Book contents
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Chapter 47 Tracheostomy
- Chapter 48 Thyroidectomy
- Chapter 49 Parathyroidectomy
- Chapter 50 Lumpectomy and mastectomy
- Chapter 51 Gastric procedures (including laparoscopic antireflux, gastric bypass, and gastric banding)
- Chapter 52 Small bowel resection
- Chapter 53 Appendectomy
- Chapter 54 Colon resection
- Chapter 55 Abdominoperineal resection/coloanal or ileoanal anastomoses
- Chapter 56 Anal operations
- Chapter 57 Cholecystectomy
- Chapter 58 Common bile duct exploration
- Chapter 59 Major hepatic resection
- Chapter 60 Splenectomy
- Chapter 61 Pancreatoduodenal resection
- Chapter 62 Adrenal surgery
- Chapter 63 Lysis of adhesions
- Chapter 64 Ventral hernia repair
- Chapter 65 Inguinal hernia repair
- Chapter 66 Laparotomy in patients with human immunodeficiency virus infection
- Chapter 67 Abdominal trauma
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Chapter 65 - Inguinal hernia repair
from Section 17 - General Surgery
Published online by Cambridge University Press: 05 September 2013
- Frontmatter
- Dedication
- Contents
- List of Contributors
- Preface
- Introduction
- Part 1 Perioperative Care of the Surgical Patient
- Part 2 Surgical Procedures and their Complications
- Section 17 General Surgery
- Chapter 47 Tracheostomy
- Chapter 48 Thyroidectomy
- Chapter 49 Parathyroidectomy
- Chapter 50 Lumpectomy and mastectomy
- Chapter 51 Gastric procedures (including laparoscopic antireflux, gastric bypass, and gastric banding)
- Chapter 52 Small bowel resection
- Chapter 53 Appendectomy
- Chapter 54 Colon resection
- Chapter 55 Abdominoperineal resection/coloanal or ileoanal anastomoses
- Chapter 56 Anal operations
- Chapter 57 Cholecystectomy
- Chapter 58 Common bile duct exploration
- Chapter 59 Major hepatic resection
- Chapter 60 Splenectomy
- Chapter 61 Pancreatoduodenal resection
- Chapter 62 Adrenal surgery
- Chapter 63 Lysis of adhesions
- Chapter 64 Ventral hernia repair
- Chapter 65 Inguinal hernia repair
- Chapter 66 Laparotomy in patients with human immunodeficiency virus infection
- Chapter 67 Abdominal trauma
- Section 18 Cardiothoracic Surgery
- Section 19 Vascular Surgery
- Section 20 Plastic and Reconstructive Surgery
- Section 21 Gynecologic Surgery
- Section 22 Neurologic Surgery
- Section 23 Ophthalmic Surgery
- Section 24 Orthopedic Surgery
- Section 25 Otolaryngologic Surgery
- Section 26 Urologic Surgery
- Index
- References
Summary
Groin hernias are a common surgical problem. They can be indirect (lateral to the inferior epigastric vessels) or direct (medial to the inferior epigastric vessels in Hesselbach's triangle). Inguinal herniorrhaphy is performed for these hernias in over a million patients in the USA each year. Elective procedures for symptomatic reducible hernias are preferred, but urgent and emergency operations are still required for irreducible hernias and strangulated (ischemic bowel) hernias, respectively.
Routine open inguinal herniorrhaphy through a transverse inguinal incision is performed under general, regional, or local anesthesia in an outpatient setting. Rectangular or oval pieces of permanent mesh are inserted in all adult patients to prevent recurrent hernias. Mesh can be placed as an overlay, as a combined over/underlay in the preperitoneal space or as a combination of a shuttlecock-shaped second prosthesis (plug) inserted under the flat sheet mentioned above. Patients are discharged home when they can void. General anesthesia is appropriate for patients with large hernias that are difficult to reduce; for patients with multiple recurrent hernias in whom orchiectomy is a consideration; and for patients who prefer to be asleep. The stress of a routine open inguinal herniorrhaphy is minimal, and blood transfusions are essentially never required. In contrast, an emergent repair of a strangulated inguinal hernia in elderly patients may become life threatening. This is due to severe stress and possible perioperative sepsis of ischemic bowel in such patients.
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- Information
- Medical Management of the Surgical PatientA Textbook of Perioperative Medicine, pp. 549 - 550Publisher: Cambridge University PressPrint publication year: 2013