intestine caught in the hernia is compromised, the hernia is deemed "strangulated" and gut ischemia and gangrene can result, with potentially fatal consequences. The timing of complications is not predictable. In men, indirect hernias follow the same route as the descending testes, which migrate from the abdomen into the scrotum during the development of the urinary and reproductive organs. The larger size of their inguinal canal, which transmitted the testicle and accommodates the structures of the spermatic cord, might be one reason why
Inguinal hernia
3748812
inguinal hernias which may be presented unilaterally (affects one testicle) or bilaterally (affects both testicles). Adults who have been oblivious to this condition may be presented with haematuria, which is when blood appears in urine because of hormonal imbalances. PMDS Type I, is also referred to as ‘Hernia Uteri Inguinalis’, which exhibits one descended testis that has also pulled the fallopian tube and sometimes uterus, through the inguinal canal. The descended testes, fallopian tube and uterus all fall in the same inguinal canal, causing an inguinal hernia. Altogether when the aforementioned conditions occur, it is called ‘Transverse Testicular Ectopia’. Under
Persistent Müllerian duct syndrome
7500821
be pushed back through the defect into the peritoneal cavity, whereas with an incarcerated hernia, the contents are stuck in the hernia sac. However, the term "incarcerated" seems to always imply that the femoral hernia is at least irreducible. The femoral canal is located below the inguinal ligament on the lateral aspect of the pubic tubercle. It is bounded by the inguinal ligament anteriorly, pectineal ligament posteriorly, lacunar ligament medially, and the femoral vein laterally. It normally contains a few lymphatics, loose areolar tissue, and occasionally a lymph node called Cloquet's node. The function of this canal appears to be
Femoral hernia
2469554
worth the trouble, since the surgery itself is usually simple and uncomplicated. In cases where the testes are identified preoperatively in the inguinal canal, orchiopexy is often performed as an outpatient and has a very low complication rate. An incision is made over the inguinal canal. The testis with accompanying cord structure and blood supply is exposed, partially separated from the surrounding tissues ("mobilized"), and brought into the scrotum. It is sutured to the scrotal tissue or enclosed in a "subdartos pouch". The associated passage back into the inguinal canal, an inguinal hernia, is closed to prevent reascent. In patients
Cryptorchidism
16993797
teaching thereof in 1845, and subsequently promoted the use of histopathology in cancer diagnosis. Medical instruments and disorders that are named after Birkett are the Birkett forceps, the Birkett haemostatic forceps, and Birkett hernia. The Birkett hernia is also known as an ascending hernia or intermusculuar hernia, and is the type of inguinal hernia where the sac extends into the anterior or inferior wall. Birkett's most memorable contribution to his field was his treatise on diseases on the mammary gland, the very first comprehensive treatment of the subject, for which he was awarded the Jacksonian Prize by The Royal College
John Birkett (surgeon)
7344414
and children (see coccygectomy). The standard surgical technique for repair of perineal hernia uses a prosthetic mesh, but this technique has a high rate of failure due to insufficient anchoring. Promising techniques to reduce the rate of failure include an orthopedic anchoring system, a gluteus maximus muscle flap, an acellular human dermis graft, and an acellular pig collagen graft. In dogs, perineal hernia usually is found on the right side. Most cases are in older intact (not neutered) male dogs (93 percent in one study). Breeds that may be at risk include Welsh Corgis, Boxers, Australian Kelpies, Boston Terriers, Collies,
Perineal hernia
8601721
have included diagnostic laparoscopy at the start for evaluation of adhesions, removal of mesh, and repair of any recurrences. If there is no improvement then a staged procedure to remove mesh and neurectomy may be considered. Chronic groin pain is more common than recurrence, and it may be lower following laparoscopic hernia repair. Pain often resolves with conservative measures. Following complete evaluation of patient and attempts at non surgical treatment, surgery may be considered. Various treatment algorithms exist with promising results. The true incidence is difficult to determine, pain having a subjective component. A prospective series of open Lichtenstein (419
Post herniorraphy pain syndrome
18194452
Edinburgh publisher, and the "Son" of Thomas Nelson & Sons. They had a family of three sons and three daughters. Their eldest son, Thomas Nelson Annandale became a famous zoologist. Attribution Thomas Annandale Thomas Annandale, FRCS FRSE (1838–1907) was a Scottish surgeon who conducted the first repair of the meniscus, the first successful removal of an acoustic neuroma and introduced the pre-peritoneal approach to inguinal hernia repair. He served as Regius Professor of Clinical Surgery at the University of Edinburgh. His collection of anatomical specimens was donated to the Surgeon's Hall in Edinburgh and is now known as the Thomas
Thomas Annandale
10626943
Charles Barrett Lockwood Charles Barrett Lockwood (23 September 1856 – 8 November 1914) was a British surgeon and anatomist who practiced surgery at St. Bartholomew's Hospital in London. Lockwood was a member of the Royal College of Surgeons. Lockwood is remembered for his surgical work with femoral and inguinal hernias. He developed an infra-inguinal approach for femoral hernia operations that is known today as the "low approach" or "Lockwood's operation". In 1893, he published an important book titled "Radical Cure of Femoral and Inguinal Hernia". He first conceived the idea of an Anatomical Society in 1887, acted as their first
Charles Barrett Lockwood
6387458
a gap where the muscles do not close and through this gap the inner intestines come up and bulge under the skin, giving rise to an umbilical hernia. The bulge and its contents can easily be pushed back and reduced into the abdominal cavity. In contrast to an inguinal hernia, the complication incidence is very low, and in addition, the gap in the muscles usually closes with time and the hernia disappears on its own. The treatment of this condition is essentially conservative: observation allowing the child to grow up and see if it disappears. Operation and closure of the
Umbilical hernia
18194447
Thomas Annandale Thomas Annandale, FRCS FRSE (1838–1907) was a Scottish surgeon who conducted the first repair of the meniscus, the first successful removal of an acoustic neuroma and introduced the pre-peritoneal approach to inguinal hernia repair. He served as Regius Professor of Clinical Surgery at the University of Edinburgh. His collection of anatomical specimens was donated to the Surgeon's Hall in Edinburgh and is now known as the Thomas Annandale Collection. Born in Newcastle-upon-Tyne on 2 February 1838, he was third son of Thomas Annandale, surgeon, by his wife Elizabeth Johnston. He was educated at Bruce's Academy in Newcastle, and
Thomas Annandale
7597360
5%. The outcomes of laparoscopic hernia repair versus open hernia repair support laparoscopic hernia repair as the method of choice. Outcomes from having laparoscopic hernia repair are: A laparoscopic hiatial hernia repair results in a hospital stay of approximately 36 to 48 hours after the procedure has been performed Laparoscopic hernia repair has several benefits compared to performing Open hernia repairs. Benefits are: Laparoscopic hiatal hernia repair Laparoscopic hernia repair is the repair of a hiatal hernia using a laparoscope, which is a tiny telescope-like instrument. A hiatial hernia is the protrusion of an organ through its wall or cavity.
Laparoscopic hiatal hernia repair
7595063
tubercle. It has the following boundaries—medial crura by pubic crest, lateral crura by pubic tubercle and inferiorly by inguinal ligament. The superficial ring is palpable under normal conditions. It becomes dilated in a condition called athletic pubalgia. Abdominal contents may protrude through the ring in inguinal hernia. Superficial inguinal ring The superficial inguinal ring (subcutaneous inguinal ring or external inguinal ring) is an anatomical structure in the anterior wall of the mammalian abdomen. It is a triangular opening that forms the exit of the inguinal canal, which houses the ilioinguinal nerve, the genital branch of the genitofemoral nerve, and the
Superficial inguinal ring
5292431
suspender of the abdomen" (). It is sometimes termed the Fallopian ligament. Colles' ligament is reflex ligament not inguinal ligament. Inguinal ligament The inguinal ligament (Poupart's ligament or groin ligament) is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may develop. The inguinal (crural) ligament runs from the anterior superior iliac crest of the ilium to the pubic tubercle of the pubic bone. It is formed by the external abdominal oblique aponeurosis and is continuous with the fascia lata of the
Inguinal ligament
5292429
Inguinal ligament The inguinal ligament (Poupart's ligament or groin ligament) is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal through which an indirect inguinal hernia may develop. The inguinal (crural) ligament runs from the anterior superior iliac crest of the ilium to the pubic tubercle of the pubic bone. It is formed by the external abdominal oblique aponeurosis and is continuous with the fascia lata of the thigh. There is some dispute over the attachments. Structures that pass deep to the inguinal ligament include: The ligament serves
Inguinal ligament
3586031
which are defined by their relationship to the inferior epigastric vessels. Direct inguinal hernias occur medial to the inferior epigastric vessels when abdominal contents herniate through a weak spot in the fascia of the posterior wall of the inguinal canal, which is formed by the transversalis fascia. Indirect inguinal hernias occur when abdominal contents protrude through the deep inguinal ring, lateral to the inferior epigastric vessels; this may be caused by failure of embryonic closure of the processus vaginalis. In the case of the female, the opening of the superficial inguinal ring is smaller than that of the male. As
Inguinal hernia
14277365
24 hours after normal vaginal delivery. Another case was that of a 29-year-old woman who presented with RLP 3 days after delivery. In both cases, initial diagnosis was inguinal hernia. In the first case, emergency surgery did not locate any hernia but found the round ligament of the uterus to be edematous and filled with thrombosed varicose veins. The thrombosed part was excised and the patient recovered without sequelae. Another case report described a 37-year-old woman presenting with inguinal mass 6 days after normal vaginal delivery. CT and MRI revealed thrombosed blood vessels along the inguinal course of the uterine
Round ligament pain
5292480
Hernia repair Hernia repair refers to a surgical operation for the correction of a hernia—a bulging of internal organs or tissues through the wall that contains it. It can be of two different types: herniorrhaphy or hernioplasty. This operation may be performed to correct hernias of the abdomen, groin, diaphragm, brain, or at the site of a previous operation. Hernia repair is often performed as an ambulatory procedure. The first differentiating factor in hernia repair is whether the surgery is done open, or laparoscopically. Open hernia repair is when an incision is made in the skin directly over the hernia.
Hernia repair
197468
erection, damage nerves, or impair blood supply. Erectile dysfunction is a common complication of treatments for prostate cancer, including prostatectomy and destruction of the prostate by external beam radiation, although the prostate gland itself is not necessary to achieve an erection. As far as inguinal hernia surgery is concerned, in most cases, and in the absence of postoperative complications, the operative repair can lead to a recovery of the sexual life of patients with preoperative sexual dysfunction, while, in most cases, it does not affect patients with a preoperative normal sexual life. ED can also be associated with bicycling due
Erectile dysfunction
5292482
used for reinforcement. Hernia repair Hernia repair refers to a surgical operation for the correction of a hernia—a bulging of internal organs or tissues through the wall that contains it. It can be of two different types: herniorrhaphy or hernioplasty. This operation may be performed to correct hernias of the abdomen, groin, diaphragm, brain, or at the site of a previous operation. Hernia repair is often performed as an ambulatory procedure. The first differentiating factor in hernia repair is whether the surgery is done open, or laparoscopically. Open hernia repair is when an incision is made in the skin directly
Hernia repair
4059203
Phthalate esters, and Zika virus infection have been found to cause testicular atrophy in animals. Testicular atrophy Testicular atrophy is a medical condition in which the male reproductive organs (the testes, which in humans are located in the scrotum) diminish in size and may be accompanied by loss of function. This does not refer to temporary changes, such as those brought on by cold. Testicular atrophy may be brought on by surgical repairs to certain types of hernias. Research has found testicular atrophy to be caused by scrotal trauma, inguinal hernia repair (rarely, and more often in very young children),
Testicular atrophy
4059202
Testicular atrophy Testicular atrophy is a medical condition in which the male reproductive organs (the testes, which in humans are located in the scrotum) diminish in size and may be accompanied by loss of function. This does not refer to temporary changes, such as those brought on by cold. Testicular atrophy may be brought on by surgical repairs to certain types of hernias. Research has found testicular atrophy to be caused by scrotal trauma, inguinal hernia repair (rarely, and more often in very young children), anabolic steroid use, and oestrogen therapy, varicocele, and ischaemia (most often secondary to testicular torsion).
Testicular atrophy
1755219
from the bladder. Extracellular matrix coming from pig small intestine submucosa are being used to repair "atrial septal defects" (ASD), "patent foramen ovale" (PFO) and inguinal hernia. After one year 95% of the collagen ECM in these patches is replaced by the normal soft tissue of the heart. Extracellular matrix proteins are commonly used in cell culture systems to maintain stem and precursor cells in an undifferentiated state during cell culture and function to induce differentiation of epithelial, endothelial and smooth muscle cells in vitro. Extracellular matrix proteins can also be used to support 3D cell culture in vitro for
Extracellular matrix